Serious adverse events associated with pediatric complementary and alternative medicine

Abstract

IntroductionComplementary and alternative medicine (CAM) use among children is extremely popular. Users consider CAM to be more ‘natural’, more aligned with personal health values, and associated with fewer side effects. However, few pediatric studies have investigated adverse events (AEs) associated with CAM therapies. The objective of this review was to identify serious AEs associated with use of pediatric CAM in partnership with the Canadian Pediatric Surveillance Program. MethodsActive surveillance of a national representative sample of Canadian pediatricians. Participants were asked to report if they had seen any suspected serious AEs associated with CAM in the past month. Harms could be direct (associated with the CAM therapy itself) or indirect (delay in diagnosis or treatment of a serious medical condition). Details of reported AEs were adjudicated by two independent experts to assess causality. ResultsDuring the study period (January 01, 2009 to December 31, 2010), Canadian pediatricians reported 12 unique cases of suspected serious adverse events associated with CAM. Of these, detailed reports were provided in nine cases, of which eight were adjudicated as serious. Six of the eight cases were considered ‘probably’ and two ‘possibly’ caused by CAM interventions. Serious pediatric AEs identified included anaphylaxis, hallucinations, muscle weakness with elevated creatine kinase, hypervitaminosis D with possible chronic nephrocalcinosis as a consequence, and short term paralysis. ConclusionFew serious AEs were identified in this study, despite widespread use of pediatric CAM. Active surveillance is challenged by under-reporting and can be enhanced by improved communication at each patient encounter.This article belongs to the Special Issue: Ensuring and Improving Patients’ Safety in Integrative Health Care.