Longitudinal analysis of complementary and alternative health care use in children with juvenile idiopathic arthritis
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Published on: January 12, 2019
Karine Toupin April1, Debbie Ehrmann Feldman, Maria Victoria Zunzunegui
1Département de médecine sociale et préventive and Groupe de Recherche Interdisciplinaire en Santé, Université de Montréal, C.P. 6128, Succ. Centre-ville, Montréal, Qc H3C 3J7, Canada. ktoupina@uottawa.ca
Insights
Complementary and alternative health care (CAHC) is frequently used by children with juvenile idiopathic arthritis (JIA). Parents often find CAHC beneficial, with continued use linked to parental history and perceived medication effectiveness.
Area of Science:
- Pediatric Rheumatology
- Integrative Medicine
- Patient-Reported Outcomes
Background:
- Juvenile idiopathic arthritis (JIA) is a chronic condition requiring comprehensive management.
- Complementary and alternative health care (CAHC) represents a diverse range of interventions used alongside conventional treatments.
- Understanding CAHC utilization in pediatric populations is crucial for holistic patient care.
Purpose of the Study:
- To determine the frequency of CAHC use in children with JIA.
- To evaluate the perceived effectiveness of CAHC by parents.
- To identify factors associated with the initiation and continuation of CAHC.
Main Methods:
- A 1-year prospective cohort study of 182 children with JIA.
- Parents completed questionnaires every 3 months.
- Statistical analyses included generalized estimating equations and polytomous regression.
Main Results:
- 36.4% of children with JIA used at least one CAHC over 12 months.
- 72% of parents perceived CAHC as beneficial.
- Predictors for continued CAHC use included parental history of CAHC use and lower perceived effectiveness of prescribed medications.
Conclusions:
- CAHC use is common in children with JIA and generally viewed as beneficial by parents.
- Parental factors, such as prior CAHC use and views on conventional medicine, influence sustained CAHC utilization.
- Healthcare providers should consider these factors when managing children with JIA.
Objectives:
The aims were to determine the frequency of use of different types of complementary and alternative health care (CAHC) in children with juvenile idiopathic arthritis (JIA), to evaluate their effectiveness from the parents' point of view and to explore the factors associated with utilization and with continued use.
Methods:
A cohort of children with JIA (n=182, mean age: 10 years) who attended out-patient clinics were followed for 1 year. Parents responded to questionnaires every 3 months. We used generalized estimating equations to analyze factors associated with CAHC use and polytomous regression to evaluate factors associated with continued use of CAHC.
Results:
Use of CAHC ranged between 10% and 24% for the various 3-month intervals and 36.4% of participants used at least one type of CAHC over the 12-month period. Seventy-two percent of parents who used CAHC for their children felt that it was at least somewhat beneficial. Predictors of continued use of CAHC included previous use of CAHC by parents for their own health problems and lower perceived helpfulness of prescribed medications. Neither children's demographic and socioeconomic characteristics nor disease status were associated with CAHC use.
Conclusions:
CAHC use in children with JIA is common and considered to be moderately beneficial by most parents who used it. Lower parents' perceived helpfulness of medications and previous use of CAHC are associated with a longer use of CAHC by their child. These facts should be taken into account by health professionals involved in the care of these children.
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