Original article
Vol. 148 No. 4344 (2018)
General practitioners’ perspectives on the use of nonpharmacological home remedies in two regions in Switzerland and France
- Paul Sebo
- Dagmar M. Haller
- Johanna Sommer
- Sophie Excoffier
- Yoann Gaboreau
- Hubert Maisonneuve
Summary
BACKGROUND
Nonpharmacological home remedies offer the potential for easily accessible and well-accepted management of common disorders in general practice. We aimed to assess general practitioners’ (GPs’) perspectives on these remedies in two French-speaking European countries.
METHODS
In 2017, we conducted a cross-sectional study among community-based GPs in the Geneva (Switzerland) and Grenoble (France) regions. They completed an anonymous questionnaire about forty common home remedies. We asked how often they prescribed each type of remedy and how effective they found them. Descriptive statistics (proportions with 95% confidence intervals [CIs]) were used to summarise the data.
RESULTS
349 GPs returned the questionnaire (172 of 500 Swiss and 177 of 500 French; participation rate 35%; male:female ratio 1:1). In the week before the study, GPs had advised 8.2% patients to use at least one remedy. The remedies that were most frequently prescribed were saline water to treat common colds (69%), mobilising and/or stretching exercises for low back pain (67%) and applying cold water or cold pads for burns (60%). The remedies that were perceived to be most effective were squatting during defaecation as a treatment for constipation (89%), phoning a traditional healer to treat skin diseases or burns (84%) and applying cold water or pads for burns (82%).
CONCLUSIONS
These findings suggest that GPs find certain nonpharmacological remedies very useful, even though they do not frequently prescribe them in practice. These remedies should receive more attention from researchers, as they could be considered by GPs as useful to treat a large number of benign conditions in primary care.
References
- Parisius LM, Stock-Schröer B, Berger S, Hermann K, Joos S. Use of home remedies: a cross-sectional survey of patients in Germany. BMC Fam Pract. 2014;15(1):116. doi:.https://doi.org/10.1186/1471-2296-15-116
- Sreeramareddy CT, Shankar RP, Sreekumaran BV, Subba SH, Joshi HS, Ramachandran U. Care seeking behaviour for childhood illness--a questionnaire survey in western Nepal. BMC Int Health Hum Rights. 2006;6(1):7. doi:.https://doi.org/10.1186/1472-698X-6-7
- Cox C, Jones M. An evaluation of the management of patients with sore throats by practice nurses and GPs. Br J Gen Pract. 2000;50(460):872–6.
- Mull DS, Nguyen N, Mull JD. Vietnamese diabetic patients and their physicians: what ethnography can teach us. West J Med. 2001;175(5):307–11. doi:.https://doi.org/10.1136/ewjm.175.5.307
- Sewani-Rusike CR, Mammen M. Medicinal plants used as home remedies: a family survey by first year medical students. Afr J Tradit Complement Altern Med. 2014;11(5):67–72. doi:.https://doi.org/10.4314/ajtcam.v11i5.11
- Boyd EL, Taylor SD, Shimp LA, Semler CR. An assessment of home remedy use by African Americans. J Natl Med Assoc. 2000;92(7):341–53.
- Freedman SB, Willan AR, Boutis K, Schuh S. Effect of Dilute Apple Juice and Preferred Fluids vs Electrolyte Maintenance Solution on Treatment Failure Among Children With Mild Gastroenteritis: A Randomized Clinical Trial. JAMA. 2016;315(18):1966–74. doi:.https://doi.org/10.1001/jama.2016.5352
- Joos S, Glassen K, Musselmann B. Herbal Medicine in Primary Healthcare in Germany: The Patient’s Perspective. Evid Based Complement Alternat Med. 2012;2012:294638. doi:.https://doi.org/10.1155/2012/294638
- Al Himdani S, Javed MU, Hughes J, Falconer O, Bidder C, Hemington-Gorse S, et al. Home remedy or hazard?: management and costs of paediatric steam inhalation therapy burn injuries. Br J Gen Pract. 2016;66(644):e193–9. doi:.https://doi.org/10.3399/bjgp16X684289
- Chan H-T, So L-T, Li S-W, Siu C-W, Lau C-P, Tse H-F. Effect of herbal consumption on time in therapeutic range of warfarin therapy in patients with atrial fibrillation. J Cardiovasc Pharmacol. 2011;58(1):87–90. doi:.https://doi.org/10.1097/FJC.0b013e31821cd888
- Mohammed Abdul MI, Jiang X, Williams KM, Day RO, Roufogalis BD, Liauw WS, et al. Pharmacodynamic interaction of warfarin with cranberry but not with garlic in healthy subjects. Br J Pharmacol. 2008;154(8):1691–700. doi:.https://doi.org/10.1038/bjp.2008.210
- Sergi G, De Rui M, Sarti S, Manzato E. Polypharmacy in the elderly: can comprehensive geriatric assessment reduce inappropriate medication use? Drugs Aging. 2011;28(7):509–18. doi:.https://doi.org/10.2165/11592010-000000000-00000
- Gallagher P, Lang PO, Cherubini A, Topinková E, Cruz-Jentoft A, Montero Errasquín B, et al. Prevalence of potentially inappropriate prescribing in an acutely ill population of older patients admitted to six European hospitals. Eur J Clin Pharmacol. 2011;67(11):1175–88. doi:.https://doi.org/10.1007/s00228-011-1061-0
- Gallagher P, O’Mahony D. STOPP (Screening Tool of Older Persons’ potentially inappropriate Prescriptions): application to acutely ill elderly patients and comparison with Beers’ criteria. Age Ageing. 2008;37(6):673–9. doi:.https://doi.org/10.1093/ageing/afn197
- Atkin PA, Veitch PC, Veitch EM, Ogle SJ. The epidemiology of serious adverse drug reactions among the elderly. Drugs Aging. 1999;14(2):141–52. doi:.https://doi.org/10.2165/00002512-199914020-00005
- Abraha I, Cruz-Jentoft A, Soiza RL, O’Mahony D, Cherubini A. Evidence of and recommendations for non-pharmacological interventions for common geriatric conditions: the SENATOR-ONTOP systematic review protocol. BMJ Open. 2015;5(1):e007488. doi:.https://doi.org/10.1136/bmjopen-2014-007488
- Menotti A, Mulder I, Nissinen A, Giampaoli S, Feskens EJ, Kromhout D. Prevalence of morbidity and multimorbidity in elderly male populations and their impact on 10-year all-cause mortality: The FINE study (Finland, Italy, Netherlands, Elderly). J Clin Epidemiol. 2001;54(7):680–6. doi:.https://doi.org/10.1016/S0895-4356(00)00368-1
- Déruaz-Luyet A, N’Goran AA, Senn N, Bodenmann P, Pasquier J, Widmer D, et al. Multimorbidity and patterns of chronic conditions in a primary care population in Switzerland: a cross-sectional study. BMJ Open. 2017;7(6):e013664. doi:.https://doi.org/10.1136/bmjopen-2016-013664
- Stevenson FA, Britten N, Barry CA, Bradley CP, Barber N. Self-treatment and its discussion in medical consultations: how is medical pluralism managed in practice? Soc Sci Med. 2003;57(3):513–27. doi:.https://doi.org/10.1016/S0277-9536(02)00377-5
- Naci H, Ioannidis JPA. Comparative effectiveness of exercise and drug interventions on mortality outcomes: metaepidemiological study. Br J Sports Med. 2015;49(21):1414–22. doi:.https://doi.org/10.1136/bjsports-2015-f5577rep
- Hostettler S, Kraft E. Statistique médicale 2017 de la FMH – les chiffres actuels. Bulletin des médecins suisses [Internet]. [cited 2018 Jun 20] Available from: https://www.fmh.ch/files/pdf20/BMS-06573.pdf
- Le Breton-Lerouvillois G. La démographie médicale en région Rhône-Alpes [Internet]. [cited 2018 Jun 20]. Available from: https://www.conseil-national.medecin.fr/sites/default/files/atlas_rhone_alpes_2015.pdf
- Segall A. A community survey of self-medication activities. Med Care. 1990;28(4):301–10. doi:.https://doi.org/10.1097/00005650-199004000-00002
- Aveni E, Bauer B, Ramelet A-S, Kottelat Y, Decosterd I, Finti G, et al. The Attitudes of Physicians, Nurses, Physical Therapists, and Midwives Toward Complementary Medicine for Chronic Pain: A Survey at an Academic Hospital. Explore (NY). 2016;12(5):341–6. doi:.https://doi.org/10.1016/j.explore.2016.06.001
- von Studnitz FSG, Eulenburg C, Mueck AO, Buhling KJ. The value of complementary and alternative medicine in the treatment of climacteric symptoms: results of a survey among German gynecologists. Complement Ther Med. 2013;21(5):492–5. doi:.https://doi.org/10.1016/j.ctim.2013.07.005
- Fleming S, Rabago DP, Mundt MP, Fleming MF. CAM therapies among primary care patients using opioid therapy for chronic pain. BMC Complement Altern Med. 2007;7(1):15. doi:.https://doi.org/10.1186/1472-6882-7-15
- Simões-Wüst AP, Rist L, Dettling M. Self-reported health characteristics and medication consumption by CAM users and nonusers: a Swiss cross-sectional survey. J Altern Complement Med. 2014;20(1):40–7. doi:.https://doi.org/10.1089/acm.2012.0762
- King D, Mitchell B, Williams CP, Spurling GKP. Saline nasal irrigation for acute upper respiratory tract infections. Cochrane Database Syst Rev. 2015;(4):CD006821.
- Cho YS, Choi YH. Comparison of three cooling methods for burn patients: A randomized clinical trial. Burns. 2017;43(3):502–8. doi:.https://doi.org/10.1016/j.burns.2016.09.010
- Coulter ID, Crawford C, Hurwitz EL, Vernon H, Khorsan R, Suttorp Booth M, et al. Manipulation and mobilization for treating chronic low back pain: a systematic review and meta-analysis. Spine J. 2018;18(5):866–79. doi:.https://doi.org/10.1016/j.spinee.2018.01.013
- Chou R, Deyo R, Friedly J, Skelly A, Hashimoto R, Weimer M, et al. Nonpharmacologic Therapies for Low Back Pain: A Systematic Review for an American College of Physicians Clinical Practice Guideline. Ann Intern Med. 2017;166(7):493–505. doi:.https://doi.org/10.7326/M16-2459
- Himmel W, Lippert-Urbanke E, Kochen MM. Are patients more satisfied when they receive a prescription? The effect of patient expectations in general practice. Scand J Prim Health Care. 1997;15(3):118–22. doi:.https://doi.org/10.3109/02813439709018500
- Sikirov D. Comparison of straining during defecation in three positions: results and implications for human health. Dig Dis Sci. 2003;48(7):1201–5. doi:.https://doi.org/10.1023/A:1024180319005
- The mystery of the “faiseurs de secret” [Internet]. House of Switzerland. [cited 2018 Apr 12]. Available from: https://houseofswitzerland.org/swissstories/society/mystery-faiseurs-de-secret
- Harkness EF, Abbot NC, Ernst E. A randomized trial of distant healing for skin warts. Am J Med. 2000;108(6):448–52. doi:.https://doi.org/10.1016/S0002-9343(00)00342-9
- Walker SR, Tonigan JS, Miller WR, Corner S, Kahlich L. Intercessory prayer in the treatment of alcohol abuse and dependence: a pilot investigation. Altern Ther Health Med. 1997;3(6):79–86.
- Beutler JJ, Attevelt JT, Schouten SA, Faber JA, Dorhout Mees EJ, Geijskes GG. Paranormal healing and hypertension. Br Med J (Clin Res Ed). 1988;296(6635):1491–4. doi:.https://doi.org/10.1136/bmj.296.6635.1491
- O’Laoire S. An experimental study of the effects of distant, intercessory prayer on self-esteem, anxiety, and depression. Altern Ther Health Med. 1997;3(6):38–53.
- Harris WS, Gowda M, Kolb JW, Strychacz CP, Vacek JL, Jones PG, et al. A randomized, controlled trial of the effects of remote, intercessory prayer on outcomes in patients admitted to the coronary care unit. Arch Intern Med. 1999;159(19):2273–8. doi:.https://doi.org/10.1001/archinte.159.19.2273
- Miller RN. Study on the effectiveness of remote mental healing. Med Hypotheses. 1982;8(5):481–90. doi:.https://doi.org/10.1016/0306-9877(82)90009-3
- Roberts L, Ahmed I, Hall S, Davison A. Intercessory prayer for the alleviation of ill health. Cochrane Database Syst Rev. 2009;(2):CD000368.
- Ernst E, Pittler MH. Efficacy of ginger for nausea and vomiting: a systematic review of randomized clinical trials. Br J Anaesth. 2000;84(3):367–71. doi:.https://doi.org/10.1093/oxfordjournals.bja.a013442
- Wong BB, Chan YH, Leow MQH, Lu Y, Chong YS, Koh SSL, et al. Application of cabbage leaves compared to gel packs for mothers with breast engorgement: Randomised controlled trial. Int J Nurs Stud. 2017;76:92–9. doi:.https://doi.org/10.1016/j.ijnurstu.2017.08.014
- Wu L-W, Chen W-L, Liaw F-Y, Sun Y-S, Yang H-F, Wang C-C, et al. Association between fluid intake and kidney function, and survival outcomes analysis: a nationwide population-based study. BMJ Open. 2016;6(5):e010708. doi:.https://doi.org/10.1136/bmjopen-2015-010708
- Leendertse AJ, Van Den Bemt PMLA, Poolman JB, Stoker LJ, Egberts ACG, Postma MJ. Preventable hospital admissions related to medication (HARM): cost analysis of the HARM study. Value Health. 2011;14(1):34–40. doi:.https://doi.org/10.1016/j.jval.2010.10.024
- Rottenkolber D, Schmiedl S, Rottenkolber M, Farker K, Saljé K, Mueller S, et al.; Net of Regional Pharmacovigilance Centers. Adverse drug reactions in Germany: direct costs of internal medicine hospitalizations. Pharmacoepidemiol Drug Saf. 2011;20(6):626–34. doi:.https://doi.org/10.1002/pds.2118
- Taylor RS, Sagar VA, Davies EJ, Briscoe S, Coats AJS, Dalal H, et al. Exercise-based rehabilitation for heart failure. Cochrane Database Syst Rev. 2014;(4):CD003331.