Complementary and alternative medicine in the treatment of acute bronchitis in children: A systematic review

Wopker, Pilar Marie; Schwermer, Melanie; Sommer, Simon; Längler, Alfred; Fetz, Katharina; Ostermann, Thomas; Zuzak, Tycho Jan

doi:10.1016/j.ctim.2019.102217

Cited by 25 publications

(21 citation statements)

References 30 publications

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“…There is some evidence that the use of phytopharmaceuticals could contribute to a reduction in the number of inappropriate antibiotic prescriptions for respiratory infections; in a recent study based on the electronic medical records from approximately 234,000 primary care and pediatric patients in Germany, the use of selected phytopharmaceuticals in ALURTI was associated with a reduced need for antibiotic prescriptions in the further course of the disease [27]. Reviews of complementary and alternative medicines for treatment of respiratory tract infections indicate that some of the treatments may be effective and safe, and help to reduce unnecessary antibiotic prescribing [28][29][30][31][32][33].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of and Factors Associated with Antibiotic Prescriptions in Patients with Acute Lower and Upper Respiratory Tract Infections—A Case-Control Study

Kern

Kostev²

2021

Antibiotics

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: Background: The goal of the present study was to estimate the prevalence of patient and physician related variables associated with antibiotic prescriptions in patients diagnosed with acute lower and upper respiratory tract infections (ALURTI), treated in general practices (GP) and pediatric practices, in Germany. Methods: The analysis included 1,140,095 adult individuals in 1237 general practices and 309,059 children and adolescents in 236 pediatric practices, from the Disease Analyzer database (IQVIA), who had received at least one diagnosis of an ALURTI between January 1, 2015 and March 31, 2019. We estimated the association between 35 predefined variables and antibiotic prescription using multivariate logistic regression models, separately for general and pediatric practices. The variables included the proportion (as a percentage) of antibiotics or phytopharmaceuticals on all prescriptions per practice, as an indicator of physician prescription preference. Results: The prevalence of antibiotic prescription was higher in patients treated in GP (31.2%) than in pediatric practices (9.1%). In GP, the strongest association with antibiotic prescription was seen in the practice preference for antibiotic use, followed by specific diagnoses (acute bronchitis, sinusitis, pharyngitis, laryngitis, and tracheitis), and higher patient age. In pediatric practices, acute sinusitis and bronchitis were the variables with the strongest association, followed by practice preference for antibiotic prescription. The strongest association with the non-prescription of antibiotics was practice preference for phytopharmaceuticals and the specific diagnosis of a viral infection. Conclusion: This study shows a high prevalence of antibiotic prescribing for patients with ALURTI in a primary care setting, especially in adult patients; physician related factors play an important role that should be addressed in interventions to reduce potentially inappropriate antibiotic prescribing.

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Section: Discussionmentioning

confidence: 99%

Prevalence of and Factors Associated with Antibiotic Prescriptions in Patients with Acute Lower and Upper Respiratory Tract Infections—A Case-Control Study

Kern

Kostev²

2021

Antibiotics

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“…Parents used to CAM intake are likely to administer CAM to their children 8 . People find them affordable because they perceive them as natural, harmless, non‐industrial, organic, and they are convinced of their efficacy 9,10 . CAM use includes both treatment and support therapy of acute and chronic disease, as well as preventive therapy in healthy children 4‐6 …”

Section: Introductionmentioning

confidence: 99%

“…8 People find them affordable because they perceive them as natural, harmless, non-industrial, organic, and they are convinced of their efficacy. 9,10 CAM use includes both treatment and support therapy of acute and chronic disease, as well as preventive therapy in healthy children. [4][5][6] This study aims to investigate the use of CAM in children in four clinics of family paediatricians in Friuli Venezia Giulia, Italy, and to assess whether there is any correlation between the use of CAM and maternal education, country of origin and vaccination status of the children.…”

mentioning

confidence: 99%

Is the use of alternative therapy in children just another form of medicalisation? A prospective study

et al. 2020

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Aim The use of complementary and alternative medicines (CAM) seems widespread in adults and children, despite the conflicting evidence regarding its effectiveness and safety. This study aims to investigate the prevalence of the use of CAM in a population of Italian children. Methods This is a prospective observational study conducted in 4 family paediatric clinics, in Friuli Venezia Giulia, Italy, from February to June 2019. Children were enrolled after being visited. The use of CAM and essential therapies (ET) in the previous year was investigated with an anonymous questionnaire. The demographic characteristics of children and families were also collected. Results Six hundred children were enrolled, mean age 5.8 years, 50% females. In the previous year, 358 (60%) children used both essential therapies and CAM, 209 children (35%) only essential therapies, 25 (4%) only CAM, and 8 (1%) no therapy. CAM was more frequently used in children whose parents have a higher educational level and come from high‐income countries (P < .0001). Non‐vaccinated children received more CAM than vaccinated ones (P < .003). Conclusion In our population, more than 60% of children receive CAM. The use of this medical approach seems strictly related to the social and cultural status of families.

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“…It is a multimodal treatment system founded by Rudolf Steiner and Ita Wegmann in the early 1920s [37] and includes complementary pharmacotherapy, medicinal baths, rhythmical massages, compresses, and embrocation (rhythmic massages with etheric oils [38]), as well as art therapy, eurythmy, speech therapies, music therapy [39], and light/ color therapy. Consensus-based guidelines for the anthroposophic therapies for children suffering from general pediatric diseases, such as acute gastroenteritis [40] and bronchitis [41] have already been published.…”

Section: Introductionmentioning

confidence: 99%

“…Considering the growing costs of health care, a better understanding of resource utilization is indispensable to provide clinically effective and financially responsible treatment. Especially within the integrative field, there is a need for research evaluating the resource utilization and benefits for patients and the health care system [41,42]. The evaluation of resource utilization parameters thus may provide valuable information that can be considered when seeking to optimize integrative strategies in order to lower health care costs and to license and scope health care investment decisions [44].…”

Section: Introductionmentioning

confidence: 99%

Comparative analysis of resource utilization in integrative anthroposophic and all German pediatric inpatient departments

Fetz

Längler

Schwermer

et al. 2020

BMC Health Serv Res

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Background Integrative Medicine (IM) combines conventional and complementary therapies. It aims to address biological, psychological, social, spiritual and environmental aspects of patients’ health. During the past 20 years, the use and request of IM in children and adults has grown. Anthroposophic Medicine (AM) is an IM approach frequently used in children in Germany. From both public health and health economic perspectives, it is relevant to investigate whether there are differences in the resource utilization between integrative pediatric departments (IPD) and the entirety of all pediatric departments. Methods Standard ward documentation data from all German integrative anthroposophic pediatric departments (2005–2016; N = 29,956) is investigated and systematically compared to data of the entirety of all pediatric departments in Germany derived from the Institute for the Hospital Reimbursement System (2005–2016, N = 8,645,173). The analyses focus on: length of stay, Diagnosis Related Groups (DRG), Major Diagnosis Categories (MDC), and effective Case Mix Index (CMI). Results The length of stay in the IPD (M = 5.38 ± 7.31) was significantly shorter than the DRG defined length of stay (M = 5.8 ± 4.71; p < .001; d = − 0.07) and did not exceed or undercut the DRG covered length of stay. Compared to the entirety of all pediatric departments (M = 4.74 ± 6.23) the length of stay was significantly longer in the in the IPD (p <. 001; d = 0.12). The effective CMI in IPD and all pediatric departments were identical (M = 0.76). The frequencies of DRG and MDC differed between IPD and all pediatric departments, with higher frequencies of DRGs and MDCs associated with chronic and severe illnesses in the IPD. Conclusions Treatment within integrative anthroposophic pediatric departments fits well in terms of the DRG defined conditions concerning length of stay, even though integrative pediatric patients has an increased length of stay of averagely 1 day, which is most likely associated to time consuming, complex integrative treatment approaches and to a certain extend to higher amount of chronic and severe diseases.

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Complementary and alternative medicine in the treatment of acute bronchitis in children: A systematic review

Cited by 25 publications

References 30 publications

Prevalence of and Factors Associated with Antibiotic Prescriptions in Patients with Acute Lower and Upper Respiratory Tract Infections—A Case-Control Study

Prevalence of and Factors Associated with Antibiotic Prescriptions in Patients with Acute Lower and Upper Respiratory Tract Infections—A Case-Control Study

Is the use of alternative therapy in children just another form of medicalisation? A prospective study

Comparative analysis of resource utilization in integrative anthroposophic and all German pediatric inpatient departments

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