Anthroposophic therapies in chronic disease: the Anthroposophic Medicine Outcomes Study (AMOS).

CONTEXT Anthroposophic medicine (AM) is used worldwide for chronic diseases. OBJECTIVE To study clinical outcomes and costs in patients treated with AM therapies for chronic conditions. DESIGN Prospective cohort study. SETTING 141 medical practices in Germany providing AM treatment. PARTICIPANTS AND INTERVENTIONS 898 outpatients aged 1-75 years referred to AM therapies (art, eurythmy or rhythmical massage, n = 665) or starting AM medical treatment (counselling, medicines, n = 233). MAIN OUTCOME MEASURES Disease severity assessed independently by physician (Disease Score) and patient (Symptom Score), and health-related quality of life (SF-36, KINDL, KITA) after 3, 6, 12, 18, and 24 months; health costs in pre-study year and first study year. RESULTS Most common indications were mental disorders (32.0%), and musculoskeletal disorders (18.9%). Disease duration at baseline was median 3.0 years (interquartile range = i.q.r. 1.0-8.5, mean 6.5 +/- 8.4 years). Median number of AM therapy sessions was 12 (i.q.r. 10-20), median therapy duration was 120 days (i.q.r. 81-195). From baseline to 6-month follow-up, Disease Score (0-10) improved from 6.40 +/- 1.76 to 3.43 +/- 2.23 (p < 0.001), Symptom Score (0-10) improved from 5.89 +/- 1.75 to 3.35 +/- 2.09 (p < 0.001). In adults, SF-36 Physical Component Summary improved from mean 43.34 +/- 10.58 at baseline to 47.44 +/- 10.32 after 6 months (p < 0.001), SF-36 Mental Component Summary improved from 38.83 +/- 12.45 to 44.93 +/- 10.92 (p < 0.001). Similar HRQoL improvements were observed in children (KINDL, KITA). All improvements remained stable until 24-month follow-up. Adverse effects from AM therapies occurred in 2.7% (19/712) of patients. Three (0.5%) patients stopped therapy due to adverse effects. Health costs were 3,637 Euro per patient in the pre-study year and 3,484 Euro in the first study year, a decrease of 152 Euro (4.2%) per patient. CONCLUSION Anthroposophic therapies were associated with long-term reduction of chronic disease symptoms, improvement of health-related quality of life, and health cost reduction.