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Use of Complementary and Alternative Medical Therapies in a Pediatric Neurology Clinic

Published online by Cambridge University Press:  02 December 2014

Isaac Soo ,
Jean K. Mah ,
Karen Barlow ,
Lorie Hamiwka  and
Elaine Wirrell
Isaac Soo
Affiliation:
Faculty of Medicine, University of Alberta, Edmonton, AB, Canada
Jean K. Mah*
Affiliation:
Division of Pediatric Neurology, Department of Pediatrics, Faculty of Medicine, University of Calgary, Calgary, AB, Canada
Karen Barlow
Affiliation:
Division of Pediatric Neurology, Department of Pediatrics, Faculty of Medicine, University of Calgary, Calgary, AB, Canada
Lorie Hamiwka
Affiliation:
Division of Pediatric Neurology, Department of Pediatrics, Faculty of Medicine, University of Calgary, Calgary, AB, Canada
Elaine Wirrell
Affiliation:
Division of Pediatric Neurology, Department of Pediatrics, Faculty of Medicine, University of Calgary, Calgary, AB, Canada
*
Alberta Children’s Hospital, 1820 Richmond Road SW, Calgary, Alberta, Canada T2T 5C7
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Abstract:

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Background:

Complementary and alternative medicine (CAM) is increasingly used in adults and children. Studies on CAM in neurological disorders have focused on the adult population and its use among pediatric neurology patients has not been well characterized.

Objectives:

The purpose of this study was: 1) To characterize the prevalence of CAM in pediatric neurology patients; 2) To determine the perceived effectiveness of CAM in these children; 3) To compare the cost of CAM with conventional therapies; and 4) To describe caregiver or patient-related variables associated with the use of CAM.

Methods:

This was a cross-sectional survey of patients and families attending the Alberta Children's Hospital neurology clinic between February and May 2004. Patients were considered eligible if they were between two and 18 years of age and had a known history of neurological disorders. Caregivers completed several self-administered questionnaires regarding their socio-demographic profile, their child's neurological illness, and their experience with CAM. Caregivers also rated their child's quality of life using the Pediatric Quality of Life Inventory.

Results:

One hundred and five of 228 (46%) families completed the survey. The mean age of the neurology patients was 9.8 ± 4.5 years. Forty-six (44%) out of 105 patients received one or more types of CAM, with the most common types being chiropractic manipulations (15%), dietary therapy (12%), herbal remedies (8%), homeopathy (8%), and prayer/faith healing (8%). Caregivers' sociodemographic variables or pediatric health-related quality of life were not significantly associated with the use of CAM. Fifty-nine percent of CAM users reported benefits, and only one patient experienced side effects. There was no significant difference in the total median cost of CAM compared to conventional therapies ($31.70 vs. $50.00 per month). Caregivers' personal experience or success stories from friends and media were common reasons for trying CAM.

Conclusions:

The use of CAM was common among pediatric neurology patients. Over half of the families reported benefits with CAM, and side effects were perceived to be few. Physicians should initiate discussion on CAM during clinic visits so that the families and patients can make informed decisions about using CAM. Further studies should address the specific role of CAM in children with neurological disorders, and to determine the potential interactions between CAM and conventional therapies in these patients.

Résumé:

RÉSUMÉ: Contexte:

La médecine complémentaire et alternative (MCA) est de plus en plus utilisée chez les adultes et chez les enfants. Il existe des études sur l’utilisation de la MCA pour traiter les maladies neurologiques chez l’adulte, mais son utilisation chez l’enfant a été peu étudiée. Objectifs: Les buts de cette étude étaient : 1) de caractériser la prévalence de l’utilisation de la MCA chez les patients pédiatriques atteints de maladies neurologiques; 2) d’en déterminer l’efficacité ressentie par les patients; 3) d’en comparer le coût à celui des traitements conventionnels; 4) de décrire les caractéristiques du soignant et du patient qui ont recours à la MCA.

Méthodes:

Il s’agit d’une étude transversale de patients et de familles suivis à la clinique de neurologie de l’Alberta Children’s Hospital entre février et mai 2004. Pour être éligibles à l’étude, les patients devaient être âgés de 2 à 18 ans et être atteints d’une maladie neurologique. Ils devaient compléter eux-mêmes plusieurs questionnaires concernant leur profil sociodémographique, la maladie neurologique de leur enfant et leur expérience de la MCA. Les soignants devaient également évaluer la qualité de vie de leur enfant au moyen de l’Inventaire systémique de qualité de vie, version pédiatrique.

Résultats:

Cent cinq des 228 familles (46%) ont retourné le questionnaire complété. L’âge moyen des patients était de 9,8 ± 4,5 ans. Quarante-six (44%) des 105 patients avaient reçu un ou plusieurs types de MCA, les plus fréquents étant des manipulations chiropractiques (15%), un traitement diététique (12%), des herbes médicinales (8%), un traitement homéopathique et des pratiques de guérison par la prière et par la foi (8%). Les variables sociodémographiques des soignants ou la qualité de vie liée à la santé chez l’enfant n’étaient pas associées de façon significative à l’utilisation de la MCA. Cinquante-neuf pour cent des utilisateurs de la MCA ont rapporté qu’ils en avaient tiré des bénéfices et seulement un patient a eu des effets secondaires. Il n’existait pas de différence significative quant au coût médian total de la MCA par rapport aux traitements conventionnels ($31,70 contre $50,00 par mois). Les raisons principales motivant l’utilisation de la MCA étaient l’expérience personnelle des soignants, des témoignages d’amis ou des publications dans les médias faisant état du succès de ces thérapies.

Conclusions:

L’utilisation de la MCA était fréquente chez les patients pédiatriques atteints de maladies neurologiques. Plus de la moitié des familles ont rapporté des bénéfices de l’utilisation de la MCA. Ces thérapies étaient perçues comme ayant peu d’effets secondaires. Les médecins devraient aborder ce sujet pendant les visites afin que les familles et les patients puissent prendre des décisions éclairées. Le rôle spécifique de la MCA chez les enfants atteints de maladies neurologiques ainsi que les interactions possibles entre la MCA et les thérapies conventionnelles chez ces patients devraient faire l’objet d’études plus poussées.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 32 , Issue 4 , November 2005 , pp. 524 - 528
Copyright
Copyright © The Canadian Journal of Neurological 2005

References

1. Panel of Definition and Description, CAM Research MethodologyConference, April 1995. Defining and describing complementary and alternative medicine. Altern Ther Health Med 1997;8:29–40.Google Scholar
2. Eisenberg, DM, Davis, RB, Ettner, SL, et al. Trends in alternativemedicine use in the United States, 1990-1997: results of a follow-up national survey. JAMA 1998;280:1569–1575.Google Scholar
3. Spigelblatt, L, Laine-Ammara, G, Pless, IB, Guyver, A. The use ofalternative medicine by children. Pediatrics 1994;94:811–814.Google Scholar
4. Jensen, P. Use of alternative medicine by patients with atopicdermatitis and psoriasis. Acta Derm Venereol 1990;70:421–424.CrossRefGoogle Scholar
5. Angsten, JM. Use of complementary and alternative medicine in thetreatment of asthma. Adolesc Med 2000;11:535–546.Google Scholar
6. Sawyer, MG, Gannoni, AF, Toogood, IR, Antoniou, G, Rice, M. Theuse of alternative therapies by children with cancer. Med J Aust 1994;160:320–322.Google Scholar
7. Southwood, TR, Malleson, PN, Roberts-Thompson, PJ, Mahy, M. Unconventional remedies used for patients with juvenile arthritis. Pediatrics 1990;85:150–154.Google Scholar
8. Varni, JW, Seid, M, Rode, CA. The PedsQL: measurement model forthe pediatric quality of life inventory. Med Care. 1999;37:126–139.Google Scholar
9. Varni, JW, Seid, M, Kurtin, PS. The PedsQL 4.0: reliability andvalidity of the Pediatric Quality of Life Inventory version 4.0 generic core scales in healthy and patient populations. Med Care 2001;39:800–12.Google Scholar
10. Tataryn, DJ. Paradigms of health and disease: A framework forclassifying and understanding complementary and alternativemedicine. J Altern Complement Med 2002;8:877–92.CrossRefGoogle Scholar
11. Ernst, E. Prevalence of complementary for children: a systematicreview. Eur J Pediatr 1999;158:7–11.CrossRefGoogle Scholar
12. Verhoef, MJ, Russell, ML, Love, EJ. Alternative medicine use in ruralAlberta. Can J Public Health 1994;85:308–309.Google Scholar
13. Pucci, E, Cartechini, E, Taus, C, Giulini, G. Why physicians need totake a look more closely at the use of complementary and alternative medicine by multiple sclerosis patients. Eur J Neurol 2004,11:263–267.Google Scholar
14. Sommer, J, Burgi, M, Theiss, R. Inclusion of complementarymedicine increases health costs. Comp Ther Med 1999;7:54–61.Google Scholar
15. Melchart, D, Linde, K, Fischer, P, et al. Acupuncture for recurrentheadaches: a systematic review of randomized controlled trials. Cephalagia 1999;19:779–786.Google Scholar
16. Schoenen, J, Jacquy, J, Lenaerts, M. Effectiveness of high-doseriboflavin in migraine prophylaxis. A randomized controlled trial. Neurology 1998;50:466–470.CrossRefGoogle ScholarPubMed
17. Sandor, PS, Di Clemente, L, Coppola, G, et al. Efficacy of coenzymeQ10 in migraine prophylaxis: a randomized controlled trial. Neurology 2005;64:713–715.CrossRefGoogle Scholar
18. Astin, JA, Ernst, E. The effectiveness of spinal manipulation for thetreatment of headache disorders: a systematic review of randomized clinical trials. Cephalalgia 2002;22:617–623.Google Scholar
19. Tyagi, A, Delanty, N. Herbal remedies, dietary supplements, andseizures. Epilepsia 2003;44:228–235.Google Scholar
20. Kloster, R, Larsson, PG, Lossius, R, et al. The effect of acupuncturein chronic intractable epilepsy. Seizure 1999;8:170–174.CrossRefGoogle Scholar
21. Moher, D, Soeken, K, Sampson, M, Ben-Porat, L, Berman, B. Assessing the quality of reports of systematic reviews in pediatric complementary and alternative medicine. BMC Pediatrics 2002;2:3.Google Scholar
22. Lefevre, F and Aronson, N. Ketogenic diet for the treatment ofrefractory epilepsy in children: a systematic review of efficacy. Pediatrics 2000;105:e46.Google Scholar
23. Freeman, JM, Vining, EPG, Pillas, DJ, et al. The efficacy of theKetogenic Diet-1998: a prospective evaluation of intervention in 150 children. Pediatrics 1998;102:1358–1363.Google Scholar
24. Kroner-Herwig, B, Mohn, U, Pothmann, R. Comparison of bio feed back and relaxation in the treatment of pediatric headache and the influence of parent involvement on outcome. Appl Psychophysiol Biofeedback 1998;23:143–157.Google Scholar
25. Powers, SW, Mitchell, MJ, Byars, KC, et al. A pilot study of one-session biofeedback training in pediatric headache. Neurology 2001;56:133.Google Scholar
26. Engel, JM. Relaxation training: a self-help approach for childrenwith headaches. Am J Occup Ther 1992;46:591–596.Google Scholar
27. Pintov, S, Lahat, E, Alstein, M, Vogel, Z, Barg, J. Acupuncture and theopioid system: implications in the management of migraine. Pediatr Neurol 1997;17:129–133.Google Scholar
28. Wang, F, Van Den Eeden, SK, Ackerson, LM, et al. Oral magnesiumoxide prophylaxis of frequent migrainous headache in children: a randomized, double blind, placebo-controlled trial. Headache 2003;43:601–610.Google Scholar
29. Dursan, E, Dursun, N, Alican Duygu. Effects of biofeedbacktreatment on gait in children with cerebral palsy. Disabil and Rehabil 2004; 26:116–120.CrossRefGoogle Scholar
30. Sun, JF, Ko, CH, Wong, V, Sun, XR. Randomized control trial oftongue acupuncture versus sham acupuncture in improving functional outcome in cerebral palsy. J Neuro Neurosurg Psychiatry 2004;75:1054–1057.CrossRefGoogle ScholarPubMed
31. Cuzzolin, L, Zaffani, S, Murgia, V, et al. Patterns and perceptions ofcomplementary/alternative medicine among paediatricians and patients' mothers: a review of the literature. Eur J Pediatr 2003;162:820–827.Google Scholar
32. Niggemann, B, Gruber, C. Side-effects of complementary andalternative medicine. Allergy 2003:58:707–716.Google Scholar
33. Tomassoni, A, Simone, K. Herbal medicines for children: an illusionof safety? Curr Opin Pediatr 2001;13:162–169.Google Scholar
34. Furnham, A, Forey, J. The attitudes, behaviors and beliefs of patientsof conventional vs. complementary (alternative) medicine. J Clin Psychol 1994;50:458–469.Google Scholar
35. Sibinga, EM, Ottolini, MC, Duggan, AK, Wilson, MH. Patient-pediatrician communication about complementary and alternative medicine use for children. Clin Pediatr 2004;43:367–373.Google Scholar
36. American Academy of Pediatrics Committee on Children withDisabilities. Counseling families who choose complementary and alternative medicine for their child with chronic illness ordisability. Pediatrics 2001;103:598–601.Google Scholar
37. Kelsey, JL, Whittemore, AS, Evans, AS, Thompson, WD. Measurement I: questionnaires. In: Kelsey, JL, Evans, AS, Thompson, WD (Eds). Methods in Observational Epidemiology. New York: Oxford University Press, 1996:364–390.Google Scholar