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Pediatricians' Recommendations for Complementary and Alternative Medical (CAM) Therapies

  • Kathi J. Kemper
    Correspondence
    Address correspondence to Kathi J. Kemper, MD, MPH, Caryl J. Guth Chair for Holistic and Integrative Medicine and Professor, Pediatrics, Public Health Sciences and Family and Community Medicine, Wake Forest University School of Medicine, Winston-Salem, NC 27157
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  • Karen G. O'Connor
    Affiliations
    From Pediatrics; Public Health Sciences; Family and Community Medicine (Dr Kemper), Wake Forest University School of Medicine, Winston-Salem, NC; and the Division of Health Policy Research (Ms O'Connor), American Academy of Pediatrics, Elk Grove Village, Ill
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      Objectives.—Increasing numbers of children use complementary and alternative medicine (CAM). The purpose of this project was to assess pediatricians' attitudes and recommendations regarding CAM.
      Methods.—This was a national survey sent to a random sample of active members of the American Academy of Pediatrics (AAP). The survey was 8 pages long and included questions on demographic and practice characteristics, attitudes about CAM, and 3 clinical vignettes asking what therapies physicians recommended in these situations.
      Results.—The 745 eligible respondents were demographically similar to the national AAP membership. Most (87%) had been asked about CAM by a patient/parent in the 3 months prior to the survey and 34% said they or an immediate family member had used CAM in the past year. Most (66%) believed that CAM therapies could enhance recovery or relieve symptoms, but even more were concerned about possible side effects (75%) or that CAM use might delay mainstream care (74%). Only 20% routinely asked patients/parents about their use of herbs, and fewer asked about other CAM therapies. Fewer than 5% felt very knowledgeable about individual CAM therapies. For the clinical vignettes, pediatricians were far more likely to recommend medications than any CAM therapy. Over 80% of pediatricians desired additional information on CAM; the highest priorities were information about herbs, dietary supplements, nutritional therapies, and therapeutic exercise.
      Conclusions.—Pediatricians recognize that many patients are interested in using CAM therapies, but do not feel comfortable discussing or recommending CAM therapies. Pediatricians are very interested in learning more about CAM.

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