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Square pegs and round holes? A review of economic evaluation in complementary and alternative medicine

Hulme, CT and Long, AF 2005, 'Square pegs and round holes? A review of economic evaluation in complementary and alternative medicine' , The Journal of Alternative and Complementary Medicine, 11 (1) , pp. 179-188.

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Abstract

INTRODUCTION: Economic evaluation, linking the costs and consequences of an intervention to indicate the potential benefits of alternative interventions, is becoming established as one of the core tools for decision making in health care. As knowledge of the safety and effectiveness of complementary and alternative medicine (CAM) interventions increases, economic evaluation within CAM has a heightened significance. OBJECTIVE: To explore whether the present framework for economic evaluation fits CAM and what modifications if any are needed for its application. Design: Systematic review. METHODS: A comprehensive search of four databases was undertaken (NHS Economic Evaluation Database, AMED, MEDLINE, CINAHL). Studies were included if they took the form of a comparative analysis of costs and consequences of a CAM treatment and were written in English. Each study was reviewed using a set of methodological questions to judge their quality as economic evaluations. RESULTS: A total of 19 studies were identified, of which 9 were cost-effectiveness studies, 7 cost-consequence studies, 2 cost-minimization studies, and 1 cost-benefit analysis. Seventeen (17) of the studies involved CAM treatments being used alongside mainstream or conventional treatments. The majority of the treatments aimed to alleviate pain, including chronic pain, back pain, neck pain, and migraine. Only a small minority of studies addressed wider outcomes of particular relevance to CAM disciplines. Nine (9) adopted a service provider perspective only, 7 included wider sickness absence costs and 3 patient costs. Only 1 study included costs to relatives. The quality of the cost and benefit dimensions of the studies was mixed. CONCLUSIONS: A CAM sensitive approach to economic evaluation is required. This needs to include a focus on outcomes that explore the range of effects of CAM treatment, an exploration of the client's perspective and not just that of the service provider and study designs that facilitate the individualized practitioner approach so central to CAM treatment.

Item Type: Article
Themes: Subjects / Themes > R Medicine > R Medicine (General)
Health and Wellbeing
Schools: Colleges and Schools > College of Health & Social Care > School of Nursing, Midwifery, Social Work & Social Sciences > Centre for Nursing, Midwifery & Social Work Research
Colleges and Schools > College of Health & Social Care
Colleges and Schools > College of Health & Social Care > School of Nursing, Midwifery, Social Work & Social Sciences > Centre for Social Justice Research
Journal or Publication Title: The Journal of Alternative and Complementary Medicine
Publisher: Mary Ann Liebert Inc
Refereed: Yes
ISSN: 10755535
Depositing User: H Kenna
Date Deposited: 02 Aug 2007 13:57
Last Modified: 20 Aug 2013 16:45
URI: http://usir.salford.ac.uk/id/eprint/53

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