Complementary and Alternative Medicine in Pediatric Rheumatology.

摘要

Background. Complementary and alternative medicine (CAM) is defined as a group of diverse medical health care systems and practices, including natural products, mind-body medicine, manipulative body-based practices, practices of energy therapy, and whole medicinal systems. Studies suggest that CAM therapy in the adult population has increased in recent decades. Information about the extent of CAM usage among children and adolescents with chronic rheumatologic disorders, although anecdotally suspected, is not routinely collected. Objective. The purpose of this exploratory study was to solicit information on CAM usage from parents seeking care for their children in a pediatric rheumatology sub-specialty clinic. Methods. A previously field-tested survey of CAM usage was adapted for the pediatric rheumatology clinic population. The survey consisted of general demographic questions and specific questions on CAM use. Parents or caregivers of patients followed in the Pediatric Rheumatology Division at an academic medical center were invited to complete the survey during the recruiting period, which extended from June to October 2010. Results. 202 of 203 parents invited to participate in the survey completed it with the majority being mothers (88%) and Caucasian (91%) with a mean age of 42 years. Their children were predominantly female (67%) with a mean age 12.8 years. 63% of patients had juvenile idiopathic arthritis, although children with several other chronic conditions were also included. Overall, 50% of patients were CAM users. Of the CAM modalities, 69% of patients reported use of high-dose vitamin, mineral, or supplements. Of the CAM users, 42% had a parent or immediate family member with a history of CAM use, compared with 15% of non-CAM users. 80% of CAM users had a parent with some degree of college education, compared with 67% of non-users. Multivariate logistic regression revealed an adjusted OR of 3.8 (CI 1.8-8.1, p0.001) for CAM use if a family member had used CAM. Conclusions. CAM use was common among patients followed in a pediatric rheumatology clinic (50%). Family use of CAM was strongly associated with patient CAM use. Very little is known about the benefits or potential harms of CAM despite its widespread use. It is important for physicians to understand factors that influence decisions to use CAM in children and what benefits parents seek with CAM use.