APPENDIX Efficacy Research Project for Anthroposophical Medicines Questionnaire and Interview Questions This research project is based on the following assumptions, and the first question is to ask to what extent you agree with these assumptions. Fundamental Assumptions of this Project Rudolf Steiner implies that although Spiritual Science can suggest medicines, the doctor's own observations and experience of their effectiveness are the ultimate criteria of their value. Although every anthroposophical doctor makes his own observation and experience with the medicines, comparatively little has been done to systematically gather these observations. Within anthroposophical medicine there is general acceptance that the physician's own relationship to the substance and the doctor/patient relationship may be therapeutically effective in themselves, alongside the direct effect of the substance. These are all seen as fully justified aspects of the healing process, rather than regarded as in some way dubious, which is often implied by the term "placebo effect". However, while acknowledging that these elements are involved in the healing effect of a medicine, few would regard them as the sole agents of healing. They would also consider that the medicine has its own effect in evoking a healing response from the human organism when correctly prescribed. I fully agree with this statement I largely agree with this statement but would like to add to it I feel this statement misses the point somewhat I consider this statement misses the point substantially Please tick the box which is nearest to your view and if you do not fully agree with these assumptions please use the space below to either add to what has been said or say how you would amend or express your opinion. ……………………………………………………………………………………………………………………… ……………………………………………………………………………………………………………………… ……………………………………………………………………………………………………………………… ……………………………………………………………………………………………………………………… …………………………………………………………………………………………… Please use an additional sheet of paper if more space is needed. The prime task of this project is to identity a list of medicines whose efficacy is most certain, based on the experience and observations of anthroposophical doctors. It is common practice with anthroposophical medicine to prescribe more than one medicine for a particular problem, as well as prescribing compound preparations. This tends to make it more difficult to get a clear impression of the efficacy of a medicine or of a particular medical substance. In spite of this, practitioners may have quite definite experiences of the efficacy of specific anthroposophical medicines, possibly through their having been prescribed singly for a particular condition or where the addition of a particular substance seems to have quite a dramatic effect. It may also be possible for practitioners to have a degree of certainty about a particular medicine through prescribing it very frequently, thus being able to observe a reliable effect. It may be that compared to the number of medicines anthroposophical doctors prescribe, the number of medicines for which efficacy has been observed with a degree of certainty, may be rather small. Please list up to ten medicines about which you feel most certain that they are efficacious on the basis of your experience from patients for whom they have been prescribed. If possible it would be helpful if they were the ten (or less) that you feel most certain about. 1…………………………………………………………………………………………….. 2…………………………………………………………………………………………….. 3…………………………………………………………………………………………….. 4…………………………………………………………………………………………….. 5…………………………………………………………………………………………….. 6…………………………………………………………………………………………….. 7…………………………………………………………………………………………….. 8…………………………………………………………………………………………….. 9…………………………………………………………………………………………….. 10…………………………………………………………………………………………… If there are more than ten medicines for which on the basis of experience you have a high degree of certainty about their efficacy, please add to this list, if possible roughly in order of certainty. 11……………………………………………………………………………………………. 12…………………………………………………………………………………………… 13…………………………………………………………………………………………… 14…………………………………………………………………………………………… 15…………………………………………………………………………………………… 16…………………………………………………………………………………………… 17…………………………………………………………………………………………… 18…………………………………………………………………………………………… 19…………………………………………………………………………………………… 20…………………………………………………………………………………………… 21……………………………………………22…………………………………………… 23……………………………………………24…………………………………………… 25……………………………………………26…………………………………………… 27……………………………………………28…………………………………………… 29……………………………………………30…………………………………………… 31……………………………………………32…………………………………………… 33……………………………………………34…………………………………………… 35……………………………………………36…………………………………………… 37……………………………………………38…………………………………………… 39……………………………………………40…………………………………………… For each of the medicines that you have listed in your "top ten", please fill in the questions on one of the following ten sheets. If you have listed more than ten, more sheets will be provided later. Additional Questions Are there a number of medicines to which you have either a very strong or fairly strong relationship, but never directly observed any therapeutic effectiveness? Yes No If "Yes", can you give ten or more examples and the indications for which you prescribed them? Medicine Indication Effect expected 1…………………………………... …………………………………….. Yes/No 2..…………………………………. …………………………………….. Yes/No 3…………………………………... …………………………………….. Yes/No 4..…………………………………. …………………………………….. Yes/No 5…………………………………... …………………………………….. Yes/No 6..………………………………..... …………………………………….. Yes/No 7………………………………..…. …………………………………….. Yes/No 8..……………………………..…... …………………………………….. Yes/No 9…………………………………... …………………………………….. Yes/No 10..………………………………... …………………………………….. Yes/No 11…………………………………. …………………………………….. Yes/No 12.……………………………….... …………………………………….. Yes/No 13..………………………………... …………………………………….. Yes/No 14…………………………………. …………………………………….. Yes/No 15.……………………………….... …………………………………….. Yes/No 16..………………………………... …………………………………….. Yes/No 17…………………………………. …………………………………….. Yes/No 18.……………………………….... …………………………………….. Yes/No 19..………………………………... …………………………………….. Yes/No 20…………………………………. …………………………………….. Yes/No Would you have expected to see an effect with these indications? Please delete accordingly. Have you found any surprising new indications for any medicines? Yes No If "Yes", can you give examples? ……………………………………………………………………………………………………………………… ……………………………………………………………………………………………………………………… ……………………………………………… Have you looked for any difference in efficacy between a substance given as a standard Weleda preparation, an Rh. preparation or as Wala preparation? Yes No Have you observed any difference in efficacy? Yes No If "Yes", can you give examples and details? ……………………………………………………………………………………………………………………… ……………………………………………………………………………………………………………………… ……………………………………………………………………………………………………… The follows questions were to be answered for each of the top 10 or more medicines listed on pp 2 & 3. Name of Medicine:……………………………………………………………….…………………..………. Most frequently used potency(ies) or strength(s)……………………………………………………………… Main pharmaceutical form prescribed, (i.e., dilution, trituration, tablets, pillules, ampoules, essence, ointment, gel) ……………………………………………………………………………………………….. Please give the indication or indications for which you find this medicine most definitely efficacious. (You may wish to answer this question in anthroposophical terms, or purely as a symptomatic indication, in terms of physicals signs, and allopathic illness diagnosis, a homoeopathic drug picture or homoeopathic characteristic symptom). ……………………………………………………………………………………………………………………… ……………………………………………………………………………………………………………………… ……………………………………………………………………………………………………… Please give an indication of your degree of certainty of the efficacy of this is medicine. Absolutely certain 5 Very certain. Very probable. Probable. 4 3 2 I think efficacious but uncertain. 1 For Office Use only. Can you give me some indication of the number of patients for whom you have used this medicine? 1-3 4-10 11-30 31-100 101-300 over 300 Can you give me some indication of the number of patients for whom you have experienced this medicine to be efficacious? 1-3 4-10 11-30 31-100 101-300 over 300 Please give an indication of how dramatic its efficacy was in the most successfully treated cases. Very dramatic Dramatic Fairly Striking Moderate Slight Roughly what percentage of cases treated responded to this degree? …….% Can you give some indication on generally what was the basis on which you formed your judgment? Please tick one of the boxes which has been the most important basis of observation. Patient's reported symptomatic improvement. Doctor's direct observation. Some kind of external measurement. Indirect signs such as temperature reaction or other reactions Suggested by Steiner, e.g., buzzing in the ears. Other, (please note) Have you encountered any "side effects" with this medicine? Yes No If "Yes", please describe and say whether you consider these therapeutically desirable or undesirable ………………………………………………………….…………………………………………………………… …………………………………………………………………………………….………………………………… ……………………………………………………………………………….……………………… Have you observed any changes in the efficacy of this medicine over the years? Yes No If "Yes", please give details…………………………………………………………………………………… Can you give me an indication of the strength of your inner relationship to this medicine? (Note: The following is a suggested guide to indicate the spectrum of possibilities. If one has read some of Rudolf Steiner's descriptions of the substance and has trade one's own phenomenological study of the substance itself and has spent some time living or meditating on it, I think this could qualify as a very strong relationship. At the other pole, if you have just prescribed it on the basis of its listing in a medicines list and possibly have no idea of what the substance is in nature, I think this could be described as superficial. Perhaps if one has a traditional herbal or homeopathic picture of the medicine, without a phenomenological or anthroposophical picture, this could qualify as a more than superficial relationship to the medicine, and if one has at least made a beginning to take this relationship further, phenomenologically and/or anthroposophically, this might qualify as a fairly strong relationship to the medicine.) Very strong. Fairly strong. More than superficial. Superficial. Have you prescribed this medicine for indications other than the ones you have listed and not experienced it to be clearly efficacious? Yes No If "Yes", please state these indications ……………………………………………………………………………………………………………………… ……………………………………………………………………………………………………………………… ……………………………………………………………………………………………………………………… ……………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………