Alternative medicine, prescriptions can collide
CHEO study discovers that parents often don’t disclose all the medicines that they give their children, JOANNE LAUCIUS reports.
Children with chronic illnesses commonly take complementary and alternative medicine — and that’s cause for concern because parents sometimes won’t or don’t tell their child’s physician, says a new study that included the families of more than 200 patients at the Children’s Hospital of Eastern Ontario.
Physicians must be more sensitive to health care choices, and families have to be more open with their physicians, says Dr. James King, the lead author of the CHEO arm of the study.
“As a profession, we need to be receptive and trained to ask the right questions of families — and be nonjudgmental.”
The researchers looked at the use of CAM among children and youth being treated in clinics at CHEO and the Stollery Children’s Hospital in Edmonton. Their illnesses ranged from asthma to cancer.
Of the 979 families approached to be surveyed, 233 were at CHEO, and 222 completed the survey.
Just over 42 per cent of the eastern Ontario families reported using CAM.
Vitamin and mineral supplements were among the most common, but the therapies reported included herbal products, homeopathy, acupuncture, magnets, Chinese traditional medicine, chiropractic, yoga, aromatherapy and faith healing.
Among the findings: Children described as being in fair or poor health were more than three times more likely to use CAM. Those whose parents used it were almost seven times more likely to be using CAM.
About half of the Ottawa families said they had private insurance that covered CAM.
The researchers noted that, over time, patients with chronic conditions were more likely to use CAM.
That means physicians need to ask the family about CAM use every time they see a patient, he says. Many parents didn’t think of overthe-counter remedies as CAM.
Physicians have to be able to tell parents if products and treatments are harmful, beneficial or have no evidence, King says.
“Sometimes people can become desperate and reach for things where there is no clear benefit. It’s important that people be open.”
One in five families surveyed did not tell their physicians they were using CAM.
Among their reasons: concern that the physician would be negative; the belief that the physician didn’t need to know and that the physician didn’t ask about CAM use.
Over 60 per cent said their source of information about CAM was “family.”
In the Ottawa portion of the study, 14 “adverse events” were reported after using CAM, 12 of them minor and two more that were moderate. The families at Stollery reported both more CAM use and more adverse events.
King says the majority of alternative therapies aren’t harmful, but there are potential interactions with medications such as blood thinners and immunosuppressants.
“There’s a need for a lot more research in this area.
“We need to know what works and
Children described as being in fair or poor health were more than three times more likely to use complementary and alternative medicine. Those whose parents used it were almost seven times more likely to be using CAM.
what’s safe,” says King, who notes that medical students at the University of Ottawa, where he is a professor, now take a course in “integrated medicine.”
Attitudes are changing. At CHEO, there are staff members who have expertise in these areas and are available to help parents, particularly in oncology.
“As a provider, one of my responsibilities is to come up with a plan for optional health,” King says.
Bryce Wylde, a homeopath who is a media commentator on alternative health, says it’s important to have an underlying health condition diagnosed by a qualified health-care professional before embarking on treatment.
All products that are safe and effective are issued an eight-digit Natural Product Number (NPN) or Homeopathic Medicine Number (DIN-HM) by Health Canada.
Distrust alternative treatments that promise a magical cure, Wylde advises. “There’s a lot of hokey stuff out there. Every industry has its weakness.”
In the past, physicians have been wary of some alternative treatments such as probiotics for colic and diarrhea in infants.
But they quickly accept these ideas once there has been enough research published in reputable sources, says Wylde. “The best solutions are evidence-based,” he says.
“I am a huge proponent of evidence-based medicine.”