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Nelson J, Mayer S, Neininger MP, Bertsche A, Lacher M, Gosemann JH. Complementary and alternative medicine (CAM) is frequently used by parents for the treatment of functional constipation in children. J Pediatr Gastroenterol Nutr 2024; 78:573-582. [PMID: 38284644 DOI: 10.1002/jpn3.12111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 10/07/2023] [Accepted: 10/29/2023] [Indexed: 01/30/2024]
Abstract
OBJECTIVES Complementary and alternative medicine (CAM) has gained increasing attention as a supportive treatment for chronic diseases such as epilepsy, migraine, autism, and cancer in children. This study aimed to determine the frequency, motivation, and outcomes of CAM in children with functional constipation. METHODS From January 2018 till September 2019, parents of patients (0-18 years) who were treated for functional constipation (ROME IV-criteria) at our colorectal center were asked to complete a questionnaire on the utilization of CAM. Demographic data and clinical assessments were documented and analyzed for patients with and without CAM treatment. RESULTS A total of 115 patients were included (mean age: 5.1 years; 49% males), of whom 29 (25%) used CAM as an alternative (4/29,14%) or in addition to conventional therapy (CT), including osteopathy (48%), homeopathy (45%), and natural/herbal remedies (17%). The main reason parents reported for the use of CAM was the urge to leave no treatment option unattempted (76%). Multivariate analysis also identified persistent constipation under CT (72%), adverse effects of CT (24%), and parental use of CAM themselves (83%) as independent variables associated with CAM use. Parents reported positive changes in stool frequency (38%) and fecal incontinence (21%) with CAM. The vast majority (93%) plan to use CAM in the future, and even non-CAM users showed high interest (60%). CONCLUSION One in four children with functional constipation receives CAM. Significant improvement in stool frequency and continence is missing in the majority. However, parental interest in CAM remains high. Physicians should be aware of CAM when counseling families for functional constipation in children.
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Affiliation(s)
- Jana Nelson
- Department of Pediatric Surgery, University of Leipzig, Leipzig, Germany
| | - Steffi Mayer
- Department of Pediatric Surgery, University of Leipzig, Leipzig, Germany
| | - Martina P Neininger
- Department of Clinical Pharmacy, Leipzig University and Drug Safety Center, Institute of Pharmacy, Medical Faculty, Leipzig University and University Hospital, Leipzig, Germany
| | - Astrid Bertsche
- Department of Pediatric Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Martin Lacher
- Department of Pediatric Surgery, University of Leipzig, Leipzig, Germany
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Gupta B, Misra P, Karuppusamy A, Balamurugan D, Parewa M, Tomar M, Rai S, Vashishth H, Sadhukhan S, Singh NK, Koley M, Saha S. Individualized Homeopathic Medicines as Adjunctive Treatment of Pediatric Epilepsy: A Double-Blind, Randomized, Placebo-Controlled Trial. HOMEOPATHY 2023; 112:170-183. [PMID: 36513330 DOI: 10.1055/s-0042-1755361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Epilepsy, one of the most common neurological diseases, contributes to 0.5% of the total disease burden. The burden is highest in sub-Saharan Africa, central Asia, central and Andean Latin America, and south-east Asia. Asian countries report an overall prevalence of 6/1,000 and that in India of 5.59/1,000. We examined whether individualized homeopathic medicines (IHMs) can produce a significantly different effect from placebos in treatment of pediatric epilepsy in the context of ongoing standard care (SC) using anti-epileptic drugs (AEDs). METHODS The study was a 6-month, double-blind, randomized, placebo-controlled trial (n = 60) conducted at the pediatric outpatient department of a homeopathic hospital in West Bengal, India. Patients were randomized to receive either IHMs plus SC (n = 30) or identical-looking placebos plus SC (n = 30). The primary outcome measure was the Hague Seizure Severity Scale (HASS); secondary outcomes were the Quality of Life in Childhood Epilepsy (QOLCE-16) and the Pediatric Quality of Life inventory (PedsQL) questionnaires; all were measured at baseline and after the 3rd and 6th month of intervention. The intention-to-treat sample was analyzed to detect group differences and effect sizes. RESULTS Recruitment and retention rates were 65.2% and 91.7% respectively. Although improvements were greater in the IHMs group than with placebos, with small to medium effect sizes, the inter-group differences were statistically non-significant - for HASS (F 1, 58 = 0.000, p = 1.000, two-way repeated measures analysis of variance), QOLCE-16 (F 1, 58 = 1.428, p = 0.237), PedsQL (2-4 years) (F 1, 8 = 0.685, p = 0.432) and PedsQL (5-18 years) (F 1, 47 = 0.000, p = 0.995). Calcarea carbonica, Ignatia amara, Natrum muriaticum and Phosphorus were the most frequently prescribed medicines. No serious adverse events were reported from either of the two groups. CONCLUSION Improvements in the outcome measures were statistically non-significantly greater in the IHMs group than in the placebos group, with small effect sizes. A different trial design and prescribing approach might work better in future trials. TRIAL REGISTRATION CTRI/2018/10/016027.
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Affiliation(s)
- Bharti Gupta
- Department of Pediatrics, National Institute of Homoeopathy, Salt Lake, Kolkata, West Bengal, India
| | - Pankhuri Misra
- Department of Materia Medica, National Institute of Homoeopathy, Salt Lake, Kolkata, West Bengal, India
| | - Avaranjika Karuppusamy
- Department of Materia Medica, National Institute of Homoeopathy, Salt Lake, Kolkata, West Bengal, India
| | - Dharshna Balamurugan
- Department of Materia Medica, National Institute of Homoeopathy, Salt Lake, Kolkata, West Bengal, India
| | - Maneet Parewa
- Department of Repertory, National Institute of Homoeopathy, Salt Lake, Kolkata, West Bengal, India
| | - Maneela Tomar
- Department of Organon of Medicine and Homeopathic Philosophy, National Institute of Homoeopathy, Salt Lake, Kolkata, West Bengal, India
| | - Shruti Rai
- Department of Organon of Medicine and Homeopathic Philosophy, National Institute of Homoeopathy, Salt Lake, Kolkata, West Bengal, India
| | - Himani Vashishth
- Department of Repertory, National Institute of Homoeopathy, Salt Lake, Kolkata, West Bengal, India
| | - Satarupa Sadhukhan
- Department of Organon of Medicine and Homeopathic Philosophy, National Institute of Homoeopathy, Salt Lake, Kolkata, West Bengal, India
| | - Navin Kumar Singh
- Department of Repertory, The Calcutta Homoeopathic Medical College and Hospital, Kolkata, West Bengal; affiliated to The West Bengal University of Health Sciences, Govt. of West Bengal, West Bengal, India
| | - Munmun Koley
- Department of Homeopathy, East Bishnupur State Homoeopathic Dispensary, Chandi Daulatabad Block Primary Health Centre, West Bengal, under Department of Health & Family Welfare, Govt. of West Bengal, West Bengal, India
| | - Subhranil Saha
- Department of Repertory, D. N. De Homoeopathic Medical College and Hospital, Govt. of West Bengal, Kolkata, West Bengal, India
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İnce T, İnce G, Üzüm Ö, Aydın A. Parent-reported complementary and alternative medicine use among pediatric patients with epilepsy at two tertiary centers in Turkey - Prevalence and predictors. Epilepsy Behav 2023; 143:109226. [PMID: 37141770 DOI: 10.1016/j.yebeh.2023.109226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 04/12/2023] [Accepted: 04/13/2023] [Indexed: 05/06/2023]
Abstract
BACKGROUND Complementary and alternative medicine (CAM) consists of various medical practices and products not recognized as a part of conventional medicine. There are few studies on CAMs used for childhood epilepsy. We aimed to determine the prevalence and socio-demographic factors affecting CAM use in children with epilepsy. METHODS This is a cross-sectional prospective descriptive study. The study included all parents who agreed to participate and had children with epilepsy. The data was collected using a questionnaire developed from a literature review of CAM use in pediatric epilepsy patients. RESULTS A total of 219 parent-child pairs were included in the study. Seventy-five participants had one or more comorbid disorders. 55.3% of participating children with epilepsy were taking more than one antiseizure medication (ASM). 30.1% of parents reported using some form of CAM for their children in the previous year. Only 60.6% of parents discussed their CAM decision with their child's doctor before using it. Univariate analysis showed that the patient's age, presence of comorbid disorders, duration of ASM, and family history of epilepsy were statistically significant predictors for CAM use. However, the presence of comorbidities was the only significant predictor of CAM use in logistic regression. CONCLUSION Even though most parents believe CAMs have no effect on their children with epilepsy, they frequently use them. We propose that the predictors identified in this study can help to identify potential CAM users. Since most parents do not report the use of CAM, physicians should routinely inquire about CAM use.
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Affiliation(s)
- Tolga İnce
- Dokuz Eylül University, Faculty of Medicine, Department of Pediatrics, Social Pediatrics Unit, İzmir, Turkey.
| | - Gülberat İnce
- University of Health Sciences, Tepecik Training and Research Hospital, Department of Pediatric Diseases, Izmir, Turkey.
| | - Özlem Üzüm
- University of Health Sciences, Tepecik Training and Research Hospital, Department of Pediatric Diseases, Izmir, Turkey
| | - Adem Aydın
- Dokuz Eylül University, Faculty of Medicine, Department of Pediatrics, Social Pediatrics Unit, İzmir, Turkey
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Zhu Z, Dluzynski D, Hammad N, Pugalenthi D, Walser SA, Mittal R, Samanta D, Brown ML, Asadi-Pooya AA, Kakooza-Mwesige A, Spalice A, Capponi M, Lekoubou A, Kumar A, Paudel S, Carney PR, Mainali G, Naik S. Use of Integrative, Complementary, and Alternative Medicine in Children with Epilepsy: A Global Scoping Review. CHILDREN (BASEL, SWITZERLAND) 2023; 10:713. [PMID: 37189961 PMCID: PMC10136598 DOI: 10.3390/children10040713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 03/23/2023] [Accepted: 04/06/2023] [Indexed: 05/17/2023]
Abstract
(1) Background: Epilepsy is one of the most common chronic neurological disorders in childhood. Complementary and alternative medicine (CAM) use is highly prevalent in patients with epilepsy. Despite CAM's widespread and increasing popularity, its prevalence, forms, perceived benefits, and potential risks in pediatric epilepsy are rarely explored. (2) Methods: We performed a scoping review of the available literature on the use of CAM in pediatric epilepsy. (3) Results: Overall, global cross-sectional studies showed a variable degree of CAM usage among children with epilepsy, ranging from 13 to 44% in prevalence. Popular types of CAMs reported were supplements, cannabis products, aromatherapy, herbal remedies, dietary therapy, massage therapy, and prayer. Families often report that CAM is effective, although there are limited objective measures of this. Potential risks lie in the use of CAM, such as herbal remedies, and/or unregulated, contaminated, or unpurified products. Studies also underscored inadequate patient-physician discussions regarding CAM. (4) Conclusions: A better understanding of this topic would aid clinicians in guiding patients/families on the use of CAM. Further studies on the efficacy of the different types of CAM used, as well as potential side effects and drug interactions are needed.
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Affiliation(s)
- Zahra Zhu
- College of Medicine, Penn State University, Hershey, PA 17033, USA (G.M.); (S.N.)
| | - Daniela Dluzynski
- College of Medicine, Penn State University, Hershey, PA 17033, USA (G.M.); (S.N.)
| | - Nouran Hammad
- School of Medicine, Jordan University of Science and Technology, Al-Ramtha 3030, Jordan
| | - Deepika Pugalenthi
- College of Medicine, Penn State University, Hershey, PA 17033, USA (G.M.); (S.N.)
| | - Sarah A. Walser
- Department of Psychiatry, Johns Hopkins Hospital, Baltimore, MD 21287, USA
| | - Rea Mittal
- College of Medicine, Penn State University, Hershey, PA 17033, USA (G.M.); (S.N.)
| | - Debopam Samanta
- Section of Child Neurology, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
| | - Melanie L. Brown
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
| | - Ali A. Asadi-Pooya
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz 71437, Iran
- Department of Neurology, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Angelina Kakooza-Mwesige
- Department of Pediatrics & Child Health, Makerere University College of Health Sciences, Kampala 7062, Uganda
| | - Alberto Spalice
- Department of Maternal Sciences, University la Sapienza, 00185 Roma, Italy
| | - Martina Capponi
- Department of Maternal Sciences, University la Sapienza, 00185 Roma, Italy
| | - Alain Lekoubou
- College of Medicine, Penn State University, Hershey, PA 17033, USA (G.M.); (S.N.)
- Department of Neurology, Hershey Medical Center, Penn State University, Hershey, PA 17033, USA
- Department of Public Health Sciences, College of Medicine, Penn State University, Hershey, PA 17033, USA
| | - Ashutosh Kumar
- College of Medicine, Penn State University, Hershey, PA 17033, USA (G.M.); (S.N.)
- Department of Pediatrics and Neurology, Penn State Health Milton S. Hershey Medical Center, Hershey, PA 17033, USA
| | - Sita Paudel
- College of Medicine, Penn State University, Hershey, PA 17033, USA (G.M.); (S.N.)
- Department of Pediatrics and Neurology, Penn State Health Milton S. Hershey Medical Center, Hershey, PA 17033, USA
| | - Paul R. Carney
- Pediatric Neurology Division, University of Missouri Health Care, Columbia, MO 65212, USA
| | - Gayatra Mainali
- College of Medicine, Penn State University, Hershey, PA 17033, USA (G.M.); (S.N.)
- Department of Pediatrics and Neurology, Penn State Health Milton S. Hershey Medical Center, Hershey, PA 17033, USA
| | - Sunil Naik
- College of Medicine, Penn State University, Hershey, PA 17033, USA (G.M.); (S.N.)
- Department of Pediatrics and Neurology, Penn State Health Milton S. Hershey Medical Center, Hershey, PA 17033, USA
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Jonkman KM, Back E, Begeer S. Predicting intervention use in autistic children: Demographic and autism-specific characteristics. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:428-442. [PMID: 35695079 DOI: 10.1177/13623613221102748] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
LAY ABSTRACT Autism is a condition that is characterised by social communication difficulties and restrictive and repetitive behaviours or interests. Autism can present in many different ways and various interventions are available. Some interventions are conventional, and they are recommended to be used for children with autism (guideline therapies) or for other disorders such as anxiety or attention-deficit hyperactivity disorder (mainstream therapies or medication), while others are less conventional (other therapies or medication, they are discouraged, unknown or alternative). Little is known about who chooses which intervention. This study found that most autistic children use some kind of intervention. Children who attend special education or have an additional diagnosis (other than autism) tend to receive more therapies, while children with a lower IQ receive fewer therapies. Older children, children with a higher IQ and girls are more likely to use conventional (mainstream or guideline) therapies. Children whose parents have a lower educational level are more likely to have used conventional medication. Whereas, children with more sensory issues (e.g. sensitivity to sound, smell or movement) were more likely to have used unconventional medication. This study found that other autism-related characteristics such as the number of autism symptoms, social skills and repetitive and restrictive behaviours were not related to the interventions used. More treatments focussed on multiple problems should be available for children with autism who have additional difficulties.
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Wu J, Li P, Luo H, Lu Y. Complementary and Alternative Medicine Use by ADHD Patients: A Systematic Review. J Atten Disord 2022; 26:1833-1845. [PMID: 35880494 DOI: 10.1177/10870547221111557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE This study aimed to review the prevalence of complementary and alternative medicine (CAM) use and its different used types, characteristics of the studied cohorts, the reasoning for CAM use, and possible predictive factors for its use amongst ADHD patients. METHOD The Web of Science Core Collection, PubMed, and Scopus were searched from inception to 10 February 2022. All of the original papers published in English which report data on CAM use by patients with ADHD were included. RESULTS Twelve original researches including 4,447 patients were included. The prevalence of CAM use varied from 7.5% to 67.6%. The most-reported CAM modalities were dietary modifications and natural products. Moreover, higher parental education should be considered as a predictive factor for CAM use. CONCLUSION CAM use by ADHD patients seems to be prevalent. Healthcare providers should be trained about the most commonly used CAM therapies and their possible adverse events.
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Affiliation(s)
| | - Ping Li
- Sichuan University, Chengdu, China
| | - Hong Luo
- Sichuan University, Chengdu, China
| | - You Lu
- Sichuan University, Chengdu, China
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Zhu Z, Mittal R, Walser SA, Lehman E, Kumar A, Paudel S, Mainali G. Complementary and Alternative Medicine (CAM) use in Children with Epilepsy. J Child Neurol 2022; 37:334-339. [PMID: 35099320 DOI: 10.1177/08830738211069790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Complementary and alternative medicine (CAM) use by the pediatric population with epilepsy in rural Pennsylvania was studied to characterize the prevalence, perceived effectiveness, and reasons for CAM use. This study additionally assessed the adequacy of parent-physician communication regarding CAM usage. A telephone survey was administered to 200 parents/caregivers of children with epilepsy followed at Hershey Medical Center. Thirteen percent of respondents indicated CAM use by their child. Common types of CAM used were cannabis-related products such as CBD oil and medical marijuana. Forty-eight percent of CAM users chose to initiate CAM owing to dissatisfaction with the outcomes of antiseizure drugs. Fifty-nine percent noticed a decrease in seizure frequency with CAM use, and more than 11% of CAM users reported side effects from CAM. Eighty percent of CAM users had discussions regarding CAM with their child's neurologist. CAM use was found to be associated with increased seizure severity (P = .004) and the prior use of cannabidiol (Epidiolex) (P < .001) or the ketogenic diet (P = .001). Increased seizure severity and the prior use of Epidiolex or the ketogenic diet may be used as predictors for the identification of patients with a higher likelihood of using CAM. Interest in future CAM use, especially cannabis-related products, was expressed in a large percentage of non-CAM users. Given the high parental or caregiver interest in CAM, providers are encouraged to be proactive in initiating discussions about CAM and collaborate with parents/caregivers to ensure the safe usage of CAM among pediatric patients.
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Affiliation(s)
- Zahra Zhu
- 12310Penn State College of Medicine, Hershey, PA, USA
| | - Rea Mittal
- 12310Penn State College of Medicine, Hershey, PA, USA
| | - Sarah A Walser
- 12311Penn State College of Medicine, University Park, State College, PA, USA
| | - Erik Lehman
- Department of Public Health Sciences, 12310Penn State College of Medicine, Hershey, PA, USA
| | - Ashutosh Kumar
- 12310Penn State College of Medicine, Hershey, PA, USA.,Department of Pediatrics and Neurology, Penn State Health Milton Hershey Medical Center, Hershey, PA, USA
| | - Sita Paudel
- 12310Penn State College of Medicine, Hershey, PA, USA.,Department of Pediatrics and Neurology, Penn State Health Milton Hershey Medical Center, Hershey, PA, USA
| | - Gayatra Mainali
- 12310Penn State College of Medicine, Hershey, PA, USA.,Department of Pediatrics and Neurology, Penn State Health Milton Hershey Medical Center, Hershey, PA, USA
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Franke H, Franke JD, Fryer G. Effectiveness of osteopathic manipulative treatment for pediatric conditions: A systematic review. J Bodyw Mov Ther 2022; 31:113-133. [DOI: 10.1016/j.jbmt.2022.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 02/23/2022] [Accepted: 03/18/2022] [Indexed: 11/25/2022]
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Xaviar S, Das S, Tiwari S. An Audit of the Quality of Reporting and Bias of Studies on Yoga in Epilepsy. Neurol India 2022; 70:2009-2014. [DOI: 10.4103/0028-3886.359244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Tastemel Ozturk T, Kanbur N, Ozmert EN, Gulhan B, Ozaltin F, Topaloglu R, Duzova A. Predictors for the use of herbal and dietary supplements in children and adolescents with kidney and urinary tract diseases. Eur J Pediatr 2021; 180:253-262. [PMID: 32761383 DOI: 10.1007/s00431-020-03757-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 07/21/2020] [Accepted: 07/27/2020] [Indexed: 10/23/2022]
Abstract
Complementary and alternative medicine are treatments administered alone or in combination with conventional medical treatments. Data on complementary and alternative medicine use in children with kidney and urinary tract diseases are limited. In this cross-sectional study, the frequency and preferred methods of complementary and alternative medicine use and factors associated with their use were evaluated in 201 patients (48% female; median age, 11 years; median disease duration, 5.1 years) with kidney and urinary tract diseases and 260 healthy (without chronic disease) controls. Data were collected through a questionnaire-based interview and patients' medical records. Herbal and dietary supplements, including fish oil, were the most commonly used complementary and alternative medicine agents in both groups. There was no difference in herbal and dietary supplement use between the groups when fish oil was excluded (29% vs. 28%; p = 0.88). Herbal and dietary supplements were mainly used to improve/mitigate renal disease (52%). Logistic regression analysis revealed that disease duration > 7 years (odds ratio (OR), 3.70; 95% confidence interval (CI), 1.48-9.20), current use of six or more drugs (OR, 5.6; 95% CI, 1.28-24.41), and recurrent urinary tract infection or nephrolithiasis (OR, 3.92; 95% CI, 1.02-15.09) were the independent risk factors for herbal and dietary supplement use, except fish oil. Middle socioeconomic status was associated with decreased herbal and dietary supplement use, except fish oil, compared with low socioeconomic status (OR, 0.30; 95% CI, 0.11-0.81). Herbal and dietary supplements were used by 78% patients, despite knowing that these products could have side effects; only 42% of the patients shared the information about herbal and dietary supplement use with their doctors.Conclusion: Herbal and dietary supplement use is frequent in children with kidney and urinary tract diseases. Educating health professionals regarding such use is mandatory for developing strategies to prevent critical consequences. What is Known: • Complementary and alternative medicine (CAM) practices are therapeutic approaches that do not have sufficient efficacy and safety evidence. • CAM is widely used in healthy children and in certain chronic diseases. What is New: • Herbal and dietary supplements (HDSs) were the most commonly used method in kidney and urinary tract diseases. • Duration of disease, number of drugs, and socioeconomic status are determinants of HDS use except fish oil.
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Affiliation(s)
- Tugba Tastemel Ozturk
- Division of Pediatric Nephrology, Hacettepe University Faculty of Medicine, Sihhiye, 06100, Ankara, Turkey
| | - Nuray Kanbur
- Division of Adolescent Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Elif Nursel Ozmert
- Division of Social & Developmental Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Bora Gulhan
- Division of Pediatric Nephrology, Hacettepe University Faculty of Medicine, Sihhiye, 06100, Ankara, Turkey
| | - Fatih Ozaltin
- Division of Pediatric Nephrology, Hacettepe University Faculty of Medicine, Sihhiye, 06100, Ankara, Turkey
| | - Rezan Topaloglu
- Division of Pediatric Nephrology, Hacettepe University Faculty of Medicine, Sihhiye, 06100, Ankara, Turkey
| | - Ali Duzova
- Division of Pediatric Nephrology, Hacettepe University Faculty of Medicine, Sihhiye, 06100, Ankara, Turkey.
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Elliott J, DeJean D, Potter BK, Coyle D, Clifford T, McCoy B, Wells GA. Barriers in accessing medical cannabis for children with drug-resistant epilepsy in Canada: A qualitative study. Epilepsy Behav 2020; 111:107120. [PMID: 32570201 DOI: 10.1016/j.yebeh.2020.107120] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 04/11/2020] [Accepted: 04/11/2020] [Indexed: 12/26/2022]
Abstract
INTRODUCTION The use of medical cannabis to treat drug-resistant epilepsy in children is increasing; however, there has been limited study of the experiences of parents with the current system of accessing medical cannabis for their children. METHODS In this qualitative study, we used a patient-centered access to care framework to explore the barriers faced by parents of children with drug-resistant epilepsy when trying to access medical cannabis in Canada. We conducted semistructured interviews with 19 parents to elicit their experiences with medical cannabis. We analyzed the data according to five dimensions of access, namely approachability, acceptability, availability, affordability, and appropriateness. RESULTS Parents sought medical cannabis as a treatment because of a perceived unmet need stemming from the failure of antiepileptic drugs to control their children's seizures. Medical cannabis was viewed as an acceptable treatment, especially compared with adding additional antiepileptic drugs. After learning about medical cannabis from the media, friends and family, or other parents, participants sought authorization for medical use. However, most encountered resistance from their child's neurologist to discuss and/or authorize medical cannabis, and many parents experienced difficulty in obtaining authorization from a member of the child's existing care team, leading them to seek authorization from a cannabis clinic. Participants described spending up to $2000 per month on medical cannabis, and most were frustrated that it was not eligible for reimbursement through public or private insurance programs. CONCLUSIONS Parents pursue medical cannabis as a treatment for their children's drug-resistant epilepsy because of a perceived unmet need. However, parents encounter barriers in accessing medical cannabis in Canada, and strategies are needed to ensure that children using medical cannabis receive proper care from healthcare professionals with training in epilepsy care, antiepileptic drugs, and medical cannabis.
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Affiliation(s)
- Jesse Elliott
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada; Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Ottawa, Canada.
| | | | - Beth K Potter
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Doug Coyle
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Tammy Clifford
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Bláthnaid McCoy
- Department of Paediatrics, University of Toronto, Ontario, Canada; Division of Neurology, The Hospital for Sick Children Toronto, Toronto, Ontario, Canada
| | - George A Wells
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada; Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Ottawa, Canada
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Shawahna R, Abdelhaq I. Important knowledge items with regard to the benefits of exercise for patients with epilepsy: Findings of a qualitative study from Palestine. Epilepsy Behav 2020; 108:107099. [PMID: 32335502 DOI: 10.1016/j.yebeh.2020.107099] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 03/07/2020] [Accepted: 04/03/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Physicians and complementary alternative medicine (CAM) specialists are not formally educated/trained on the benefits of exercises for people living with epilepsy (PWE). This study was performed to develop a consensus-based knowledge items on the benefits of exercises for PWE that physicians and CAM specialists need to know. METHODS Knowledge items were collected after an extensive review of the scientific literature and from in-depth interviews with key contacts in the domain (6 primary healthcare providers, 4 neurologists, 4 exercise and medicine specialists, 4 CAM practitioners, 4 researchers who did studies on the benefits of exercise for PWE, and 4 PWE). Items collected were reviewed by 12 researchers who did studies on exercise for PWE. A Delphi technique was followed among a panel of 50 members to develop the consensus-based core list. RESULTS The final consensus-based core list contained 64 items that were grouped into the following categories: 1) general items recommending exercise for PWE, 2) benefits of exercise on prevention of seizures, 3) benefits of exercise on antiepileptic therapy, 4) benefits of exercise in preventing comorbidities associated with epilepsy, 5) benefits of exercise in improving quality of life of PWE, and 6) psychosocial benefits of exercise for PWE. CONCLUSION This consensus-based core list might guide educators, trainers, or authorities while designing educational or training courses to increase knowledge of physicians in primary healthcare and CAM specialists with regard to the benefits of exercise for PWE. Further investigations are needed to determine if such consensus-based core list might improve care and wellbeing of PWE.
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Affiliation(s)
- Ramzi Shawahna
- Department of Physiology, Pharmacology and Toxicology, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine; An-Najah BioSciences Unit, Centre for Poisons Control, Chemical and Biological Analyses, An-Najah National University, Nablus, Palestine.
| | - Imad Abdelhaq
- Department of Physical Education, Faculty of Educational Sciences and Teachers' Training, An-Najah National University, Nablus, Palestine
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Shawahna R, Abdelhaq I. Exploring perceived benefits, motives, barriers, and recommendations for prescribing yoga exercises as a nonpharmacological intervention for patients with epilepsy: A qualitative study from Palestine. Epilepsy Behav 2020; 106:107041. [PMID: 32247178 DOI: 10.1016/j.yebeh.2020.107041] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 03/09/2020] [Accepted: 03/12/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Yoga is believed to play a role in stabilizing the electroencephalogram and the autonomic nervous system, thus might help control seizures in people with epilepsy (PWE). This qualitative study was conducted to explore experiences of Palestinian PWE with regard to benefits, motives, barriers, and recommendations of prescribing yoga exercises as a nonpharmacological intervention. METHODS Purposive and snowball sampling techniques were used to recruit PWE who practiced yoga. Semi-structured in-depth interviews (n = 18) were conducted with the study participants. The interpretive description method was used to qualitatively analyze the data collected during the interviews. RESULTS Following the thematic analysis adopted for this study, four major themes emerged. These themes were as follows: perceived benefits of yoga, motives to practice yoga, barriers to practice yoga, and recommendations on effective yoga practice for PWE. The perceived benefits included improvements in management of seizures, psychological, physical, and social well-being. People with epilepsy were motivated by the health benefits of yoga. Barriers of adherence to practice included personal and logistic factors. The interviewees recommended tailoring yoga sessions to the needs of PWE. CONCLUSION This explorative qualitative study reported perceived benefits, motives, barriers, and recommendations of yoga as a nonpharmacological intervention for PWE. People with epilepsy used yoga as a beneficial nonpharmacological intervention to improve their health and reduce the negative effects of epilepsy on their physical and psychosocial well-being. Future studies are needed to investigate the health benefits of yoga when sessions are tailored to the needs of PWE.
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Affiliation(s)
- Ramzi Shawahna
- Department of Physiology, Pharmacology and Toxicology, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine; An-Najah BioSciences Unit, Centre for Poisons Control, Chemical and Biological Analyses, An-Najah National University, Nablus, Palestine.
| | - Imad Abdelhaq
- Department of Physical Education, Faculty of Educational Sciences and Teachers' Training, An-Najah National University, Nablus, Palestine
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14
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Hannan N, Steel A, McMillan SS, Tiralongo E. Health Service Use and Treatment Choices for Pediatric Eosinophilic Esophagitis: Findings From a Cross-Sectional Survey of Australian Carers. Front Pediatr 2020; 8:147. [PMID: 32363170 PMCID: PMC7180181 DOI: 10.3389/fped.2020.00147] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 03/16/2020] [Indexed: 01/09/2023] Open
Abstract
Objectives: The incidence and the prevalence of eosinophilic esophagitis (EoE) are increasing, and healthcare utilization among children with EoE is high. This study provides novel insights into the health services and the treatments, including complementary medicines (CMs), used by carers to manage their children's EoE as well as the carers' beliefs and attitudes toward these treatments. Methods: A national cross-sectional online survey was conducted in Australia between September 2018 and February 2019. The survey included questions about health service and treatment utilization, health insurance and government support, health-related quality of life of children with EoE and their carers, views and attitudes toward CM use, and perceived efficacy of treatment. Results: The survey was completed by 181 carers (96.6% of whom were mothers) of EoE children. Most children (91.2%, n = 165) had seen a medical doctor for their EoE, and almost half had consulted with a CM practitioner (40.3%, n = 73). Pharmaceuticals (n = 156, 86.2%) were the most commonly used treatment option, followed by dietary changes (n = 142, 78.5%), CM products (n = 109, 60.2%), and CM therapies (n = 42, 23.2%). Most children received care from numerous practitioners on multiple occasions, indicating a substantial financial and treatment-related burden. Conclusions: A variety of practitioners are involved in the care of children with EoE, and a high rate of CM use warrants further attention to ensure that appropriate treatment is provided. Carer involvement and guidance, combined with individual practitioner expertise, referrals, and collaboration between providers, is essential to successfully navigate this complex disease and provide adequate care for these patients.
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Affiliation(s)
- Nicole Hannan
- School of Pharmacy and Pharmacology, Griffith University, Southport, QLD, Australia
| | - Amie Steel
- Faculty of Health, Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Ultimo, NSW, Australia
| | - Sara S McMillan
- School of Pharmacy and Pharmacology, Griffith University, Southport, QLD, Australia
| | - Evelin Tiralongo
- School of Pharmacy and Pharmacology, Griffith University, Southport, QLD, Australia
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15
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Bosak M, Słowik A. Use of complementary and alternative medicine among adults with epilepsy in a university epilepsy clinic in Poland. Epilepsy Behav 2019; 98:40-44. [PMID: 31299531 DOI: 10.1016/j.yebeh.2019.06.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 06/02/2019] [Accepted: 06/02/2019] [Indexed: 12/28/2022]
Abstract
INTRODUCTION The use of complementary and alternative medicine (CAM) is becoming increasingly prevalent both in general population and patients with chronic diseases. The aim of the study was to determine the prevalence, reasons, and factors influencing the use of CAM in Polish patients with epilepsy (PWE). MATERIAL AND METHODS This prospective study involved PWE treated in a university epilepsy clinic. Data on epilepsy, antiepileptic drugs, level of education, vocational activity, and patterns of CAM were collected from a structured interview and from medical records. RESULTS The sample population consisted of 473 PWE (mean age: 35.3 years); 220 (46.5%) were females, and 228 (46.5%) were in remission. Overall 26.8% (127) of the cohort used at least one type of CAM. The CAM modalities most frequently used were herbal and dietary supplements (32.3%), energy healing (31.5%), and marijuana (27.6%). The internet was the most common source of information on CAM (45.7%). In one-third of subjects, CAM usage affected negatively compliance to standard treatment. Logistic regression analysis revealed several independent risk factors for CAM use in PWE: younger age, longer duration of epilepsy, lack of remission, and lower level of education. CONCLUSION A significant proportion of PWE uses CAM, and its usage may affect negatively compliance to standard treatment. Our findings highlight poor communication between patients and physicians with regard to CAM use. Healthcare professionalists should routinely check for CAM utilization in PWE to prevent potential harm related to its use.
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Affiliation(s)
- Magdalena Bosak
- Dept. of Neurology, Jagiellonian University Medical College, Krakow, Poland.
| | - Agnieszka Słowik
- Dept. of Neurology, Jagiellonian University Medical College, Krakow, Poland
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Trifa M, Tumin D, Walia H, Lemanek KL, Tobias JD, Bhalla T. Caregivers' knowledge and acceptance of complementary and alternative medicine in a tertiary care pediatric hospital. J Pain Res 2018. [PMID: 29535550 PMCID: PMC5837374 DOI: 10.2147/jpr.s156585] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background The use of complementary and alternative medicine (CAM) therapies has increased in children, especially in those with chronic health conditions. However, this increase may not translate into acceptance of CAM in the perioperative setting. We surveyed caregivers of patients undergoing surgery to determine their knowledge and acceptance of hypnotherapy, acupuncture, and music therapy as alternatives to standard medication in the perioperative period. Materials and methods An anonymous, 12-question survey was administered to caregivers of children undergoing procedures under general anesthesia. Caregivers reported their knowledge about hypnotherapy, music therapy, and acupuncture and interest in one of these methods during the perioperative period. CAM acceptance was defined as interest in one or more CAM methods. Results Data from 164 caregivers were analyzed. The majority of caregivers were 20-40 years of age (68%) and mothers of the patient (82%). Caregivers were most familiar with acupuncture (70%), followed by music therapy (60%) and hypnotherapy (38%). Overall CAM acceptance was 51%. The acceptance of specific CAM modalities was highest for music therapy (50%), followed by hypnotherapy (17%) and acupuncture (13%). In multivariable logistic regression, familiarity with music therapy was associated with greater odds of CAM acceptance (odds ratio=3.36; 95% CI: 1.46, 7.74; P=0.004). Conclusion Overall CAM acceptance among caregivers of children undergoing surgery was 51%, with music therapy being the most accepted CAM method. Familiarity with music therapy was the only factor that was independently associated with accepting CAM in the perioperative period. The low acceptance for acupuncture and hypnosis in the perioperative situation may be related to insufficient parental knowledge and information.
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Affiliation(s)
- Mehdi Trifa
- Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA.,Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia
| | - Dmitry Tumin
- Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA.,Department of Anesthesiology and Pain Medicine, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Hina Walia
- Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA
| | - Kathleen L Lemanek
- Department of Pediatric Psychology and Neuropsychology, Nationwide Children's Hospital, Columbus, OH, USA
| | - Joseph D Tobias
- Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA.,Department of Anesthesiology and Pain Medicine, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Tarun Bhalla
- Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA.,Department of Anesthesiology and Pain Medicine, The Ohio State University College of Medicine, Columbus, OH, USA
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Beliveau PJH, Wong JJ, Sutton DA, Simon NB, Bussières AE, Mior SA, French SD. The chiropractic profession: a scoping review of utilization rates, reasons for seeking care, patient profiles, and care provided. Chiropr Man Therap 2017; 25:35. [PMID: 29201346 PMCID: PMC5698931 DOI: 10.1186/s12998-017-0165-8] [Citation(s) in RCA: 147] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 10/31/2017] [Indexed: 12/31/2022] Open
Abstract
Background Previous research has investigated utilization rates, who sees chiropractors, for what reasons, and the type of care that chiropractors provide. However, these studies have not been comprehensively synthesized. We aimed to give a global overview by summarizing the current literature on the utilization of chiropractic services, reasons for seeking care, patient profiles, and assessment and treatment provided. Methods Systematic searches were conducted in MEDLINE, CINAHL, and Index to Chiropractic Literature using keywords and subject headings (MeSH or ChiroSH terms) from database inception to January 2016. Eligible studies: 1) were published in English or French; 2) were case series, descriptive, cross-sectional, or cohort studies; 3) described patients receiving chiropractic services; and 4) reported on the following theme(s): utilization rates of chiropractic services; reasons for attending chiropractic care; profiles of chiropractic patients; or, types of chiropractic services provided. Paired reviewers independently screened all citations and data were extracted from eligible studies. We provided descriptive numerical analysis, e.g. identifying the median rate and interquartile range (e.g., chiropractic utilization rate) stratified by study population or condition. Results The literature search retrieved 14,149 articles; 328 studies (reported in 337 articles) were relevant and reported on chiropractic utilization (245 studies), reason for attending chiropractic care (85 studies), patient demographics (130 studies), and assessment and treatment provided (34 studies). Globally, the median 12-month utilization of chiropractic services was 9.1% (interquartile range (IQR): 6.7%-13.1%) and remained stable between 1980 and 2015. Most patients consulting chiropractors were female (57.0%, IQR: 53.2%-60.0%) with a median age of 43.4 years (IQR: 39.6-48.0), and were employed (median: 77.3%, IQR: 70.3%-85.0%). The most common reported reasons for people attending chiropractic care were (median) low back pain (49.7%, IQR: 43.0%-60.2%), neck pain (22.5%, IQR: 16.3%-24.5%), and extremity problems (10.0%, IQR: 4.3%-22.0%). The most common treatment provided by chiropractors included (median) spinal manipulation (79.3%, IQR: 55.4%-91.3%), soft-tissue therapy (35.1%, IQR: 16.5%-52.0%), and formal patient education (31.3%, IQR: 22.6%-65.0%). Conclusions This comprehensive overview on the world-wide state of the chiropractic profession documented trends in the literature over the last four decades. The findings support the diverse nature of chiropractic practice, although common trends emerged.
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Affiliation(s)
| | - Jessica J. Wong
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Toronto, Canada
- Department of Research, Canadian Memorial Chiropractic College, 6100 Leslie St, Toronto, ON M2H 3J1 Canada
| | - Deborah A. Sutton
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Toronto, Canada
| | - Nir Ben Simon
- Department of Research, Canadian Memorial Chiropractic College, 6100 Leslie St, Toronto, ON M2H 3J1 Canada
| | - André E. Bussières
- School of Physical and Occupational Therapy, McGill University, Montréal, Canada
- Département chiropratique, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
- Centre de recherche interdisciplinaire en réadaptation (CRIR), Montréal, Canada
| | - Silvano A. Mior
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Toronto, Canada
- Department of Research, Canadian Memorial Chiropractic College, 6100 Leslie St, Toronto, ON M2H 3J1 Canada
| | - Simon D. French
- Department of Public Health Sciences, Queen’s University, Kingston, Canada
- School of Rehabilitation Therapy, Queen’s University, Kingston, Canada
- Department of Chiropractic, Macquarie University, Sydney, Australia
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18
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Beattie JF, Thompson MD, Parks PH, Jacobs RQ, Goyal M. Caregiver-reported religious beliefs and complementary and alternative medicine use among children admitted to an epilepsy monitoring unit. Epilepsy Behav 2017; 69:139-146. [PMID: 28285234 DOI: 10.1016/j.yebeh.2017.01.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 01/26/2017] [Accepted: 01/26/2017] [Indexed: 10/20/2022]
Abstract
Complementary and alternative medicine (CAM) includes a wide range of practices and products that are generally outside the use of conventional medicine as practiced in Western cultures. Use of CAM in persons with epilepsy is high, even compared to individuals with other chronic health conditions. In this study, we surveyed caregivers of children admitted to a regional epilepsy monitoring unit (EMU) in the southeast United States to assess CAM use among patients (N=225). Thirteen percent of respondents indicated current use of CAM by their child, 16% reported past use, and 43% reported interest in future use, most commonly in marijuana as a potential treatment (23%). Over 25% of respondents expressed interest in CAM use related to side effects of anti-epileptic medications. Regarding prayer as a form of CAM, a large majority of respondents in this sample identified as Christian and actively prayed for their child's illness, revealing a high prevalence of spiritual practices in this population. Eighty-one percent of respondents reported that they had not discussed CAM use with their doctor. Discussing CAM use with a health care provider was significantly related to past CAM use (p<.02), but not current use or willingness to try CAM in the future (p>.05). These results have important implications for future practice and support increased communication and patient education, as many anti-epileptic medications interact with certain herbs and supplements, posing a potential health risk and treatment barrier in this population.
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Affiliation(s)
- Julia Fleming Beattie
- Department of Psychology, University of Alabama at Birmingham, Campbell Hall 415, 1720 2nd Avenue South, Birmingham, AL 35294, USA.
| | - Matthew D Thompson
- Children's of Alabama, 1600 7th Avenue South, Birmingham, AL 35233, USA.
| | - Pamela H Parks
- Children's of Alabama, 1600 7th Avenue South, Birmingham, AL 35233, USA.
| | - Ruth Q Jacobs
- Department of Psychology, University of Alabama at Birmingham, Campbell Hall 415, 1720 2nd Avenue South, Birmingham, AL 35294, USA.
| | - Monisha Goyal
- Department of Pediatrics, Division of Neurology, University of Alabama at Birmingham, 1600 7th Ave S, Birmingham, AL 35233, USA.
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Ding JL, Taylor DM, Lee M, Johnson OG, Ashok A, Griffiths M, Simma L, Craig SS, Cheek JA, Babl FE. Observational study of alternative therapies among paediatric emergency department patients. Emerg Med Australas 2017; 29:136-142. [PMID: 28244266 DOI: 10.1111/1742-6723.12744] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 01/22/2017] [Accepted: 01/24/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE While complementary medicine use among ED paediatric patients is common, the use of alternative therapies (ATs; physical or spiritual therapies) is unknown. We aimed to determine the 12 month period prevalence and nature of AT use among paediatric patients and parent perceptions of AT use. METHODS We undertook a cross-sectional survey of a convenience sample of parents of paediatric patients in three EDs in metropolitan Melbourne, Australia (January-June, 2015). Parents were invited to complete a validated, anonymous, self-administered questionnaire. The main outcomes were AT use by the patient and parent perceptions of ATs. RESULTS A total of 806 parents were enrolled. In the previous 12 months, 393 (48.8%) patients had received at least one AT. There were no gender or ethnicity differences between AT users and non-users. AT use was more common among older patients (P < 0.05). Patients with chronic illness tended to use more ATs (P = 0.12). A total of 1091 courses of 43 different ATs had been provided. The most common were massage (16% of patients), chiropractic therapy (9.8%), relaxation (7.2%), meditation (6.2%) and aromatherapy (6.1%). ATs were generally used for musculoskeletal problems, health maintenance, stress and anxiety. Parents who arranged the ATs were significantly more likely to report that ATs are safe, prevent and treat illness, assist prescription medicines and offer a more holistic approach to healthcare (P < 0.001). CONCLUSION AT use is common among paediatric ED patients. Parents who arrange AT have differing perceptions of AT usefulness and safety from those who do not.
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Affiliation(s)
- Juen-Li Ding
- Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia
| | - David McD Taylor
- Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia.,Emergency Department, Austin Health, Melbourne, Victoria, Australia
| | - Marina Lee
- Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia.,Emergency Department, Austin Health, Melbourne, Victoria, Australia
| | - Olivia G Johnson
- Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia
| | - Aadith Ashok
- Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia
| | - Meg Griffiths
- Paediatric Emergency Department, Monash Medical Centre, Emergency Program, Monash Health, Melbourne, Victoria, Australia.,Monash Emergency Research Collaborative, Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia
| | - Leopold Simma
- Emergency Department, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Simon S Craig
- Paediatric Emergency Department, Monash Medical Centre, Emergency Program, Monash Health, Melbourne, Victoria, Australia.,Monash Emergency Research Collaborative, Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - John A Cheek
- Paediatric Emergency Department, Monash Medical Centre, Emergency Program, Monash Health, Melbourne, Victoria, Australia.,Emergency Department, Royal Children's Hospital, Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Franz E Babl
- Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia.,Emergency Department, Royal Children's Hospital, Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, Melbourne, Victoria, Australia
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20
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Survey of parental acceptance of massage therapy, energy therapy and acupuncture for their children in the acute pediatric inpatient rehabilitation setting. Complement Ther Med 2016; 27:102-7. [DOI: 10.1016/j.ctim.2016.06.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 06/06/2016] [Accepted: 06/14/2016] [Indexed: 12/23/2022] Open
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Complementary and alternative medicines use among pediatric patients with epilepsy in a multiethnic community. Epilepsy Behav 2016; 60:68-74. [PMID: 27179195 DOI: 10.1016/j.yebeh.2016.04.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 03/18/2016] [Accepted: 04/02/2016] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Prior studies highlighted that patients on chronic medications who used complementary and alternative medicines (CAMs) did not share this information with their healthcare providers. Furthermore, there might be potential adverse interactions between CAMs and antiepileptic drug (AED) therapy. However, there are no studies that investigate the effect of religion or race on CAM use in a multiethnic community. Therefore, we aimed to investigate CAM usage among pediatric patients with epilepsy (PPE) and identify predictors of CAM usage in our multiethnic setting. METHODS This was a cross-sectional study where caregivers of recruited at an outpatient epilepsy clinic between September 2013 and July 2014 completed a self-administered survey. Those who declined participation, lacked understanding of English or Mandarin, or missed the clinic appointments were excluded. Those caring for more than one patient participated only once. RESULTS Of the 195 surveys collected, 178 were used for analysis. The PPE used an average of 1.50 AEDs (range: 0-4). Forty-nine (27.5%) caregivers reported giving CAMs to their PPE. Commonly used CAMs were multivitamins (44.4%), traditional herbs (42.2%), and acupuncture (17.4%). Multivitamins were mostly given by Christian/Catholic caregivers while Buddhist caregivers mostly gave traditional herbs or acupuncture. The majority of the CAM users were Chinese. Univariate analysis showed that caregivers with secondary school (high school) education were 3.52 times more likely to use CAMs compared to those with primary school (elementary school) education. CONCLUSIONS While some caregivers gave CAMs to their PPE, they had various misconceptions and did not discuss the usage with their healthcare providers. We propose that the predictors identified in this study can help to identify potential CAM users. Healthcare providers should routinely probe about the usage of CAMs by PPE, and thereafter, the suitability of CAM use could be evaluated. The caregivers will benefit from open discussion with healthcare professionals on the safe use of AEDs with or without CAMs.
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Kenney D, Jenkins S, Youssef P, Kotagal S. Patient Use of Complementary and Alternative Medicines in an Outpatient Pediatric Neurology Clinic. Pediatr Neurol 2016; 58:48-52.e7. [PMID: 26923752 DOI: 10.1016/j.pediatrneurol.2015.11.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Revised: 10/23/2015] [Accepted: 11/01/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND This article describes the use of complementary and alternative medicines in an outpatient pediatric neurology clinic, and assesses family attitudes toward the efficacy of complementary and alternative medicines versus prescription medications. Complementary and alternative medicine is an important element of the modern health care landscape. There is limited information about whether, and to what extent, families perceive its utility in childhood neurological disorders. DESIGN/METHODS Surveys were distributed to 500 consecutive patients at a child neurology clinic in Rochester, Minnesota. Questions pertained to the child's diagnoses, use of complementary and alternative medicines, and the specific complementary and alternative medicine modalities that were used. Opinions were also gathered on the perceived efficacy of complementary and alternative medicines and prescription medications. Data were compared using χ(2) or Fisher exact tests as indicated. RESULTS A total of 484 surveys were returned, of which 327 were usable. Only 17.4% admitted to use of complementary and alternative medicine to treat neurological problems. However, in follow-up questioning, actually 41.6% of patients recognized that they were using one or more types of complementary and alternative medicines. Disorders associated with a statistically significant increased prevalence of complementary and alternative medicine use were headache (50.8% with headache used complementary and alternative medicine versus 35.7% without headache; P = 0.008, Fisher exact test), chronic fatigue (63.2% vs 38.8%; P = 0.005, Fisher exact test), and sleep disorders (77.1% vs 37.3%; P < 0.0001, Fisher exact test). CONCLUSIONS A large proportion of pediatric neurology patients in our clinic are also using complementary and alternative medicine. Only 38.5% of these recognize themselves as using complementary and alternative medicine, underlining the need to inquire in-depth about its use. Patients who are less satisfied with their prescription medications are more likely to use complementary and alternative medicine, perhaps reflecting the less tractable nature of their disorders.
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Affiliation(s)
- Daniel Kenney
- Mayo Clinic Department of Child and Adolescent Neurology, Rochester, Minnesota.
| | - Sarah Jenkins
- Mayo Clinic Department of Biomedical Statistics and Informatics, Rochester Minnesota
| | - Paul Youssef
- Mayo Clinic Department of Child and Adolescent Neurology, Rochester, Minnesota
| | - Suresh Kotagal
- Mayo Clinic Department of Child and Adolescent Neurology, Rochester, Minnesota
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Abstract
Investigators from the Mayo Clinic, Rochester MN, determined the use of complementary and alternative medicine (CAM) in an outpatient pediatric neurology clinic, and assessed family attitudes toward the efficacy of CAM versus prescription medications.
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Affiliation(s)
- J Gordon Millichap
- Division of Neurology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Departments of Pediatrics and Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL
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von Schoen-Angerer T, Madeleyn R, Kienle G, Kiene H, Vagedes J. Viscum Album in the Treatment of a Girl With Refractory Childhood Absence Epilepsy. J Child Neurol 2015; 30:1048-52. [PMID: 25038133 DOI: 10.1177/0883073814541473] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Accepted: 06/01/2014] [Indexed: 01/01/2023]
Abstract
Viscum album (European mistletoe) extracts have known immunomodulatory effects but little data exist on anticonvulsant activity despite its usefulness having been reported for centuries. A 4½-year-old girl with childhood absence epilepsy and global developmental delay was treated with different antiepileptic drugs and ketogenic diet but failed to become seizure free over a 2-year period. She also received different herbal remedies as part of an integrative medicine approach. Initial improvement occurred on valproate-ethosuximide, a further improvement was seen after adding clobazam to valproate. Final cessation of absence activity occurred after a dose increase of V album. She was still seizure free at the 12-month follow-up. V album appears to have been a necessary adjunct treatment for this child to become seizure free. We call on physicians to report their experiences of V album in epilepsy and suggest further study.
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Affiliation(s)
- Tido von Schoen-Angerer
- ARCIM Institute, Filderklinik, Filderstadt, Germany Department of Pediatrics, Fribourg Hospital HFR, Fribourg, Switzerland
| | - René Madeleyn
- Department of Pediatrics, Filderklinik, Filderstadt, Germany
| | - Gunver Kienle
- Institute for Applied Epistemology and Medical Methodology (IFAEMM), University of Witten/Herdecke, Fribourg, Germany
| | - Helmut Kiene
- Institute for Applied Epistemology and Medical Methodology (IFAEMM), University of Witten/Herdecke, Fribourg, Germany
| | - Jan Vagedes
- ARCIM Institute, Filderklinik, Filderstadt, Germany Department of Pediatrics, Filderklinik, Filderstadt, Germany Department of Pediatrics, University Hospital, Tübingen, Germany
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Sivaswamy L, Kamat D. Childhood epilepsy. Pediatr Ann 2015; 44:64-5. [PMID: 25658212 DOI: 10.3928/00904481-20150203-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Işler A, Turan FD, Gözüm S, Oncel S. Complementary and alternative approaches used by parents of children with epilepsy on epilepsy management. Epilepsy Behav 2014; 32:156-61. [PMID: 24462737 DOI: 10.1016/j.yebeh.2013.12.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Revised: 11/26/2013] [Accepted: 12/15/2013] [Indexed: 11/15/2022]
Abstract
The aim of this study was to determine the complementary and alternative approaches used by parents of children with epilepsy on epilepsy management. This descriptive study included a total of 304 parents of children with epilepsy aged between 0 and 18years evaluated at the Pediatric Neurology Clinic of Akdeniz University Hospital in Turkey between January and May 2013. Data were collected by using a questionnaire developed by the researchers. It was determined that all the parents use complementary and alternative approaches for their children with epilepsy, and the most common approaches are praying (99.3%); keeping their children away from the effects of smoking (79.8%); feeding their children walnuts (79.6%), butter (59.2%), and bone marrow (58.6%); providing their children with good quality sleep (58.6%); and enabling their children to play games (51%). The approaches commonly applied during seizures include praying (96.2%), comforting their children in their arms and showing affection (55.6%), waiting for seizures to finish at home (45.7%), and laying children on their side (41.1%). Of parents, 98% stated that alternative approaches enable them to control their child's seizures, 100% said that alternative approaches have no adverse effect, and 98.4% stated that they will continue to use these approaches. The children's approaches to cope with epilepsy included looking after pets (72.7%), listening to music (70.1%), watching television (64.5%), playing games (55.3%), praying (51%), and spending time with friends (48.7%). Most of the approaches used by parents and children with epilepsy for the management of illness are determined to consist of complementary approaches that may contribute to management of epilepsy. Knowing the approaches of parents and children with epilepsy that could adversely affect disease management is important for educating parents and children to avoid these potentially harmful interventions.
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Affiliation(s)
- Ayşegül Işler
- Akdeniz University, Nursing Faculty, Pediatric Nursing Department, Antalya, Turkey.
| | - Fatma Dilek Turan
- Akdeniz University, Nursing Faculty, Pediatric Nursing Department, Antalya, Turkey.
| | - Sebahat Gözüm
- Akdeniz University, Nursing Faculty, Public Health Nursing Department, Antalya, Turkey.
| | - Selma Oncel
- Akdeniz University, Nursing Faculty, Public Health Nursing Department, Antalya, Turkey.
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