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

  • Kathi J. Kemper
    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
    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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        • Breuner CC
        • Barry PJ
        • Kemper KJ
        Alternative medicine use by homeless youth.
        Arch Pediatr Adolesc Med. 1998; 152: 1071-1075
        • Chan E
        • Rappaport LA
        • Kemper KJ
        Complementary and alternative therapies in childhood attention and hyperactivity problems.
        J Dev Behav Pediatr. 2003; 24: 4-8
        • Davis MP
        • Darden PM
        Use of complementary and alternative medicine by children in the United States.
        Arch Pediatr Adolesc Med. 2003; 157: 393-396
        • Grootenhuis MA
        • Last BF
        • de Graaf-Nijkerk JH
        • van der Wel M
        Use of alternative treatment in pediatric oncology.
        Cancer Nurs. 1998; 21: 282-288
        • Heuschkel R
        • Afzal N
        • Wuerth A
        • et al.
        Complementary medicine use in children and young adults with inflammatory bowel disease.
        Am J Gastroenterol. 2002; 97: 382-388
        • Hurvitz EA
        • Leonard C
        • Ayyangar R
        • Nelson VS
        Complementary and alternative medicine use in families of children with cerebral palsy.
        Dev Med Child Neurol. 2003; 45: 364-370
        • Loman DG
        The use of complementary and alternative health care practices among children.
        J Pediatr Health Care. 2003; 17: 58-63
        • Ottolini M
        • Hamburger E
        • Lopreiato J
        • et al.
        Complementary and alternative medicine use among children in the Washington, DC area.
        Ambul Pediatr. 2001; 1: 122-125
        • Pitetti R
        • Singh S
        • Hornyak D
        • Garcia SE
        • Herr S
        Complementary and alternative medicine use in children.
        Pediatr Emerg Care. 2001; 17: 165-169
        • Sanders H
        • Davis MF
        • Duncan B
        • et al.
        Use of complementary and alternative medical therapies among children with special health care needs in southern Arizona.
        Pediatrics. 2003; 111: 584-587
        • Simpson N
        • Pearce A
        • Finlay F
        • Lenton S
        The use of complementary medicine in pediatric outpatient clinics.
        Ambul Child Health. 1998; 3: 352-356
        • Tsang WO
        • McRae A
        • Leo PJ
        • Santiago L
        The use of alternative medicine by children at an urban community hospital emergency department.
        J Altern Complement Med. 2001; 7: 309-311
        • Wilson KM
        • Klein JD
        Adolescents' use of complementary and alternative medicine.
        Ambul Pediatr. 2002; 2: 104-110
        • Yussman SM
        • Auinger P
        • Weitzman M
        • Ryan SA
        Complementary and alternative medicine use by children and adolescents in the United States.
        Comp Ther Med. 2002; 10: 114
        • Sibinga E
        • Ottolini M
        • Duggan A
        • Wilson M
        Communication about complementary/alternative medicine use in children.
        Pediatr Res. 2000; 47: 226A
        • Berman BM
        • Singh BB
        • Hartnoll SM
        • Singh BK
        • Reilly D
        Primary care physicians and complementary-alternative medicine: training, attitudes, and practice patterns.
        J Am Board Fam Pract. 1998; 11: 272-281
        • Boucher TA
        • Lenz SK
        An organizational survey of physicians: attitudes about and practice of complementary and alternative medicine.
        Altern Ther. 1998; 4: 59-64
        • Diehl DL
        • Kaplan G
        • Coulter I
        • Glik D
        • Hurwitz EL
        • et al.
        Use of acupuncture by American physicians.
        J Altern Complement Med. 1997; 3: 119-126
        • Kemper KJ
        • Vincent EC
        • Scardapane JN
        Teaching an integrated approach to complementary, alternative, and mainstream therapies for children: a curriculum evaluation.
        J Altern Complement Med. 1999; 5: 261-268
        • Kemper KJ
        Family medicine clinic survey on the treatment of upper respiratory tract infections [Letter].
        Arch Fam Med. 1998; 7: 517-518
        • Sikand A
        • Laken M
        Pediatricians' experience with and attitudes toward complementary/alternative medicine.
        Arch Pediatr Adolesc Med. 1998; 152: 1059-1064
        • Kline MW
        • O'Connor KG
        Disparity between pediatricians' knowledge and practices regarding perinatal human immunodeficiency virus counseling and testing.
        Pediatrics. 2003; 112: E367
        • Gupta VB
        • O'Connor KG
        • Quezada-Gomez C
        Care coordination services in pediatric practices.
        Pediatrics. 2004; 113: 1517-1521
        • Woolf AD
        Herbal remedies and children: do they work? Are they harmful?.
        Pediatrics. 2003; 112: 240-246
        • Ernst E
        Serious adverse effects of unconventional therapies for children and adolescents: a systematic review of recent evidence.
        Eur J Pediatr. 2003; 162: 72-80
        • Cranswick N
        • Coghlan D
        Paracetamol efficacy and safety in children: the first 40 years.
        Am J Ther. 2000; 7: 135-141
        • Sheen CL
        • Dillon JF
        • Bateman DN
        • Simpson KJ
        • Macdonald TM
        • et al.
        Paracetamol toxicity: epidemiology, prevention and costs to the health-care system.
        Q J Med. 2002; 95: 609-619
        • Henry D
        • McGettigan P
        Epidemiology overview of gastrointestinal and renal toxicity of NSAIDs.
        Int J Clin Pract Suppl. 2003; 135: 43-49
        • Cummings SM
        • Savitz LA
        • Konrad TR
        Reported response rates to mailed physician questionnaires.
        Health Serv Res. 2001; 35: 1347-1355
      1. Cull WL, O'Connor KG, Tang SS, Sharp S. Age and gender response bias: results from 50 surveys of pediatricians. Health Serv Res 2004 in press

        • Kellerman SE
        • Herold J
        Physician response to surveys. A review of the literature.
        Am J Prev Med. 2001; 20: 61-67
        • Kemper KJ
        • Cassileth B
        • Ferris T
        Holistic pediatrics: a research agenda.
        Pediatrics (Journal of the Ambulatory Pediatric Association). 1999; 103: 902-909