Elsevier

Ambulatory Pediatrics

Volume 4, Issue 5, September–October 2004, Pages 429-435
Ambulatory Pediatrics

Visits to Complementary and Alternative Medicine Providers by Children and Adolescents in the United States

https://doi.org/10.1367/A03-091R1.1Get rights and content

Objective.—Determine the prevalence, patterns, costs, and predictors of visits to complementary and alternative medicine (CAM) providers and subsequent remedy use in a nationally representative pediatric sample.

Methods.—The 1996 Medical Expenditure Panel Survey provided data on 7371 subjects ≤21 years of age. The primary outcome variable was CAM provider visits as defined by consulting a CAM provider “for health reasons.” Predictors included sociodemographics, family resources, health status, parental CAM use, and perceptions and use of conventional medical care. Bivariate analyses and logistic regression determined independent factors associated with CAM use.

Results.—Overall, 2.0% used CAM. Only 12.3% disclosed this use to their usual source of care (USC). The most common providers were chiropractors and clergy or spiritualists. The most common therapies were herbal remedies and spiritual healing. Mean amount spent per person on CAM visits was $73.40 and on remedies was $13.06. Weighted estimates to the national pediatric population of annual expenditures on CAM visits and remedies were $127 million and $22 million, respectively. Significant factors independently associated with CAM visits were female gender, older age, good and very good perceived physical health as compared with excellent health, parental CAM use, and dissatisfaction with the quality of care received from the USC.

Conclusions.—Two percent of parents reported that their children consulted a CAM provider and rarely disclosed this use to their USC. While dissatisfaction with the quality of care by the USC and less good perceived physical health predicted CAM visits, parental CAM use was the most predictive.

Section snippets

Sample

This study involved a cross-sectional analysis of the Household Component of the 1996 Medical Expenditure Panel Survey (MEPS), a subsample of the 1995 National Health Interview Survey. MEPS is a nationally representative random sample of the US civilian noninstitutionalized population, designed to provide estimates of health care use, expenditures, sources of payment, and insurance coverage.30 MEPS Household Component is a longitudinal, overlapping panel design consisting of 5 rounds over a

Survey Respondents

The primary survey respondent was a biologic parent in 86% and a step or foster parent in less than 1% of cases. Of the remaining subjects, 4% of respondents were unknown, 3% responded for themselves, and the rest were other family members.

Of the total sample, over 70% had 2 parents living at home and 75.7% of their mothers were married. About 20% of subjects reported a family income under the poverty level for 1996, and 24.1% was ≥400% of the poverty level. Overall, 12.2% were uninsured, with

DISCUSSION

This study is one of the first to describe the use of CAM professionals by a nationally representative pediatric and adolescent sample. Our study adds to the understanding of prevalence, use patterns, and costs of visits to CAM providers and subsequent practitioner-provided therapy use. The most common CAM providers in this study are similar to those found in adult studies.1, 34

Our 2.0% overall prevalence is lower than other studies in pediatric and adolescent populations. Over the past 10

CONCLUSION

Two percent of parents reported that their child consulted a CAM provider for health reasons. The independent associated factors for these visits were female gender, older adolescent age, good perceived physical health, dissatisfaction with the quality of care from the USC, and parental CAM use. In future research, it will be important to determine the effectiveness and satisfaction with CAM use as well as which therapies are used for which conditions and why such a low disclosure rate exists.

ACKNOWLEDGMENT

Funded by MCHB grant 2T71MC00012-06.

REFERENCES (43)

  • BreunerCC et al.

    Alternative medicine use by homeless youth

    Arch Pediatr Adolesc Med

    (1998)
  • SandersH et al.

    Use of complementary and alternative medical therapies among children with special health care needs in southern Arizona

    Pediatrics

    (2003)
  • ChanE et al.

    Complementary and alternative therapies in childhood attention and hyperactivity problems

    J Dev Behav Pediatr

    (2003)
  • HagenLE et al.

    Use of complementary and alternative medicine by pediatric rheumatology patients

    Arthritis Rheum

    (2003)
  • FernandezCV et al.

    Alternative and complementary therapy use in pediatric oncology patients in British Columbia: prevalence and reasons for use and nonuse

    J Clin Oncol

    (1998)
  • SawyerMG et al.

    The use of alternative therapies by children with cancer

    Med J Austral

    (1994)
  • SouthwoodTR et al.

    Unconventional remedies used for patients with juvenile arthritis

    Pediatrics

    (1990)
  • FriedmanT et al.

    Use of alternative therapies for children with cancer

    Pediatrics

    (1997)
  • SpigelblattL et al.

    The use of alternative medicine by children

    Pediatrics

    (1994)
  • SandersH et al.

    Use of complementary and alternative medical therapies among children with special health care needs in southern Arizona

    Pediatrics

    (2003)
  • LanskiSL et al.

    Herbal therapy use in a pediatric emergency department population: expect the unexpected

    Pediatrics

    (2003)
  • Cited by (66)

    • Traditional and complementary approaches to health for children: Modelling the parental decision-making process using Andersen's sociobehavioural model

      2013, Complementary Therapies in Medicine
      Citation Excerpt :

      However, a subsequent phase of this project, which used semi-structured interviews with GPs and nurses, identified mismatched perspectives and criteria regarding TCA between professionals and patients, which may create communication problems during consultation43 These interviews also identified time constraints as limiting discussion of TCA.44 Parent-reported rates of discussion of around a third were similar to American studies.16,34,45 The influence of GP advice may be stronger in children with eczema.46

    • Overview of integrative medicine in child and adolescent psychiatry

      2013, Child and Adolescent Psychiatric Clinics of North America
    View all citing articles on Scopus
    View full text