Acceptance, satisfaction and cost of an integrative anthroposophic program for pediatric respiratory diseases in a Swiss teaching hospital: An implementation report

Schoen-Angerer, Tido von; Vagedes, Jan; Schneider, Romy; Vlach, Livia; Pharisa, Cosette; Kleeb, Simon; Wildhaber, Johannes H.; Huber, Benedikt M.

doi:10.1016/j.ctim.2017.10.005

Cited by 6 publications

(7 citation statements)

References 20 publications

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“…Of the 22 articles included, 12 were from HICs [ 20 , 23 , 25 , 31 , 33 – 40 ] and 10 were from LMICs [ 17 , 18 , 21 , 22 , 24 , 26 – 29 , 32 ]. For HICs, most were from a United States of America (USA) context [ 20 , 34 , 35 , 37 , 38 ].…”

Section: Resultsmentioning

confidence: 99%

“…For HICs, most were from a United States of America (USA) context [ 20 , 34 , 35 , 37 , 38 ]. Amongst all articles, six were CEAs [ 17 , 30 , 35 , 37 – 39 ], six were CUAs [ 18 , 21 , 27 , 32 , 33 , 36 ], two were CMAs [ 25 , 40 ], and eight were cost analyses [ 22 – 24 , 26 , 28 , 29 , 31 , 34 ] (see Table 2 ). Of the EEs included 17/22 were trial-based, and 5/22 [ 17 , 22 , 30 , 32 , 39 ] were model-based.…”

Section: Resultsmentioning

confidence: 99%

“…2 ), we identified 8 articles on asthma [ 29 , 33 – 39 ], eleven on pneumonia [ 18 , 20 – 22 , 24 , 26 – 28 , 31 , 32 , 40 ], two on both asthma and pneumonia [ 23 , 25 ] and one on tuberculosis (TB) [ 17 ]. Articles which covered asthma were predominantly from HICs (7/8) [ 33 – 39 ], pneumonia articles were fairly evenly distributed between HICs [ 20 , 25 , 31 , 40 ] and LMICs [ 18 , 21 , 22 , 24 , 26 – 28 , 32 ], and the only TB study [ 17 ] was from a LMIC. The interventions evaluated included diagnostic tests, operational guidelines, antibiotic use (oral vs intravenous), inhaled corticosteroids and supplementary oxygen.…”

Section: Resultsmentioning

confidence: 99%

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Systematic review of economic evaluations for paediatric pulmonary diseases

Chitando

Cleary

Cunnama

2023

Cost Eff Resour Alloc

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Background Paediatric pulmonary diseases are the leading causes of mortality amongst children under five globally. Economic evaluations (EEs) seek to guide decision-makers on which health care interventions to adopt to reduce the paediatric pulmonary disease burden. This study aims to systematically review economic evaluations on different aspects of the inpatient management of paediatric pulmonary diseases globally. Methods We systematically reviewed EEs published between 2010 and 2020, with a subsequent search conducted for 2020–2022. We searched PubMed, Web of Science, MEDLINE, Paediatric Economic Database Evaluation (PEDE) and the Cochrane library. We extracted data items guided by the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. We collected qualitative and quantitative data which we analysed in Microsoft Excel and R software. Results Twenty-two articles met the inclusion criteria. Six of the articles were cost-effectiveness analyses, six cost-utility analyses, two cost-minimisation analyses and eight cost analyses. Twelve articles were from high-income countries (HICs) and ten were from low- and middle-income countries (LMICs). Eight articles focused on asthma, eleven on pneumonia, two on asthma and pneumonia, and one on tuberculosis. Conclusion Conducting more EEs for paediatric pulmonary diseases in LMICs could allow for more evidence-based decision-making to improve paediatric health outcomes.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Systematic review of economic evaluations for paediatric pulmonary diseases

Chitando

Cleary

Cunnama

2023

Cost Eff Resour Alloc

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“…One integrative health approach for treating respiratory diseases, in addition to others, is based on anthroposophic medicine (AM) [4]. AM treatments include medications administered through oral, intramuscular, intravenous, inhalation, and topical routes of administration, as well as external applications such as chest compresses [5][6][7]. Warm chest compresses with warm water (hereafter referred to as WA) have been reported to stimulate the warmth balance and are described as strengthening the patients' immune system, activating self-regulatory processes, and reducing susceptibility to new infections [8,9].…”

Section: Introductionmentioning

confidence: 99%

Do Chest Compresses with Mustard or Ginger Affect Warmth Regulation in Healthy Adults? A Randomized Controlled Trial

Vagedes

Kuderer

Vagedes

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Background. Chest compresses with mustard (MU) or ginger (GI) are a complementary treatment option for respiratory tract infections. However, little is known about their specific thermogenic qualities. This study examines the short-term effects of MU, GI, and chest compresses with warm water only (WA) on measurable and self-perceived body warmth in healthy adults. Methods. This was a single-center, randomized controlled trial with cross-over design (WA versus MU versus GI). 18 participants (23.7 ± 3.4 years; 66.7% female) received MU, GI, and WA in a random order on three different days with a mean washout period of 13.9 days. Chest compresses were applied to the thoracic back for a maximum of 20 minutes. The primary outcome measure was skin temperature of the posterior trunk (measured by infrared thermography) immediately following removal of the compresses (t1). Secondary outcome measures included skin temperature of the posterior trunk 10 minutes later (t2) and several parameters of self-perceived warmth at t1 and t2 (assessed with the Herdecke Warmth Perception Questionnaire). Results. Skin temperature of the posterior trunk was significantly higher with MU compared to WA and GI at t1 ( p < 0.001 for both, primary outcome measure) and t2 (WA versus MU: p = 0.04 , MU versus GI: p < 0.01 ). Self-perceived warmth of the posterior trunk was higher with MU and GI compared to WA at t1 (1.40 ≥ d ≥ 1.79) and remained higher with GI at t2 (WA versus GI: d = 0.74). The overall warmth perception increased significantly with GI (d = 0.69), tended to increase with MU (d = 0.54), and did not change with WA (d = 0.36) between t0 and t1. Conclusions. Different effects on warmth regulation were observed when ginger and mustard were applied as chest compresses. Both substances induced self-perceived warming of the posterior trunk, but measurable skin temperature increased only with MU. Further research is needed to examine the duration of these thermogenic effects and how chest compresses with ginger or mustard might be incorporated into practice to influence clinical outcomes in respiratory tract infections.

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“…During the last 20 years, the implementation of integrative approaches for children has grown [2,[5][6][7][8][9][10][11][12][13][14][15] worldwide: IM is used in pediatrics in the USA [9,11,[16][17][18][19], in Canada [20] and in Europe [5,8,[21][22][23][24][25] in private practices, outpatient-and inpatient-departments [23]. Current literature suggests that 30-50% of parents of children with acute or chronic diseases use IM for their children [26][27][28][29], while it seems to be used more frequently for children with chronic diseases in the US [16,[30][31][32][33][34][35].…”

Section: Introductionmentioning

confidence: 99%

Comparative analysis of resource utilization in integrative anthroposophic and all German pediatric inpatient departments

Fetz

Längler

Schwermer

et al. 2020

BMC Health Serv Res

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Background Integrative Medicine (IM) combines conventional and complementary therapies. It aims to address biological, psychological, social, spiritual and environmental aspects of patients’ health. During the past 20 years, the use and request of IM in children and adults has grown. Anthroposophic Medicine (AM) is an IM approach frequently used in children in Germany. From both public health and health economic perspectives, it is relevant to investigate whether there are differences in the resource utilization between integrative pediatric departments (IPD) and the entirety of all pediatric departments. Methods Standard ward documentation data from all German integrative anthroposophic pediatric departments (2005–2016; N = 29,956) is investigated and systematically compared to data of the entirety of all pediatric departments in Germany derived from the Institute for the Hospital Reimbursement System (2005–2016, N = 8,645,173). The analyses focus on: length of stay, Diagnosis Related Groups (DRG), Major Diagnosis Categories (MDC), and effective Case Mix Index (CMI). Results The length of stay in the IPD (M = 5.38 ± 7.31) was significantly shorter than the DRG defined length of stay (M = 5.8 ± 4.71; p < .001; d = − 0.07) and did not exceed or undercut the DRG covered length of stay. Compared to the entirety of all pediatric departments (M = 4.74 ± 6.23) the length of stay was significantly longer in the in the IPD (p <. 001; d = 0.12). The effective CMI in IPD and all pediatric departments were identical (M = 0.76). The frequencies of DRG and MDC differed between IPD and all pediatric departments, with higher frequencies of DRGs and MDCs associated with chronic and severe illnesses in the IPD. Conclusions Treatment within integrative anthroposophic pediatric departments fits well in terms of the DRG defined conditions concerning length of stay, even though integrative pediatric patients has an increased length of stay of averagely 1 day, which is most likely associated to time consuming, complex integrative treatment approaches and to a certain extend to higher amount of chronic and severe diseases.

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Acceptance, satisfaction and cost of an integrative anthroposophic program for pediatric respiratory diseases in a Swiss teaching hospital: An implementation report

Abstract: Introduction of anthroposophic treatments were well-accepted and led to high parent satisfaction. Additional insurance reimbursements outweighed costs. The program has now been expanded into a center for integrative pediatrics.

Cited by 6 publications

References 20 publications

Systematic review of economic evaluations for paediatric pulmonary diseases

Systematic review of economic evaluations for paediatric pulmonary diseases

Do Chest Compresses with Mustard or Ginger Affect Warmth Regulation in Healthy Adults? A Randomized Controlled Trial

Comparative analysis of resource utilization in integrative anthroposophic and all German pediatric inpatient departments

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