Scripties UMCG - Rijksuniversiteit Groningen
 
English | Nederlands

Baat het niet dan schaadt het niet? : Over nadelige effecten van niet-reguliere behandelwijzen bij kinderen

(2018) Visser, B.O.

Purpose
Currently it is difficult for pediatricians to give good advice with regards to the safe usage of complementary and alternative medicine (CAM) by children. This research aims to provide insight into the safety of pediatric CAM usage in the Netherlands.
Research questions
What adverse events due to pediatric CAM usage do pediatricians and parents in the Netherlands identify and how do they communicate about CAM in the consulting room?
Methods
An analysis was done on cases of adverse events from pediatric CAM usage that were reported to a registration at the Nederlands Signalerings Centrum Kindergeneeskunde in three years (2015-2017). Pediatricians in a selection of hospitals were also actively educated and facilitated regarding reporting adverse events to this registration. Next to that, parents of children visiting outpatient clinics in the same hospitals were interviewed using a questionnaire regarding CAM usage in their children and any associated adverse events. Finally, both parents and pediatricians received a questionnaire about current and expected communication with regards to pediatric CAM usage in the consulting room.
Results
Pediatricians registered 32 valid reports of adverse events after pediatric CAM usage. Serious adverse events were mainly associated with indirect consequences like delaying or stopping regular a diagnosis or treatment and the toxicity of dietary supplements and herbs. Cervical manipulation was another source of adverse events. There were strong indications for underreporting during the study.
Of the children that visited the outpatient clinic 36 percent used at least one kind of CAM in the last year. Most of these were ingestible CAM-products like herbs, dietary supplements and vitamins. Parents indicated a (self-reported) adverse event 6 percent of the time. These adverse events also were mainly due to ingestible CAM-products.
Parents only disclosed the CAM usage of their children to the pediatrician 21 percent of the time and they reported themselves as the main initiators of this conversation. The most important reason for not discussing pediatric CAM usage was that the pediatrician did not ask them about it. Pediatricians indeed reported that they asked about CAM usage in a minority of cases.
Conclusion
It is not possible to make any quantitative statements regarding the prevalence of adverse events of pediatric CAM usage in the Netherlands from this research. However, the cases of (serious) adverse events that were collected, highlight the risks of pediatric CAM usage and can be used to create specific recommendations to parents regarding the safe usage of CAM by their children. Pediatricians should start asking about pediatric CAM usage but need more knowledge to do so. This knowledge and the skills to effectively discuss the use of CAM should be taught already in medical school.






 
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