engleski

Complementary and alternative medicine in pediatric rheumatology patients – a single centre study

Introduction: Rheumatic diseases are one of the most common chronic diseases in childhood. Although novel therapies are emerging, there is still a significant number of patients not reaching remission easily. That is why many parents/legal guardians turn to complementary and alternative medicine (CAM), usually not revealing it to their physicians. Even though valid tools for assessing CAM use exist, such as questionnaires, they are not routinely used probably due to their relative complexity. Objectives: To assess the prevalence and patterns of CAM use and variables associated with it in children with chronic rheumatic diseases in a single center pediatric rheumatology clinic. Methods: We conducted the cross-sectional study from April to May 2017 at the Department of Clinical Immunology and Rheumatology, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia, on the consecutive sample of parents/legal guardians of the children diagnosed with chronic rheumatic diseases. The outcome was the self-reported frequency of CAM use. For the purposes of our study, we developed an anonymous questionnaire to answer our study questions and written informed consent was obtained from all the parents/legal guardians prior to enrollment in the study. Results: Out of the 100 children whose parents/legal guardians were interviewed, 67 (67%) had juvenile idiopathic arthritis (JIA) while other diagnosis included systemic lupus erythematosus, juvenile scleroderma, juvenile dermatomyositis, etc. 63 (63% ; CI 95% 54% −73%) of parents/legal guardians have used CAM in the treatment of their child. Out of those, 43/63 parents/legal guardians (68, 25%) did not inform any medical staff about it. The majority of them, 55/63 (87% ; CI 95% 77%−94%) used it concomitantly to their standard therapy and 40/63 (64% ; CI 95% 50%−75%) declared their intent to use it in the future as well. Only 6/63 (10% ; CI 95% 4%−20%) were sure they would no longer use it. Out of the listed CAM groups, the most commonly used were herbal remedies (30.49%) along with orthomolecular therapy (25%) such as vitamins, minerals, immune boosting products and probiotics. Statistical analyses of collected data showed that a significantly higher frequency of CAM use was associated with parents/legal guardians with lower monthly income (OR 9.66 ; p<0.05), acquaintances who use CAM (OR 4.58 ; p<0.05) and certain types of disease (JIA-polyarticular type ; OR 5.40 ; p<0.05 ; JIA-oligoarticular type ; OR 4.30 ; p<0.05). Parents/legal guardians from medical professions have used CAM less often than those from non-medical professions (OR 0.27 ; p<0.05). Conclusion: Our study showed that the frequency of CAM use is associated with the nature of the parent/legal guardian’s profession, their monthly income, acquaintances who use CAM and their child’s diagnosis. CAM was concomitantly used to the standard therapy and medical staff was not informed about it (87% ; 68.25%, respectively). Due to rarely documented CAM side-effects and the possible interferences between CAM and standard therapy, it is essential for pediatric rheumatologists and other medical personnel to improve the communication with families in order to achieve optimum disease management outcomes. Therefore, more data on population characteristics and commonly used types of CAM, would allow medical staff to raise awareness of the benefits and consequences that such therapies offer.

CAM ; complementary medicine ; alternative medicine ; pediatric rheumatology

nije evidentirano