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doi:10.1111/jpc.12898

ORIGINAL ARTICLE

Complementary and alternative medicine use among paediatric emergency department patients David McDonald Taylor,1,2 Reetika Dhir,1,3 Simon S Craig,4,5 Thalia Lammers,6 Kaya Gardiner,3,7 Kirrily Hunter,1 Paul Joffe,3 David Krieser2,6,7 and Franz E Babl2,3,7 1

Emergency Department, Austin Health, 2Department of Medicine, University of Melbourne, 3Emergency Department, Royal Children’s Hospital, 4Emergency Department, Monash Medical Centre, 5School of Clinical Sciences at Monash Health, Monash University, 6Emergency Department, Sunshine Hospital and 7 Murdoch Children’s Research Institute, Melbourne, Victoria, Australia

Aim: To determine the period prevalence and nature of complementary and alternative medicine (CAM) use among paediatric emergency department (ED) patients and the perceptions of CAM among the CAM administrators. Methods: A survey was undertaken in four Victorian EDs (January to September 2013). A convenience sample of parents/carers accompanying paediatric patients completed a self-administered questionnaire. The main outcome measures were CAM use and perceptions of CAM. Results: The parents/carers of 883 patients participated. Three hundred eighty-eight (43.9%, 95% confidence interval (CI) 40.6–47.3) and 53 (6.0%, 95% CI 4.6–7.8) patients had taken a CAM within the previous 12 months and on the day of presentation, respectively. There were no gender differences between CAM users and non-users (P = 0.83). The use of CAM was significantly more common among older patients (P < 0.001), those with European ethnicity (P = 0.046) and among those with chronic disease (P < 0.01). Fish oil, garlic, chamomile and acidophilus were the most commonly used CAM. Only 4.4% of CAM use was reported to the ED doctor. There were reports of potentially dangerous CAM use (St John’s wort, ginseng). Parents/carers who had administered CAM were more likely to report that CAMs are safe, drug free and could prevent illness (P < 0.01). In addition, a number of this group reported that CAMs are more effective than prescription medicines and safe when taken with prescription medicines. Conclusion: CAM use is common among paediatric ED patients although rarely reported to the ED doctor. Parents/carers who administer CAM have differing perceptions of CAM safety from those who do not. Key words:

alternative medicine; child; complementary medicine; emergency department.

What is already known on this topic

What this paper adds

1 The use of complementary and alternative medicines (CAMs) within the general population is common. 2 The safety and efficacy of many CAMs are not known.

1 CAM use is common among paediatric emergency department (ED) patients with 43.9% having taken a CAM in the previous 12 months. 2 Only 4.4% of parents/carers reported their child’s CAM use to the ED doctor. 3 Parents/carers who administer CAM have differing perceptions of CAM safety from those who do not.

The Cochrane Collaboration defines complementary and alternative medicine (CAM) as ‘a broad domain of healing resources that encompasses all health systems, modalities, and practices and their accompanying theories and beliefs, other than those intrinsic to the politically dominant health system of a particular society or culture in a given historical period’.1 For the purposes of this study, we have limited CAM to include herbal products, Correspondence: Professor David McDonald Taylor, Emergency Department, Austin Health, PO Box 5555, Heidelberg, Melbourne, Vic. 3084, Australia. Fax: +61 3 9496 3380; email: [email protected] Conflict of interest: The authors declare no conflicts of interest. Accepted for publication 5 March 2015.

natural products and probiotics that may be purchased, without a prescription and from any source, for the purpose of self-treatment. The reported prevalence of CAM use among adults ranges between 9% and 65%.2 CAM use is less among children, with a reported overall prevalence of 12% to 18%.3 However, outpatient studies report that 10–55% of children have used CAM at least once3–5 and use may be as high as 60–70% among children with chronic disease.6 Despite high reported prevalence, there is little research on the effectiveness and adverse effects of CAM. A previous emergency department (ED) study in the USA reported a high prevalence of CAM use and raised concerns about CAM toxicity and potential drug interactions.7 There is a paucity of work on CAM use in the Australian paediatric ED

Journal of Paediatrics and Child Health 51 (2015) 895–900 © 2015 The Authors Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians)

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population. This project aimed to determine the prevalence and nature of CAM use among paediatric ED patients, the high-use demographic groups and the perceptions of CAM among the CAM administrators.

Methods A survey of the parents/carers of paediatric ED patients was conducted between January and September 2013. Data were collected at two tertiary and two secondary paediatric care centres in metropolitan Melbourne (annual paediatric census range 17 000–82 000). Ethics committee approval was obtained at each centre. Parents/carers were suitable for inclusion if their child was aged

Complementary and alternative medicine use among paediatric emergency department patients.

To determine the period prevalence and nature of complementary and alternative medicine (CAM) use among paediatric emergency department (ED) patients ...
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