Marco Picchi

Aim: To study the effect of homeopathic treatment on adult patients with atopic diseases visited at the Homeopathic Clinic of Lucca (Italy) and long-term evolution of the disease over approximately an 8-year period. Materials and Methods: Data derive from an observational longitudinal study carried out on 563 atopic adult patients who were consecutively visited from 1998 to 2017; 202 (35.9%) suffered from atopic dermatitis, 204 (36.2%) from allergic rhinitis, and 157 (27.9%) from asthma. Moreover, a long-term study was conducted on a subset of 45/104 adult patients, consecutively visited from 2006 to 2012, and with ≥ 5 years follow-up. The study also investigated the evolution of overall symptoms in those patients with a complex atopic symptomatology. Results: 69.3% of atopic adults had moderate or major improvement (71.1% with asthma as the primary disease; 69.8% rhinitis; 67.1% dermatitis). At re-evaluation after 5-12 years, complete remission of atopic symptoms was observed in 69.6% of adult patients: 100% in dermatitis; 59.2% in allergic rhinitis, 75% in asthma. Adult patients with more than one atopic diseases at the first visit were completely cured in 54.3% of cases. Conclusion: The results seem to confirm that homeopathic medicine produces positive therapeutic response also in adult atopic patients.

Aim: To develop a systematic approach to detect and prevent clinical risks in complementary medicine (CM) and increase patient safety through the analysis of activities in homeopathy and acupuncture centres in the Tuscan region using a significant event audit (SEA) and failure modes and effects analysis (FMEA). Methods: SEA is the selected tool for studying adverse events (AE) and detecting the best solutions to prevent future incidents in our Regional Healthcare Service (RHS). This requires the active participation of all the actors and external experts to validate the analysis. FMEA is a proactive risk assessment tool involving the selection of the clinical process, the input of a multidisciplinary group of experts, description of the process, identification of the failure modes (FMs) for each step, estimates of the frequency, severity, and detectability of FMs, calculation of the risk priority number (RPN), and prioritized improvement actions to prevent FMs. Results: In homeopathy, the greatest risk depends on the decision to switch from allopathic to homeopathic therapy. In acupuncture, major problems can arise, mainly from delayed treatment and from the modalities of needle insertion. Conclusions: The combination of SEA and FMEA can reveal potential risks for patients and suggest actions for safer and more reliable services in CM.