Study looks at the patient-practitioner relationship in complementary and alternative therapies

Why do patients opt for complementary and alternative therapies when they are ill? Is the relationship and communication between a patient and a practitioner as important in the treatment as the complementary treatments prescribed?

The answers to these questions are the focus of a new research study at one of the country's foremost complementary medicine research centres, thanks to Department of Health (DoH) funding of £330,000.

Dr Sarah Brien, a Senior Research Fellow at the University of Southampton, has received a DoH fellowship award to run a dedicated programme evaluating herbal and homeopathic medicines in the treatment of arthritic-type conditions.

In particular, she is focusing on the relationship between the patient and the practitioner and looking carefully at how this relationship affects the overall benefit of these treatments. In addition, the DoH award also includes funding for a doctoral studentship that will investigate the role of the practitioner to identify how they provide an effective consultation and outcome from their treatment.

Her research will look at three specific issues in separate studies:

• Are the positive effects of homeopathic treatment in patients with rheumatoid arthritis due to the homeopathic remedy, the consultation with the practitioner or both?
• Why do patients use complementary and alternative medicine: is emotional and/or spiritual communication important and why do patients choose a particular practitioner?
• What do complementary and alternative medicine practitioners perceive to be an effective consultation?

Dr Brien explains: 'People with arthritis are frequent users of complementary and alternative medicine but at the moment we don't understand why this is. It's possible that the effectiveness of treatment is affected by a variety of factors other than the specific type of treatment given, be that the herbal or homeopathic remedy. For example, the consultation process and how the practitioner might empathise with the patient may well be important. Indeed data from interviews of patients attending their GPs suggest that talking about psychological or social issues is important to them.'

'The results of these studies are likely to have broad relevance for both complementary and alternative medicine and conventional medicine. They will help us to understand what patients want from the consultation, what the practitioners consider is important and, where there is a mismatch between these two, it will help identify those elements that practitioners could focus on to ensure they provide the optimum consultation for their patients. These issues will be relevant not only to CAM practitioners but also to health professionals in conventional medicine. '

Approximately 200 volunteers will take part in the three studies which will include interviewing both patients and practitioners about their experiences of a complementary medicine consultation, and a clinical trial to monitor improvement in joint pain and swelling, as well as patients' quality of life and use of painkillers.

Dr George Lewith, Senior Research Fellow in the University's Complementary Medicine Research Unit, said: 'Southampton has had remarkable success in winning DoH support over the last two years. This success makes us one of the - if not the - premier primary research unit for complementary and alternative medicine in the United Kingdom. We have produced 60 peer reviewed papers since 2001, with many more currently in submission which makes it clear that we are one of the leading units in the world in this area.'

The results of Dr Brien's research will be available in late 2006.