Prevalence and determinants of use of complementary and alternative medicine in a Canadian pediatric inflammatory bowel disease (IBD) population

Abstract

Background: Surveys of the US general population have indicated that about 40% of people used some form of complementary and alternative medicine (CAM) in the previous year. Hilsden et al [1998] showed that CAM had been used by 51% of adult IBD patients in a tertiary clinic within the past year. There are no studies on the use of CAM in pediatric IBD patients. Aims: To perform an assessment of prevalence and determinants of CAM use in pediatric IBD patients living in the Maritime provinces. Methods: Consecutive pediatric patients (<18 years of age), and one of their parents, seen through IBD clinic over a 4 month period were asked to complete a structured questionnaire. The IWK HC is the sole tertiary referral centre for pediatric gastroenterology for the three Canadian Maritime provinces, and currently follows approximately 170 pediatric IBD patients. Potential factors associated with the use of CAM were assessed using Fisher's exact tests and logistic regression. Results: 90 of 114 questionnaires were received (79% response rate). Patient characteristics included: mean age 13.9_+2. yrs; 56% male; 62.2% CD; mean disease duration 4_+2.5yrs; previous hospitalization 57.8% or surgery 23.3%. 22.2% of patients had used CAM at some point in the past compared with 27.8% of parents. However, only 6.7% of pediatric patients were currently using CAM for their IBD. Of the potential determinants of current use for IBD, only age was significant (9.4_+4yrs for current users, 14.2-+3yrs for nonusers, p<O.O01). For determinants of the patients ever having used CAM, the only significant factor was use of CAM by the parent (44% use vs 13% nonuse, p =0.003). In patients currently using CAM for their IBD, dietary therapies were the preferred modalities (4 of 6 patients). The most strongly endorsed reasons for not using CAM were that treatments seemed to be successful and so I didn't need to try other forms of therapy, and 1 worry it might interfere with conventional medical treatment. Conclusions: Use of CAM among pediatric IBD patients is much less prevalent than has been reported for adult IBD patients. If CAM is chosen for treatment of pediatric IBD, the patient tends to be younger and dietary therapies are preferred. Further studies in other pediatric populations will need to be done to determine whether this low prevalence of CAM use is unique to our population or is the norm. This work was funded in part by a grant from the Crohn's and Colitis Foundation of Canada.