Published online March 1, 2005
PEDIATRICS Vol. 115 No. 3 March 2005, pp. e338-e343 (doi:10.1542/peds.2004-1901)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Wilson, K.
Right arrow Articles by Mills, E.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Wilson, K.
Right arrow Articles by Mills, E.
Related Collections
Right arrow Office Practice

ELECTRONIC ARTICLE

Characteristics of Pediatric and Adolescent Patients Attending a Naturopathic College Clinic in Canada

Kumanan Wilson, MD, MSc, FRCP(C)*,{ddagger}, Jason W. Busse, DC, MSc§, Amy Gilchrist, BA||, Sunita Vohra, MD, MSc, FRCP(C), Heather Boon, PhD{ddagger},# and Edward Mills, MSc§,||

* Departments of Medicine
{ddagger} Health Policy, Management, and Evaluation
# Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
§ Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
|| Department of Research, Canadian College of Naturopathic Medicine, Toronto, Ontario, Canada
CARE Program, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada

Objectives. The use of complementary and alternative medicine (CAM) has grown substantially in North America and has drawn the attention of conventional-medicine practitioners. Conventional-medicine practitioners have expressed concern about the potential for unregulated CAM therapies to cause harm, the sometimes-uncertain cost-benefit ratios associated with these therapies, and the possibility that some CAM providers might advise against established conventional therapies, such as vaccination. These concerns are heightened with respect to the pediatric use of CAM products. To address this issue, we conducted a systematic audit of pediatric and adolescent case files at a large, college-based, Canadian naturopathic teaching clinic. We specifically sought to describe the demographic characteristics, reasons for presentation, use of CAM products, and vaccinations status of children presenting for naturopathic assessment. We also determined factors associated with the use of CAM products and vaccination status.

Methods. We identified all charts for children (<18 years of age) who presented to the Robert Schad Naturopathic Clinic, the teaching clinic of the Canadian College of Naturopathic Medicine, between February 1 and May 31, 2002. Data were abstracted directly from the standardized patient intake forms and from clinical notes recorded during the patient’s initial visit to the clinic. The following data were obtained: age, gender, chief presenting complaints reported by parents, CAM product use at presentation, vaccination status, and reactions to vaccination. We conducted logistic regression analyses to identify factors associated with both CAM product use and vaccination status.

Results. A total of 482 charts were identified. The mean age of patients was 6.5 years (95% confidence interval [CI]: 1.6–11.4 years). The ratio of female subjects to male subjects was 1.09:1 (248:227). The most common reasons for presentation were skin disorders (23%), gastrointestinal complaints (17%), and psychiatric/behavioral disorders (15%). Thirty-five percent of children were using CAM products at presentation (21.2% when both vitamins and minerals were excluded). Vitamins were the most commonly used products (34.6%), followed by herbal remedies (14.9%), oil blends/fats (7.2%), minerals (5.6%), probiotics (4.5%), and homeopathic remedies (3.7%). Of charts with vaccination information, 8.9% indicated that children had not been vaccinated; possible vaccine-associated adverse events were reported for 27% of those who had been vaccinated. Partial or unvaccinated status was associated with younger age, attending the Canadian College of Naturopathic Medicine for advice regarding vaccination, and greater use of CAM products. CAM product use was associated with unvaccinated or partially vaccinated status (odds ratio [OR]: 2.86; 95% CI: 1.46–5.63), presenting with poor energy or fatigue (OR: 3.36; 95% CI: 1.00–11.26), or presenting with throat or sinus infections (OR: 4.06; 95% CI: 1.23–13.04).

Conclusions. Children present for naturopathic assessment for diverse reasons, are high-level consumers of CAM products, and have lower rates of vaccination than population averages. The conventional-medicine community should work with naturopaths to address public health concerns in this population.

Key Words: naturopathy • pediatrics • medical records • complementary and alternative medicine • vaccination

Abbreviations: CAM, complementary and alternative medicine • CCNM, Canadian College of Naturopathic Medicine • OR, odds ratio • CI, confidence interval

Accepted Oct 14, 2004.