Utilization of psychotropic drugs by patients consulting for sleeping disorders in homeopathic and conventional primary care settings: the EPI3 cohort study

Lamiae Grimaldi-Bensouda; Lucien Abenhaim; Jacques Massol; Didier Guillemot; Bernard Avouac; Gerard Duru; France Lert; Anne-Marie Magnier; Michel Rossignol; Frederic Rouillon; Bernard Begaud

doi:10.1016/j.homp.2015.05.002

Homeopathy, Table of Contents

Homeopathy 2015; 104(03): 170-175
DOI: 10.1016/j.homp.2015.05.002

Original Paper

Utilization of psychotropic drugs by patients consulting for sleeping disorders in homeopathic and conventional primary care settings: the EPI3 cohort study

Lamiae Grimaldi-Bensouda

¹LA-SER, 10 Place de Catalogne, 75014 Paris, France

²Conservatoire national des arts et métiers (CNAM), 292 Rue Saint-Martin, 75003 Paris, France

,

Lucien Abenhaim

³LA-SER Europe Limited, 66 Chiltern St, London W1U 4JT, United Kingdom

⁴Department of Epidemiology, London School of Hygiene & Tropical Medicine, Keppel St, Bloomsbury, London WC1E 7HT, United Kingdom

,

Jacques Massol

⁵Faculty of Medicine, University of Franche Comté, 9 Rue Ambroise Paré, 25000 Besançon, France

,

Didier Guillemot

⁶Pasteur Institute, 28 Rue du Docteur Roux, 75015 Paris, France

⁷University of Paris-Ile de France Ouest, 9 Boulevard d'Alembert, 78280 Guyancourt, France

,

Bernard Avouac

¹LA-SER, 10 Place de Catalogne, 75014 Paris, France

,

Gerard Duru

⁸Cyklad Group, 16 Rue André Le Nôtre, 69140 Rillieux-la-Pape, France

,

France Lert

⁹INSERM U1018, Centre for Epidemiology and Population Health, Hôpital Paul Brousse, Bât 15/16, 16 Avenue Paul Vaillant Couturier, 94807 Villejuif, France

,

Anne-Marie Magnier

¹⁰Faculty of Medicine, University Pierre and Marie Curie, 4 Place Jussieu, 75005 Paris, France

,

Michel Rossignol

¹¹Department of Epidemiology, Biostatistics and Occupational Health, McGill University, 1020 Pine Avenue West, Montreal, Quebec H3A 1A2, Canada

,

Frederic Rouillon

¹²Sainte-Anne Hospital, University of Paris V René Descartes, 100 Rue de la Santé, 75674 Paris, France

,

Bernard Begaud

¹³INSERM U657, University of Bordeaux Segalen, 146 Rue Léo Saignat, 33076 Bordeaux, France

› Author Affiliations

Abstract

Background: Utilization of sedative hypnotic drugs for sleeping disorders (SD) raises concerns, particularly among older people. This study compared utilization of conventional psychotropic drugs for SD among patients seeking care from general practitioners (GPs) who strictly prescribe conventional medications (GP-CM), regularly prescribe homeopathy in a mixed practice (GP-Mx), or are certified homeopathic GPs (GP-Ho).

Methods: This was a French population-based cohort study of GPs and their patients consulting for SD, informed through the Pittsburgh sleep quality index (PSQI) questionnaire. Information on psychotropic drugs utilization was obtained from a standardized telephone interview at inclusion, one, three and 12 months.

Results: 346 patients consulting for SD were included. Patients in the GP-Ho group experienced more often severe SD (41.3%) than patients in the GP-CM group (24.3%). Adjusted multivariate analyses showed that patients who chose to be managed by GP-Ho were less likely to use psychotropic drugs over 12 months as opposed to the GP-CM group, with Odds ratio (OR) = 0.25; 95% confidence interval (CI): 0.14 to 0.42. Patients in the GP-Mx group also used less psychotropic drugs but the result was not statistically significant (OR = 0.67; 95% CI: 0.39–1.16). Rates of clinical improvement of the SD did not differ between groups.

Conclusions: Patients with SD who chose to consult GPs certified in homeopathy consumed less psychotropic drugs and had a similar evolution of their condition to patients treated with conventional medical management. This result may translate in a net advantage with reduction of adverse events related to psychotropic drugs.

Keywords

Insomnia - Homeopathy - Primary care

Full Text

References

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