Alternative medicine: Should it be used by children?

Spigelblatt, Linda

doi:10.1016/s0045-9380(06)80032-0

Cited by 35 publications

(22 citation statements)

References 40 publications

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“…39,40 Furthermore, there are no mandatory quality standards for many CAM products, 14 and a number of such products can be harmful when taken by children. 4,41,42 Interactions between CAM products and prescription drugs exist and can have serious clinical consequences, [43][44][45] and this issue has not been examined formally in pediatrics. 46,47 Some of the products that parents reported their children were taking have the potential to produce adverse effects, and excess use of any vitamin supplements can produce toxicity.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of Pediatric and Adolescent Patients Attending a Naturopathic College Clinic in Canada

Wilson¹,

Busse

Gilchrist

et al. 2005

Pediatrics

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ABSTRACT. Objectives. The use of complementary and alternative medicine (CAM) has grown substantially in North America and has drawn the attention of conventional-medicine practitioners. Conventional-medicine practitioners have expressed concern about the potential for unregulated CAM therapies to cause harm, the sometimes-uncertain cost-benefit ratios associated with these therapies, and the possibility that some CAM providers might advise against established conventional therapies, such as vaccination. These concerns are heightened with respect to the pediatric use of CAM products. To address this issue, we conducted a systematic audit of pediatric and adolescent case files at a large, college-based, Canadian naturopathic teaching clinic. We specifically sought to describe the demographic characteristics, reasons for presentation, use of CAM products, and vaccinations status of children presenting for naturopathic assessment. We also determined factors associated with the use of CAM products and vaccination status.Methods. We identified all charts for children (<18 years of age) who presented to the Robert Schad Naturopathic Clinic, the teaching clinic of the Canadian College of Naturopathic Medicine, between February 1 and May 31, 2002. Data were abstracted directly from the standardized patient intake forms and from clinical notes recorded during the patient's initial visit to the clinic. The following data were obtained: age, gender, chief presenting complaints reported by parents, CAM product use at presentation, vaccination status, and reactions to vaccination. We conducted logistic regression analyses to identify factors associated with both CAM product use and vaccination status.Results. A total of 482 charts were identified. The mean age of patients was 6.5 years (95% confidence interval [CI]: 1.6 -11.4 years). The ratio of female subjects to male subjects was 1.09:1 (248:227). The most common reasons for presentation were skin disorders (23%), gastrointestinal complaints (17%), and psychiatric/behavioral disorders (15%). Thirty-five percent of children were using CAM products at presentation (21.2% when both vitamins and minerals were excluded). Vitamins were the most commonly used products (34.6%), followed by herbal remedies (14.9%), oil blends/fats (7.2%), minerals (5.6%), probiotics (4.5%), and homeopathic remedies (3.7%). Of charts with vaccination information, 8.9% indicated that children had not been vaccinated; possible vaccine-associated adverse events were reported for 27% of those who had been vaccinated.

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Section: Discussionmentioning

confidence: 99%

Characteristics of Pediatric and Adolescent Patients Attending a Naturopathic College Clinic in Canada

Wilson¹,

Busse

Gilchrist

et al. 2005

Pediatrics

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“…For the purpose of this study, we developed this definition of CAM, based on previous reports (7,9,12): CAM is any supplement, therapy, or remedy used by a patient that has not been prescribed by the patient's rheumatologist, other physician, or registered dietitian, excluding once-a-day multivitamins and meal-replacement products, and including the act of consulting with an alternative health care practitioner (e.g., naturopath, homeopath, or chiropractor). It is important to note that although we excluded multivitamins, we did indeed consider self prescribed single vitamins and/or minerals as CAM.…”

Section: Methodsmentioning

confidence: 99%

“…A convenience sample of 5 patients and their families were asked to pilot the survey for readability and ease of administration. To ensure adequate content validity, we followed 3 steps: 1) a review of the literature, 2) a review of other tools used (7,9), and 3) a detailed review of survey questions by an experienced chiropractor.…”

Section: Methodsmentioning

confidence: 99%

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Use of complementary and alternative medicine by pediatric rheumatology patients

Hagen

Schneider

Stephens

et al. 2003

Arthritis & Rheumatism

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Objective. To assess how often the patients in The Hospital for Sick Children's rheumatology clinic use complementary and alternative medicine (CAM), and the type of CAM used. Methods. Cross-sectional descriptive survey study in a tertiary care referral center. Results. We found that 90 (64%) of 141 respondents used at least 1 form of CAM; 45 (50%) of these 90 used more than 1 form. Duration of illness was positively associated with the use of CAM; the difference in the mean length of illness between users (4.12 ؎ 3.60 years) and nonusers (2.82 ؎ 3.23 years) was 1.3 years (P ‫؍‬ 0.04). Of the 41 respondents with more than 1 illness, 32 used CAM, compared with 57 of 96 who had only 1 illness (P ‫؍‬ 0.036). Conclusion. Health care providers must be aware of their patients' possible use of CAM, especially those with more than 1 illness.

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“…One of the authors (Dr Harrison) has worked with team members who disagree about whether to call child protection services regarding children who are obese and whose parents resist advice about diet and exercise, children with asthma whose parents continue against medical advice to smoke in their presence, and children for whom parental treatment decisions do not place them at risk of harm now but may result in significant harm for them as adults. Health care providers are encouraged to maintain good relationships with parents because it encourages disclosure and discussion of CAM use, 27 allows ongoing monitoring of the child, 28 increases levels of trust, 29 and avoids causing the child distress when he or she perceives conflict between parents and clinicians. 30 With regard to the involvement of the child in decision-making, it is commonly understood that children's decisions should have increasingly more weight as they mature.…”

Section: Ethical Principlesmentioning

confidence: 99%

Pediatric Use of Complementary and Alternative Medicine: Legal, Ethical, and Clinical Issues in Decision-Making

et al. 2011

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In this article we introduce a series of 8 case scenarios and commentaries and explore the complex legal, ethical, and clinical concerns that arise when pediatric patients and their parents or health care providers use or are interested in using complementary and alternative medicine (CAM). People around the world rely on CAM, so similar issues face clinicians in many countries. In law, few cases have dealt with CAM use. The few that have apply the same general legal principles used in cases that involved conventional care while taking into account considerations unique to CAM. In ethics, as with conventional care, the issues surrounding pediatric CAM use usually involve questions about who the appropriate decision-makers are, on what ethical principles should clinical decision-making rely, and what obligations arise on the part of physicians and other health care providers. Clinical decision-making is made more complex by the relatively limited research on the efficacy and safety of CAM compared with conventional medicine, especially in children, which requires clinicians to make decisions under conditions of uncertainty. The clinical scenarios presented focus on patients who represent a range of ages, clinical conditions, and settings. They act as anchors to explore particular CAM policy issues and illustrate the application of and shortcomings in existing guidance and intervention principles. Although the focus on a pediatric population adds another layer of complexity to the analysis, many of the concepts, issues, principles, and recommendations also apply to adults.

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Alternative medicine: Should it be used by children?

Cited by 35 publications

References 40 publications

Characteristics of Pediatric and Adolescent Patients Attending a Naturopathic College Clinic in Canada

Characteristics of Pediatric and Adolescent Patients Attending a Naturopathic College Clinic in Canada

Use of complementary and alternative medicine by pediatric rheumatology patients

Pediatric Use of Complementary and Alternative Medicine: Legal, Ethical, and Clinical Issues in Decision-Making

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