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CHARacterizing Pediatric Integrative Medicine Within a Large Academic Medical Center (CHARM)
Varun Natarajan1, Samuel N Rodgers-Melnick1,2,3, David W Miller1,4,5
1Connor Whole Health, University Hospitals of Cleveland, Cleveland, OH, USA.
Insights
Pediatric integrative medicine (PIM) offers comprehensive care for children with chronic illnesses, integrating conventional and complementary therapies. This study describes PIM
Area of Science:
- Integrative Medicine
- Pediatric Health
- Chronic Illness Management
Background:
- Conventional medical systems often fail to adequately address the complex health needs of pediatric patients with chronic illnesses.
- Pediatric integrative medicine (PIM) presents an interdisciplinary approach, combining complementary therapies with conventional medicine for holistic care.
- There is a growing demand for PIM, lifestyle-oriented care, and multimodal biopsychosocial interventions, yet limited data exists on its clinical implementation in academic settings.
Purpose of the Study:
- To characterize the demographics and clinical profiles of patients receiving care in a physician-led PIM clinic.
- To identify the range of interventions and treatments utilized within this PIM setting.
- To describe the operational model of PIM within a major pediatric academic medical center.
Main Methods:
- A retrospective review of 2677 outpatient PIM visits from March 2020 to September 2023.
- Inclusion of 657 pediatric patients aged birth to 25 years.
- Data extraction from electronic health records, including demographics, diagnoses, interventions, and supplements, followed by descriptive statistical analysis.
Main Results:
- The patient cohort (mean age 12.24 years) was predominantly female (56%) and White (68%).
- Commonly treated conditions included anxiety, fatigue, headaches, abdominal pain, constipation, nausea, vitamin D deficiency, myofascial pain, and depression.
- Key interventions comprised dietary changes, myofascial self-care, massage therapy, acupuncture, pacing, sleep hygiene, and exercise, alongside supplements like probiotics, vitamin D, and Chinese herbs.
Conclusions:
- PIM effectively delivers whole-person, integrative care for pediatric patients with complex conditions within an academic medical center.
- The clinic's structure supports integrated services, meeting the demand for comprehensive healthcare solutions.
- Further research with standardized metrics is essential to evaluate PIM's clinical efficacy.
Background:
Pediatric patients with chronic illnesses face a multitude of health challenges that are often inadequately addressed by conventional, siloed medical systems. Pediatric integrative medicine (PIM), blending complementary therapies with conventional medicine, offers an interdisciplinary and comprehensive approach to addressing these complex challenges. Despite growing demand for PIM, lifestyle-oriented care, and multimodal biopsychosocial interventions, few studies have described the clinical delivery of PIM within a large academic medical center.
Objectives:
To describe the demographics, clinical characteristics, and interventions utilized within a physician-led, PIM clinic at a large, pediatric academic medical center.
Methods:
A retrospective review was conducted of 2677 outpatient PIM physician office visits (March 2020-September 2023) among 657 pediatric patients (birth-25 years). Data on demographics, diagnoses, interventions, and supplements were extracted from the electronic health record and summarized using descriptive statistics.
Results:
Patients (mean age 12.24 ± 5.20 years) were predominantly female (56%) and White (68%). Common conditions included anxiety (59.2%), fatigue (44.4%), headache (43.1%), abdominal pain (33.6%), constipation (33.0%), nausea (31.7%), vitamin D deficiency (30.1%), myofascial pain (29.5%), and depression (26.8%). Key intervention recommendations included dietary changes (61.8%), myofascial self-care interventions (33.8%), massage therapy (21.0%), acupuncture (19.2%), pacing (18.4%), sleep hygiene (18.3%), and exercise (18.1%). Common supplements recommended included probiotics (49.9%), vitamin D (42.6%), multivitamins (41.9%), fish oil (39.4%), magnesium (32.0%), Chinese herbs (29.7%), and melatonin (22.8%).
Conclusion:
PIM can provide whole-person, integrative care within a large academic medical center for pediatric populations with complex presentations. Its self-governed structure within an academic medical center facilitates broad service integration, addressing demands for comprehensive care. Future practice-based research with standardized documentation and outcome measures is needed to understand PIM's clinical effectiveness.
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