Abstract
BackgroundThe use of complementary alternative medicine (CAM) is potentially prevalent among paediatric patients with chronic diseases but with variable rates among different age groups, diseases and countries. There are no recent reports on CAM use among paediatric patients with inflammatory bowel disease (IBD) and juvenile idiopathic arthritis (JIA) in Europe. We hypothesized that CAM use associates with a more severe disease in paediatric IBD and JIA.MethodsA cross-sectional questionnaire study among adolescent outpatients with IBD and JIA addressing the frequency and type of CAM use during the past year. The patients were recruited at the Children’s Hospital, University of Helsinki, Finland.ResultsOf the 147 respondents, 97 had IBD (Crohn’s disease: n = 46; median age 15.5, disease duration 3.4 years) and 50 had JIA (median age 13.8, disease duration 6.9 years). During the past 12 months, 48% regularly used CAM while 81% reported occasional CAM use. Compared to patients with JIA, the use of CAM in IBD patients tended to be more frequent. The most commonly used CAM included probiotics, multivitamins, and mineral and trace element supplements. Self-imposed dietary restrictions were common, involving 27.6% of the non-CAM users but 64.8% of all CAM users. Disease activity was associated with CAM use in JIA but not in IBD.ConclusionsCAM use is frequent among adolescents with IBD and JIA and associates with self-imposed dietary restrictions. Reassuringly, adherence to disease modifying drugs is good in young CAM users. In JIA, patients with active disease used more frequently CAM than patients with inactive disease. As CAM use is frequent, physicians should familiarise themselves with the basic concepts of CAM. The potential pharmacological interaction or the toxicity of certain CAM products warrants awareness and hence physicians should actively ask their patients about CAM use.
Highlights
The use of complementary alternative medicine (CAM) is potentially prevalent among paediatric patients with chronic diseases but with variable rates among different age groups, diseases and countries
The total response rate of inflammatory bowel disease (IBD) patients compared to juvenile idiopathic arthritis (JIA) patients was significantly higher (76% versus 51%, p = 0.0001)
Of the patients recruited during in-house visits, 8.8% refused to participate in the study (IBD: n = 5, male: n = 2; JIA: n = 8, male: n = 4)
Summary
The use of complementary alternative medicine (CAM) is potentially prevalent among paediatric patients with chronic diseases but with variable rates among different age groups, diseases and countries. There are no recent reports on CAM use among paediatric patients with inflammatory bowel disease (IBD) and juvenile idiopathic arthritis (JIA) in Europe. We hypothesized that CAM use associates with a more severe disease in paediatric IBD and JIA. In Finland, the incidence of paediatric IBD is high, approximating 15/ 100 000 in 2003, with an estimated annual increase of 6.5% [2]. The incidence of juvenile idiopathic arthritis (JIA), another common chronic autoimmune disease in childhood, is approximately 20-25/100 00 in Finland, but in contrast to IBD, no increase in the number of cases has been observed in recent years [10]. The first-line medications used for JIA are non-steroidal anti-inflammatory drugs (NSAID) and intra-articular corticoid injections, followed by disease modifying drugs (DMARD), and in the most severe cases, new biological drugs [14]
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