Use of Complementary and Alternative Medicine in Children with Recurrent Acute Otitis Media in Italy

Abstract

Controlling environmental factors, chemoprophylaxis, immunoprophylaxis and surgery are considered possible means of preventing recurrent acute otitis media (RAOM), but there are no available data concerning the paediatric use of complementary and alternative medicine (CAM). We evaluated the uses of CAM (homeopathy and/or herbal medicine) as means of preventing AOM in children with a history of RAOM. Eight hundred and forty Italian children with RAOM (~3 episodes in six months) aged 1-7 years were surveyed in 2009 using a face-to-face questionnaire, filled by parents or caregivers, that explored the prevalence, determinants, reasons, cost, and perceived safety and efficacy of CAM. About one-half (46%) of the children used CAM, significantly more than the number who used immunoprophylaxis (influenza vaccine 15%; p<0.05), PCV-7 34%; p< 0.05) or chemoprophylaxis (2%; p<0.001). Use of CAM in the family was the only important factor positively associated with the use of CAM in children (adjusted OR 7.94; 95% CI: 5.26-11.99).The main reasons for using CAM were a fear of the adverse effects of conventional medicine (40%) and to increase host defences (20%). CAM was widely seen as safe (95%) and highly effective (68%). CAM prescribers were paediatricians in 50.7% of cases; self-initiation was reported by 23% of respondents. CAM expenditure was between €25 and €50/ month in 27.6% of cases and~€50/month in 16%. Children with RAOM should be considered among the categories of subjects likely to be using CAM. Together with the fact that paediatricians are the main prescribers, this is worrying because of the current lack of evidence regarding the efficacy, safety and cost-effectiveness of CAM in the prevention of RAOM.The use ofcomplementary and alternative medicine (CAM) in paediatrics has grown dramatically in the Western world over recent years. It has been shown that approximately 20-40% of healthy children seen in outpatient paediatric clinics (1-3) and more than 50% of children with chronic, recurrent or incurable conditions use CAM, almost always in conjunction with mainstream medicine (4-10). Most families use

Good Quality and Clinical Practices for the Future Development of Herbal Medicines

“…Of the 405 respondents 229 (57%) reported lifetime CAM use. Among CAM users, the most prevalent therapies were homeopathy (25%), herbal remedies (8%), anthroposophic medicine (7%), vitamin preparations (6%), and acupuncture (5%) [26]. Similar reports have been published from the United States where CAM and HM use in children is high and continuing to increase.…”

“…CAM was widely seen as safe (95%) and highly effective (68%), and CAM prescribers were pediatricians in 50.7% of cases [25]. A similar study in Germany looked at CAM use in 500 children in outpatient clinics [26]. Of the 405 respondents 229 (57%) reported lifetime CAM use.…”

Substitutes or complements? Diagnosis and treatment with non-conventional and conventional medicine

“…The applications of this work are several and they provide the empirical background for the independent variables used in the work presented here (28)(29)(30)(31). A relevant branch of the existing literature is related to the efficacy, safety, and also cost effectiveness of CAM (32,33). There is also some work on the use of CAM for particular diseases and on the attitude of physicians towards CAM (34,35).…”

Use of bodily sensations as a risk assessment tool: exploring people with Multiple Sclerosis’ views on risks of negative interactions between herbal medicine and conventional drug therapies

“…While it is known that different types of CAM treatments entail the risk of negative interactions when combined with CDT [12], it has been shown that CAM users in general do not reflect upon risks of adverse effects or negative interactions with conventional treatments [8,13,14]. CAM studies have in particular emphasized this tendency related to the use of herbal medicine [15,16]. …”