Sometimes, a study serves to uncover something completely unknown before. However, many times, it confirms something that we already suspected to be true. In the case of a recent report, the news out of the United Kingdom that homeopathy is more frequently recommended by bad physicians is something that we could have easily predicted.
The UK’s National Health Service has been pretty vocal about cutting down on the use of alternative medicines, with a particular focus on homeopathy. Although it has been recommended that physicians stop prescribing homeopathic remedies, the use of homeopathy has not stopped as of yet. (It has declined, however.)
But, who is prescribing homeopathy? A research group led by Ben Goldacre sought to understand if there is a difference between the medical practices that prescribe homeopathy and those that don't.
The study first identified medical practices that had prescribed homeopathy in the course of a six month period out of 7618 total primary care practices. They did this by analyzing the data available on the website "Open Prescribing", which has information on the use of medicines within the NHS. They found that 8.5% of practices (644) prescribed homeopathy between December 2016 and May 2017.
After establishing how many medical practices had prescribed homeopathy, they wanted to establish whether there was a difference in the quality of the care provided in those practices versus those that don't prescribe homeopathy. In order to do that, they scored medical practices on a spectrum of "high-quality" to "low-quality." This was based on multiple performance measures - with the practices being judged on 70 standards of good practice in prescribing - based on whether or not medical guidelines were being followed.
Practices that scored in the worst category of prescribing quality were 2.1 times more likely to prescribe homeopathy than those in the best category. Not only that, but, they found a dose–response relationship. So, the higher the performance of the practice, the less likely they were to use homeopathy and vice versa. Even infrequent homeopathy prescribing was strongly associated with a poor performing practice.
The researchers are not suggesting a causal relationship. Meaning that the reason that homeopathy is prescribed by medical practices is not because they are lacking in other ways. However, this study establishes a link between the two. Goldacre suggests that the link may be a lack of respect for evidence-backed practices - something that their patients may be interested in knowing.
Source: Walker AJ, et al. Is use of homeopathy associated with poor prescribing in English primary care? A cross-sectional study Journal of the Royal Society of Medicine April 18, 2018 https://doi.org/10.1177/0141076818765779
