Article: A comparison of the effectiveness between Western medicine and Chinese medicine outpatient consultations in primary care

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TitleA comparison of the effectiveness between Western medicine and Chinese medicine outpatient consultations in primary care
AuthorsWong, W1
Lam, LKC1
Li, R3
Ho, SH3
Fai, LK2
Li, Z4
KeywordsChinese medicine
Health-related quality of life
Primary care
Western medicine
Issue Date2011
PublisherChurchill Livingstone. The Journal's web site is located at http://www.elsevier.com/locate/issn/09652299
CitationComplementary Therapies In Medicine, 2011, v. 19 n. 5, p. 264-275 [How to Cite?]
DOI: http://dx.doi.org/10.1016/j.ctim.2011.07.001
AbstractBackground: Traditional Chinese medicine (TCM) plays an important role in the primary care system in many places, but research evidence on its effectiveness is largely lacking. The aim of the present study was to compare the effectiveness between TCM and Western medicine (WM) consultations in primary care. Objectives: To evaluate whether medical consultations could improve the quality of life and health condition of patients in primary care and to find out whether there was any difference in the effectiveness bewteen TCM and WM. Design, setting and subjects: This was a prospective, longitudinal study on 290 patients of one TCM public and 841 patients of two WM general outpatient clinics (GOPC) in Hong Kong when they consulted for an episodic illness. Methods: All patients attending a TCM GOPC in TWH, and the two WM GOPC (TWH and ALC), who fullfilled the inclusion criteria were invited to participate. Each patient answered a structured questionnaire on the presenting complaint, socio-demography, chronic morbidity and service utilization, the Chinese Quality of Life instrument (ChQOL) and the SF-36V2 Health Survey immediately before and two weeks after the doctor consultation. The Global Rating on change Scale (GRS) was also administered in the week 2 assessment. Outcome measures: The primary outcomes were changes in the ChQOL and SF-36V2 HRQOL scores. Secondary outcomes included the GRS score. The significance of the change within individual were tested by paired t-tests. The differences in change in scores between WM and TCM were tested by independent sample- t-tests or chi-square, as appropriate. Multivariate regresions were used to determine the independent effect of type of medicine on the change in HRQOL scores. Results: Mean ChQOL and SF-36V2 scores of subjects improved significantly two weeks after TCM or WM consultations in all domains except for the Physical form domain of ChQOL. The greatest improvements were found in the SF-36V2 physical-health related domains. 78% TCM clinics and 71% of subjects WM clinics reported an improvement in GRS. The proportion of subjects who had improvement in HRQOL scores were lower among subjects consulting the WM clinic (72.3%) than those consulting TCM clinics (100%) but the difference was not significant after correction for baseline scores. Conclusions: Both TCM and WM consultations were associated with significant improvement in HRQOL in over 90% of patients. There was no singificant difference between the effectiveness of TCM and WM consultations. The results support the role of TCM as an alternative primary care service in Hong Kong. © 2011 Elsevier Ltd.
ISSN0965-2299
2011 Impact Factor: 1.872
2011 SCImago Journal Rankings: 0.072
DOIhttp://dx.doi.org/10.1016/j.ctim.2011.07.001
ISI Accession Number IDWOS:000296114800004
ReferencesReferences in Scopus
DC Field
Value
dc.contributor.authorWong, W
dc.contributor.authorLam, LKC
dc.contributor.authorLi, R
dc.contributor.authorHo, SH
dc.contributor.authorFai, LK
dc.contributor.authorLi, Z
dc.date.accessioned2011-09-23T05:49:41Z
dc.date.available2011-09-23T05:49:41Z
dc.date.issued2011
dc.description.abstractBackground: Traditional Chinese medicine (TCM) plays an important role in the primary care system in many places, but research evidence on its effectiveness is largely lacking. The aim of the present study was to compare the effectiveness between TCM and Western medicine (WM) consultations in primary care. Objectives: To evaluate whether medical consultations could improve the quality of life and health condition of patients in primary care and to find out whether there was any difference in the effectiveness bewteen TCM and WM. Design, setting and subjects: This was a prospective, longitudinal study on 290 patients of one TCM public and 841 patients of two WM general outpatient clinics (GOPC) in Hong Kong when they consulted for an episodic illness. Methods: All patients attending a TCM GOPC in TWH, and the two WM GOPC (TWH and ALC), who fullfilled the inclusion criteria were invited to participate. Each patient answered a structured questionnaire on the presenting complaint, socio-demography, chronic morbidity and service utilization, the Chinese Quality of Life instrument (ChQOL) and the SF-36V2 Health Survey immediately before and two weeks after the doctor consultation. The Global Rating on change Scale (GRS) was also administered in the week 2 assessment. Outcome measures: The primary outcomes were changes in the ChQOL and SF-36V2 HRQOL scores. Secondary outcomes included the GRS score. The significance of the change within individual were tested by paired t-tests. The differences in change in scores between WM and TCM were tested by independent sample- t-tests or chi-square, as appropriate. Multivariate regresions were used to determine the independent effect of type of medicine on the change in HRQOL scores. Results: Mean ChQOL and SF-36V2 scores of subjects improved significantly two weeks after TCM or WM consultations in all domains except for the Physical form domain of ChQOL. The greatest improvements were found in the SF-36V2 physical-health related domains. 78% TCM clinics and 71% of subjects WM clinics reported an improvement in GRS. The proportion of subjects who had improvement in HRQOL scores were lower among subjects consulting the WM clinic (72.3%) than those consulting TCM clinics (100%) but the difference was not significant after correction for baseline scores. Conclusions: Both TCM and WM consultations were associated with significant improvement in HRQOL in over 90% of patients. There was no singificant difference between the effectiveness of TCM and WM consultations. The results support the role of TCM as an alternative primary care service in Hong Kong. © 2011 Elsevier Ltd.
dc.description.natureLink_to_subscribed_fulltext
dc.identifier.citationComplementary Therapies In Medicine, 2011, v. 19 n. 5, p. 264-275 [How to Cite?]
DOI: http://dx.doi.org/10.1016/j.ctim.2011.07.001
dc.identifier.citeulike10187949
dc.identifier.doihttp://dx.doi.org/10.1016/j.ctim.2011.07.001
dc.identifier.epage275
dc.identifier.hkuros195165
dc.identifier.isiWOS:000296114800004
dc.identifier.issn0965-2299
2011 Impact Factor: 1.872
2011 SCImago Journal Rankings: 0.072
dc.identifier.issue5
dc.identifier.pmid21944656
dc.identifier.scopuseid_2-s2.0-80053132375
dc.identifier.spage264
dc.identifier.urihttp://hdl.handle.net/10722/139440
dc.identifier.volume19
dc.languageeng
dc.publisherChurchill Livingstone. The Journal's web site is located at http://www.elsevier.com/locate/issn/09652299
dc.publisher.placeUnited Kingdom
dc.relation.ispartofComplementary Therapies in Medicine
dc.relation.referencesReferences in Scopus
dc.subject.meshMedicine
dc.subject.meshMedicine, Chinese Traditional
dc.subject.meshOutcome Assessment (Health Care)
dc.subject.meshOutpatients
dc.subject.meshPrimary Health Care - methods
dc.subjectChinese medicine
dc.subjectHealth-related quality of life
dc.subjectPrimary care
dc.subjectWestern medicine
dc.titleA comparison of the effectiveness between Western medicine and Chinese medicine outpatient consultations in primary care
dc.typeArticle
Author Affiliations
  1. The University of Hong Kong
  2. Queen Elizabeth Hospital Hong Kong
  3. Tung Wah Group of Hospitals
  4. Chinese University of Hong Kong