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Is complementary and alternative healthcare use associated with better outcomes in children with juvenile idiopathic
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 and Centre de recherche interdisciplinaire en réadaptation, Montreal, Quebec, Canada. ktoupina@uottawa.ca
Insights
Complementary and alternative healthcare (CAHC) use in children with juvenile idiopathic arthritis (JIA) did not improve health outcomes. However, CAHC users showed better adherence to conventional treatments.
Area of Science:
- Pediatric Rheumatology
- Integrative Medicine
- Health Services Research
Background:
- Juvenile idiopathic arthritis (JIA) is a chronic condition requiring ongoing management.
- Complementary and alternative healthcare (CAHC) is frequently used by patients with chronic diseases.
- The impact of CAHC on health outcomes and treatment adherence in JIA is not well understood.
Purpose of the Study:
- To investigate the association between CAHC use and health outcomes in children with JIA.
- To explore the relationship between CAHC use and adherence to conventional treatments in this population.
Main Methods:
- A one-year prospective cohort study of 182 children with JIA (mean age 10 years).
- Regular assessment of CAHC use, health-related quality of life (HRQOL), global health, physical functioning, pain, and disease severity.
- Evaluation of perceived adherence to prescribed medications.
- Statistical analysis using general estimating equations to control for confounders.
Main Results:
- CAHC was utilized by 36.4% of participants over the 12-month study period.
- CAHC use was associated with poorer global health and physical functioning (p < 0.05).
- No significant association was found between CAHC use and improved HRQOL, reduced pain, or decreased disease severity.
- CAHC users demonstrated higher adherence to prescribed medications as assessed by rheumatologists.
Conclusions:
- CAHC use in children with JIA does not lead to improved health outcomes in the short term.
- Despite lack of outcome improvement, CAHC use is linked to enhanced adherence to conventional medical treatments in JIA patients.
- Further research is needed to understand the complex interplay between CAHC, treatment adherence, and outcomes in pediatric rheumatic diseases.
Objective:
The objectives of this study were (1) to examine the association between the use of complementary and alternative healthcare (CAHC) and subsequent health outcomes; and (2) to explore the association between CAHC use and adherence to conventional treatments in children with juvenile idiopathic arthritis (JIA).
Methods:
A cohort of children with JIA (n = 182, mean age 10 yrs) who attended outpatient clinics were followed for one year. We evaluated the use of CAHC, health-related quality of life (HRQOL), global health, physical functioning, pain, and disease severity at 3-month intervals. We also evaluated perceived adherence to treatments. General estimating equations were performed to determine the association between use of CAHC and subsequent outcomes while controlling for possible confounders.
Results:
CAHC was used by 36.4% of participants over the 12-month period. Use of CAHC was associated with subsequent lower global health and physical functioning despite higher adherence to prescribed medications as assessed by the rheumatologist (p < 0.05). Use of CAHC was not associated with subsequent improved HRQOL or decreased pain or disease severity.
Conclusion:
Children with JIA who use CAHC do not have improved outcomes, at least over the relatively short term. Nevertheless, they seem to be more adherent to conventional treatment according to the rheumatologist.
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