Long-term outcomes of anthroposophic treatment for chronic disease: a four-year follow-up analysis of 1510 patients from a prospective observational study in routine outpatient settings

Abstract

BackgroundAnthroposophic treatment includes special artistic and physical therapies and special medications. We here report an update to a previously published study of anthroposophic treatment for chronic diseases, including more patients and a longer follow up. The Anthroposophic Medicine Outcomes Study (AMOS) was a prospective observational cohort study of anthroposophic treatment for chronic indications in routine outpatient settings in Germany. Anthroposophic treatment was associated with improvements of symptoms and quality of life. Previous follow-up-analyses have been performed after 24 months or, in subgroups of patients enrolled in the period 1999-2001, after 48 months. We conducted a 48-month follow-up analysis of all patients enrolled in AMOS in the period 1999-2005.Methods1,510 outpatients aged 1-75 years, starting anthroposophic treatment for chronic conditions in routine German outpatient settings, participated in a prospective cohort study. Main outcomes were Symptom Score (primary outcome, mean symptom severity on numerical rating scales), SF-36 Physical and Mental Component scores in adults, and disease-specific outcomes in the six most common diagnosis groups: asthma, anxiety disorders and migraine (numerical rating scales), depression (Center for Epidemiological Studies Depression Scale), attention deficit hyperactivity symptoms (FBB-HKS Total score), and low back pain (Hanover Functional Ability Questionnaire, Low Back Pain Rating Scale).ResultsMedian disease duration at baseline was 3.5 years. From baseline to 48-month follow-up all ten outcomes improved significantly (p < 0.001 for all pre-post comparisons). Standardised Response Mean effect sizes were large (range 0.84-1.24 standard deviations) for seven comparisons, medium for two comparisons (SF-36 Mental Component: 0.60, Low Back Pain Rating Scale: 0.55), and small for one comparison (SF-36 Physical Component: 0.39). Symptom Score improved significantly with large effect sizes in adults and children, and in the four main anthroposophic therapy modality groups (art therapy, eurythmy therapy, rhythmical massage therapy, medical therapy).ConclusionsThis 48-month follow-up analysis confirmed previous analyses from the AMOS study. Outpatients receiving anthroposophic treatment for chronic indications had sustained, clinically relevant improvements of symptoms and quality of life.

Overview of the Publications from the Anthroposophic Medicine Outcomes Study (AMOS): A Whole System Evaluation Study

“…Of the 16 pre-post analyses not showing significant improvements, five analyses had a sample size of < 17 patients. All significant symptom and quality of life improvements were maintained at the last follow-up assessment after 12 months, 41 24 months, 27 - 30 , 32 , 33 and 48 months, 26 , 34 - 37 respectively (one exception: KINDL total score in the asthma group, n = 12 29 ). …”

“…At the primary follow-up assessments of clinical outcomes after 6 or 12 months, the follow-up rate was 91% and 87%, respectively, in all patients 26 (range 77%-92% in subgroups, Table 2). For each primary outcome assessment after 6 months 25 , 27 , 28 , 30 , 33 , 41 or 12 months, 29 , 31 , 34 - 38 nonrespondent analyses were performed: Respondents and nonrespondents at the respective follow-ups did not differ significantly with regard to age, gender, disease duration, disease severity at baseline, and, if appropriate, diagnosis 25 , 27 - 31 , 33 - 38 , 41 (one exception in 73 nonrespon-dent analyses: significant difference for age in the rhythmical massage therapy group 37 ).…”

“…Most frequent indications were mental disorders (ICD-10 F00-F99, 35.2%, n = 532/1510); musculoskeletal disorders (M00-M99, 15.4%); respiratory disorders (J00-J99, 9.9%); and neurological disorders (G00-G99, 7.2%) 26 . The most frequent diagnosis groups are listed in Table 2.…”

Anthroposophy and Integrative Care at the End of Life

“…These therapies are known to provide long-term benefits with a low risk of side-effects, lower treatment cost, and improved patient quality of life (QoL). [6][7][8][9][10][11] Nevertheless, there are very few reports about the applicability and benefits of such therapies in end-of-life care. [12][13][14][15] The central purpose of this article is to present anthroposophic knowledge in relation to end-of-life care and the premise that the anthroposophic approach to death can be understood as a similar model to that of the modern hospice movement.…”

The Contribution of Anthroposophic Medicine to Self-Management: An Exploration of Concepts, Evidence, and Patient Perspectives

“…The symptom and stress-reducing effects of AM therapies have been demonstrated in several studies, e.g., overall [34], in non-verbal treatment with, for example, eurythmy therapy [35,36], art therapy [37,38], rhythmical massage [39,40], with medicinal products (e.g., [41][42][43][44][45][46]), and in complex AM treatment for chronic indications [47,48].…”