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Romero-García PA, Ramirez-Perez S, Miguel-González JJ, Guzmán-Silahua S, Castañeda-Moreno JA, Komninou S, Rodríguez-Lara SQ. Complementary and Alternative Medicine (CAM) Practices: A Narrative Review Elucidating the Impact on Healthcare Systems, Mechanisms and Paediatric Applications. Healthcare (Basel) 2024; 12:1547. [PMID: 39120250 PMCID: PMC11311728 DOI: 10.3390/healthcare12151547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 06/29/2024] [Accepted: 07/03/2024] [Indexed: 08/10/2024] Open
Abstract
While research on complementary and alternative medicine (CAM) for the general population is expanding, there remains a scarcity of studies investigating the efficacy and utilisation of CAM practices, specifically in the paediatric population. In accordance with the World Health Organization (WHO), the prevalence of the parental utilisation of CAM in their dependents is estimated to reach up to 80%. This literature review identified broad, heterogeneous, and inconclusive evidence regarding CAM's applications and effectiveness, primarily attributed to variance in sociodemographic factors and differences in national healthcare systems. Additionally, the review identified a lack of consensus and polarised positions among mainstream professionals regarding the mechanisms of action, applications, and effectiveness of CAM. This narrative review presents varied results concerning the efficacy of most CAM therapies and their applications; however, some evidence suggests potential benefits for acupuncture, yoga, tai chi, and massage in improving physical and mental health. Moreover, the available evidence indicates that meditation may enhance mental health, while reiki may only influence patients' perceptions of comfort. In light of the intricate and multifaceted nature of herbal medicine, it is imperative to assess its efficacy on a case-by-case basis, taking into account the specific compounds and procedures involved. This comprehensive review serves as a valuable resource for health professionals, offering guidance for personalised healthcare approaches that consider the values and beliefs of patients, thereby facilitating integrated, evidence-based practices aimed at enhancing the quality of healthcare services and patient satisfaction.
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Affiliation(s)
- Patricia Anaid Romero-García
- School of Medicine, Universidad Autónoma de Guadalajara, Zapopan 45129, Jalisco, Mexico; (S.R.-P.); (J.J.M.-G.); (S.G.-S.); (J.A.C.-M.)
| | - Sergio Ramirez-Perez
- School of Medicine, Universidad Autónoma de Guadalajara, Zapopan 45129, Jalisco, Mexico; (S.R.-P.); (J.J.M.-G.); (S.G.-S.); (J.A.C.-M.)
- Instituto de Investigación en Reumatología y del Sistema Músculo-Esquelético (IIRSME), CUCS, Universidad de Guadalajara, Guadalajara 44100, Jalisco, Mexico
| | - Jorge Javier Miguel-González
- School of Medicine, Universidad Autónoma de Guadalajara, Zapopan 45129, Jalisco, Mexico; (S.R.-P.); (J.J.M.-G.); (S.G.-S.); (J.A.C.-M.)
- Departamento de Investigación, Instituto Cardiovascular de Mínima Invasión (ICMI), Zapopan 45116, Jalisco, Mexico
| | - Sandra Guzmán-Silahua
- School of Medicine, Universidad Autónoma de Guadalajara, Zapopan 45129, Jalisco, Mexico; (S.R.-P.); (J.J.M.-G.); (S.G.-S.); (J.A.C.-M.)
- Unidad de Investigación Epidemiológica y en Servicios de Salud, CMNO OOAD Jalisco Instituto Mexicano del Seguro Social, Guadalajara 44160, Jalisco, Mexico
| | - Javier Adan Castañeda-Moreno
- School of Medicine, Universidad Autónoma de Guadalajara, Zapopan 45129, Jalisco, Mexico; (S.R.-P.); (J.J.M.-G.); (S.G.-S.); (J.A.C.-M.)
| | - Sophia Komninou
- Faculty of Health and Life Science, Swansea University, Swansea SA2 8PP, UK;
| | - Simón Quetzalcoatl Rodríguez-Lara
- School of Medicine, Universidad Autónoma de Guadalajara, Zapopan 45129, Jalisco, Mexico; (S.R.-P.); (J.J.M.-G.); (S.G.-S.); (J.A.C.-M.)
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Hensel A, Bauer R, Heinrich M, Hempel G, Kelber O, Kraft K, Lehmann B, Medà MM, Nieber K, Roether B, Rollinger JM, Wiebelitz R. Rationalising Optimal Dosing of Phytotherapeutics For Use In Children: Current Status - Potential Solutions - Actions Needed. PLANTA MEDICA 2024; 90:416-425. [PMID: 38527490 DOI: 10.1055/a-2294-5259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
"Children are not small adults with respect to the treatment with medicinal products." This statement of the WHO was the basis for the initiative of the European Commission for the establishment of a paediatric regulation in 2007 to improve the health of children by facilitating the development of medicines for children and adolescents. Seventeen years later, in the field of herbal medicinal products, results are still sobering. Therefore, the Foundation Plants for Health, Society for Medicinal Plants and Natural Products Research, and German Society for Phytotherapy organised a symposium to assess the status quo for the paediatric use of herbal medicinal products (HMPs), to analyse the causes of the current situation, and to discuss strategies for establishing the proof of safe and efficacious HMPs for children.The current situation for HMPs and their use in children is not fulfilling the requirements of legislation. HMPs in paediatrics are effective and safe, but considering the needs of children is necessary. In European countries, the use, registration, and marketing of HMPs are different, depending on the respective national regulations and specific traditions. EU herbal monographs are the best common denominator for such procedures. Emerging safety discussions must be considered. New approaches with real-world data might be a solution. The regulatory framework is to be adapted. Defining rationalised dosing for HMPs can be achieved by the extrapolation of data from adults, by using existing clinical data for children, and by using RWD. Therefore, a strong need for revising restrictions for the use of HMPs in children and rationalising defined dosage regimes is obvious.
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Affiliation(s)
- Andreas Hensel
- Institute of Pharmaceutical Biology and Phytochemistry, University of Münster, Germany
| | - Rudolf Bauer
- Institut für Pharmazeutische Wissenschaften, Pharmakognosie, Universitaet Graz, Austria
| | - Michael Heinrich
- School of Pharmacy, University College London, United Kingdom of Great Britain and Northern Ireland
| | - Georg Hempel
- Pharmaceutical and Medical Chenistry, University of Münster, Germany
| | - Olaf Kelber
- Research and Development, Bayer Consumer Health, Steigerwald Arzneimittelwerk GmbH, Darmstadt, Germany
| | - Karin Kraft
- Centre of Internal Medicine, University Medicine Rostock, Germany
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Nieber K, Raskopf E, Möller J, Kelber O, Fürst R, Shah-Hosseini K, Singh J, Kraft K, Mösgens R. Pharmaco-epidemiological research on herbal medicinal products in the paediatric population: data from the PhytoVIS study. Eur J Pediatr 2020; 179:507-512. [PMID: 31823076 PMCID: PMC7028796 DOI: 10.1007/s00431-019-03532-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 11/04/2019] [Accepted: 11/19/2019] [Indexed: 10/25/2022]
Abstract
In paediatrics, clinical study data are limited, especially on herbal medicinal products. To address this gap, 2063 datasets from the paediatric population were evaluated in the PhytoVIS data base. By screening for paediatric data, information on indication, gender, treatment, co-medication and tolerability were evaluated. The majority of patients was treated because of common cold, fever, digestive complaints, skin diseases, sleep disturbances and anxiety. The perceived effect of the therapy was rated in 84% of the patients as very good or good without adverse events. The data shed light on a still neglected field of phyto-pharmacotherapy by giving information on the use of herbal medicines in an unselected cohort of paediatric patients. The results confirm the good clinical effects and safety of herbal medicinal products in this patient population and show that they are widely used in Germany.What is Known:• In Germany, about 85% of children receive one or more herbal medicinal products per year.• Despite international initiatives to promote clinical research in paediatrics, there are still many gaps of knowledge in the use of drugs in paediatrics.What is New:• The PhytoVIS project evaluated 2063 data sets from the paediatric population using herbal medicinal products.• The majority of patients was treated because of common cold, fever, digestive complaints, skin diseases, sleep disturbances and anxiety, and 84% of the patients rated the therapy as very good or good without adverse events.
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Affiliation(s)
- Karen Nieber
- Institute of Pharmacy, University of Leipzig, Brüderstr. 34, 04103, Leipzig, Germany. .,Kooperation Phytopharmaka GbR, Plittersdorfer Str. 218, 53173, Bonn, Germany.
| | - Esther Raskopf
- grid.6190.e0000 0000 8580 3777Institute of Medical Statistics and Computational Biology, Faculty of Medicine, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany ,ClinNovis GmbH, Genter Str. 7, 50672 Cologne, Germany
| | - Johanna Möller
- Bayer Consumer Health, Research & Development, Phytomedicines Supply and Development Center, Steigerwald Arzneimittelwerk GmbH, Havelstr. 5, 64295 Darmstadt, Germany
| | - Olaf Kelber
- Kooperation Phytopharmaka GbR, Plittersdorfer Str. 218, 53173 Bonn, Germany ,ClinNovis GmbH, Genter Str. 7, 50672 Cologne, Germany
| | - Robert Fürst
- Kooperation Phytopharmaka GbR, Plittersdorfer Str. 218, 53173 Bonn, Germany ,grid.7839.50000 0004 1936 9721Institute of Pharmaceutical Biology, Goethe University Frankfurt, Max-von-Laue-Str. 9, 60438 Frankfurt, Germany
| | - Kija Shah-Hosseini
- Kooperation Phytopharmaka GbR, Plittersdorfer Str. 218, 53173 Bonn, Germany
| | - Jaswinder Singh
- grid.6190.e0000 0000 8580 3777Institute of Medical Statistics and Computational Biology, Faculty of Medicine, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany ,ClinNovis GmbH, Genter Str. 7, 50672 Cologne, Germany
| | - Karin Kraft
- Kooperation Phytopharmaka GbR, Plittersdorfer Str. 218, 53173 Bonn, Germany ,grid.10493.3f0000000121858338Chair of Naturopathy, University Medicine Rostock, Ernst-Heydemann Str. 6, 18057 Rostock, Germany
| | - Ralph Mösgens
- grid.6190.e0000 0000 8580 3777Institute of Medical Statistics and Computational Biology, Faculty of Medicine, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany ,ClinNovis GmbH, Genter Str. 7, 50672 Cologne, Germany
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Anheyer D, Frawley J, Koch AK, Lauche R, Langhorst J, Dobos G, Cramer H. Herbal Medicines for Gastrointestinal Disorders in Children and Adolescents: A Systematic Review. Pediatrics 2017; 139:peds.2017-0062. [PMID: 28562281 DOI: 10.1542/peds.2017-0062] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/22/2017] [Indexed: 11/24/2022] Open
Abstract
CONTEXT Gastrointestinal disorders are common childhood complaints. Particular types of complementary and alternative medicine, such as herbal medicine, are commonly used among children. Research information on efficacy, safety, or dosage forms is still lacking. OBJECTIVES To systematically summarize effectiveness and safety of different herbal treatment options for gastrointestinal disorders in children. DATA SOURCES Medline/PubMed, Scopus, and the Cochrane Library were searched through July 15, 2016. STUDY SELECTION Randomized controlled trials comparing herbal therapy with no treatment, placebo, or any pharmaceutical medication in children and adolescents (aged 0-18 years) with gastrointestinal disorders were eligible. DATA EXTRACTION Two authors extracted data on study design, patients, interventions, control interventions, results, adverse events, and risk of bias. RESULTS Fourteen trials with 1927 participants suffering from different acute and functional gastrointestinal disorders were included in this review. Promising evidence for effectiveness was found for Potentilla erecta, carob bean juice, and an herbal compound preparation including Matricaria chamomilla in treating diarrhea. Moreover, evidence was found for peppermint oil in decreasing duration, frequency, and severity of pain in children suffering from undifferentiated functional abdominal pain. Furthermore, evidence for effectiveness was found for different fennel preparations (eg, oil, tea, herbal compound) in treating children with infantile colic. No serious adverse events were reported. LIMITATIONS Few studies on specific indications, single herbs, or herbal preparations could be identified. CONCLUSIONS Because of the limited number of studies, results have to be interpreted carefully. To underpin evidence outlined in this review, more rigorous clinical trials are needed.
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Affiliation(s)
- Dennis Anheyer
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, and
| | - Jane Frawley
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney, Australia
| | - Anna Katharina Koch
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, and.,Department of Integrative Gastroenterology, University of Duisburg-Essen, Essen, Germany; and
| | - Romy Lauche
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, and.,Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney, Australia
| | - Jost Langhorst
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, and.,Department of Integrative Gastroenterology, University of Duisburg-Essen, Essen, Germany; and
| | - Gustav Dobos
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, and
| | - Holger Cramer
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, and.,Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney, Australia
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