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Is use of homeopathy associated with poor prescribing in English primary care? A cross-sectional study

Overview of attention for article published in Journal of the Royal Society of Medicine, April 2018
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • One of the highest-scoring outputs from this source (#2 of 1,818)
  • High Attention Score compared to outputs of the same age (99th percentile)
  • High Attention Score compared to outputs of the same age and source (94th percentile)

Mentioned by

news
17 news outlets
blogs
7 blogs
twitter
1846 tweeters
facebook
12 Facebook pages
reddit
1 Redditor

Citations

dimensions_citation
2 Dimensions

Readers on

mendeley
25 Mendeley
Title
Is use of homeopathy associated with poor prescribing in English primary care? A cross-sectional study
Published in
Journal of the Royal Society of Medicine, April 2018
DOI 10.1177/0141076818765779
Pubmed ID
Authors

Alex J Walker, Richard Croker, Seb Bacon, Edzard Ernst, Helen J Curtis, Ben Goldacre

Abstract

Objectives Prescribing of homeopathy still occurs in a small minority of English general practices. We hypothesised that practices that prescribe any homeopathic preparations might differ in their prescribing of other drugs. Design Cross-sectional analysis. Setting English primary care. Participants English general practices. Main outcome measures We identified practices that made any homeopathy prescriptions over six months of data. We measured associations with four prescribing and two practice quality indicators using multivariable logistic regression. Results Only 8.5% of practices (644) prescribed homeopathy between December 2016 and May 2017. Practices in the worst-scoring quartile for a composite measure of prescribing quality (>51.4 mean percentile) were 2.1 times more likely to prescribe homeopathy than those in the best category (<40.3) (95% confidence interval: 1.6-2.8). Aggregate savings from the subset of these measures where a cost saving could be calculated were also strongly associated (highest vs. lowest quartile multivariable odds ratio: 2.9, confidence interval: 2.1-4.1). Of practices spending the most on medicines identified as 'low value' by NHS England, 12.8% prescribed homeopathy, compared to 3.9% for lowest spenders (multivariable odds ratio: 2.6, confidence interval: 1.9-3.6). Of practices in the worst category for aggregated price-per-unit cost savings, 12.7% prescribed homeopathy, compared to 3.5% in the best category (multivariable odds ratio: 2.7, confidence interval: 1.9-3.9). Practice quality outcomes framework scores and patient recommendation rates were not associated with prescribing homeopathy (odds ratio range: 0.9-1.2). Conclusions Even infrequent homeopathy prescribing is strongly associated with poor performance on a range of prescribing quality measures, but not with overall patient recommendation or quality outcomes framework score. The association is unlikely to be a direct causal relationship, but may reflect underlying practice features, such as the extent of respect for evidence-based practice, or poorer stewardship of the prescribing budget.

Twitter Demographics

The data shown below were collected from the profiles of 1,846 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 25 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 25 100%

Demographic breakdown

Readers by professional status Count As %
Student > Ph. D. Student 5 20%
Student > Master 5 20%
Student > Bachelor 4 16%
Researcher 4 16%
Unspecified 3 12%
Other 4 16%
Readers by discipline Count As %
Medicine and Dentistry 6 24%
Unspecified 4 16%
Nursing and Health Professions 4 16%
Sports and Recreations 2 8%
Environmental Science 2 8%
Other 7 28%

Attention Score in Context

This research output has an Altmetric Attention Score of 1211. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 15 May 2019.
All research outputs
#2,364
of 12,971,414 outputs
Outputs from Journal of the Royal Society of Medicine
#2
of 1,818 outputs
Outputs of similar age
#156
of 268,993 outputs
Outputs of similar age from Journal of the Royal Society of Medicine
#1
of 18 outputs
Altmetric has tracked 12,971,414 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 99th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,818 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 17.1. This one has done particularly well, scoring higher than 99% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 268,993 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 99% of its contemporaries.
We're also able to compare this research output to 18 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 94% of its contemporaries.