Has time come for a re-assessment of spa therapy? The NAIADE survey in Italy
- 221 Downloads
Goal of this study was to investigate whether appropriately applied spa therapy in several indications could be associated with a subsequent fall in the need for costly health services and missed working days due to sick-leave. The Naiade project was a multicenter observational, longitudinal, questionnaire-based study comparing an “entry” inquiry addressed to patients before an entry thermal cycle, and a “return” inquiry after 1 year. Routine statistical methods were used for comparisons. The study was carried out in 297 of the 340 certified Italian spa centers. Inquiries were managed by the spa doctor(s), with the collaboration of family doctors, and when necessary, hospitals, other health services, labour offices and employers. After exclusion of regular customers and of patients with acute disease phases or severe health conditions, 39,943 patients divided into eight diseases subgroups (rheumatic, respiratory, dermatologic, gynaecologic, otorhynologic, urinary, vascular and gastroenteric) underwent entry inquiry and appropriate spa treatment. Patients who returned for treatment after 1 year (“index year”) were 23,680 (59.2%) and received return inquiry. Outcomes considered were: frequency and duration of hospitalisation periods; missed working days; regular use of disease-specific drugs; and resort to “non-spa” rehabilitation therapies. The data collected at return inquiry were compared with those of entry inquiry. All the considered outcomes appeared to be significantly reduced in the index year in seven of the eight disease subgroups in comparison with the previous year. In conclusion, disease-appropriate spa treatments were followed by a reduction in the need of subsequent health interventions in most disease subgroups. The health promoting value of spa treatments should therefore undergo more rigorous assessment with randomised controlled studies.
KeywordsSpa treatments Health resources Hospital admissions Sick-leave Drug consumption
The Naiade project collaborative group also included: A. Abramo, E. Altobelli, M. Anti, G. Busellu, A.O. Carlesimo, A. D’Alessandro, V. Danesino, S. De Luca, E. Ercoli, A. Fioravanti, R. Marcolongo, T. Marullo, F. Masedu, R. Melillo.
- Coccheri S, Nappi G, Valenti M, Di Orio F, Altobelli E, De Luca S; on behalf of the Naiade study project (2002) Changes in the use of health resources by patients with chronic phlebopathies after thermal hydrotherapy. Report from the Naiade project, a nation-wide survey on thermal therapies in Italy. Int Angiol 21:196–200PubMedGoogle Scholar
- Coiro V, Irali L, Saccani Jotti G, Varacca G, Danesino V (2003) The therapy of gynaecological diseases with salty mineral water: a branch of the “Naiade project”. Ital J Gynecol Obstet 15:88–94Google Scholar
- De Luca S, Nappi G, Menconi Orsini A (2001) “Project Naiade”: lithiasic pathology of urinary tracts and water therapy with oligomineral waters. Med Clin Term 47:197–206Google Scholar
- Melillo G, Nappi G, Valenti M (2002) Thermal inhalation treatment of chronic lower airway diseases. Results of the NAIADE project. Ital Rev Resp Dis 17:37–42Google Scholar
- Ministero del Tesoro, del Bilancio e della Programmazione Economica. Relazione Generale sulla situazione economica del Paese, anno 1998 (Rapporto sanità 1998) (1999) Roma, Istituto Poligrafico dello StatoGoogle Scholar
- Rossi A, Cantisani C, Carlesimo M, Calvieri S (2003) Terme e cute. G Ital Dermatol Venereol 138:519–524Google Scholar
- SAS Institute (1996) SAS/STAT Software: release 6.11, Cary NC: SAS InstituteGoogle Scholar
- van Tubergen A, Landewe R, van der Heijde D, Hidding A, Wolter N, Asscher M, Falkenbach A, Genth E, The HG, van der Linden S (2001) Combined spa-exercise therapy is effective in patients with ankylosing spondylitis: a randomized controlled trial. Arthritis Rheum 45:430–438PubMedCrossRefGoogle Scholar
- Verhagen AP, De Vet HC, De Bie RA, Kessels AG, Knipshild PG (2003) Balneotherapy for rheumatoid arthritis and ostheoarthritis. Cochrane Database Syst Rev (4):CD000518Google Scholar