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

Abstract

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.

Preventive Screening of Women Who Use Complementary and Alternative Medicine Providers

“…Following HEDIS guidelines, we computed a dichotomous Chlamydia screening outcome for each sexually active woman aged [16][17][18][19][20][21][22][23][24][25] …”

“…A study based on the 1996 U.S. Medical Expenditure Panel Survey found about 85% of U.S. users of provider-based CAM to have used conventional physicians as well, with only 15% using CAM providers exclusively. 17 Although much has been written about associations between CAM use and preventive care of children (in particular, pediatric vaccination), [18][19][20][21][22][23][24][25] considerably less is known about associations between CAM and adult preventive care. Reported results for adults have varied, depending on the sample used and the types of CAM and preventive care considered.…”

The effect of social determinants on immunization programs

“…Their popularity is due, at least in part, to the belief that conventional medicine, including vaccine administration, is associated with greater risk than benefit. 89 Thus, certain CAM practitioners advise patients against immunizations 89,90 and several studies demonstrated lower vaccination rates among CAM pediatric patients, [90][91][92] with higher rate of vaccine-preventable diseases. 92 In addition to the belief that vaccines are associated with greater risk than harm, a strong philosophical reasoning plays a significant role in the choices made by certain CAM patients.…”

Complementary and Alternative Medicine Use Among Chronically Ill Adolescents from 2 German Birth Cohorts

“…A Japanese study stated that CAM use among children with food allergies is very high, but comparability with European studies is limited [24]. Another study conducted in an Israeli CAM clinic found that allergy problems were the most mentioned reason for using CAM [25], and Canadian children reported allergies among the most reported reasons for visiting a naturopathic college clinic [26]. …”