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P558. Complementary and alternative medicine use in Finnish adolescents with IBD and juvenile idiopathic arthritis

P. Nousiainen1,2, K. Aalto2, K.-L. Kolho2, 1Kuopio University Hospital, Department of Pediatrics, Kuopio, Finland, 2Helsinki University Hospital, Children's Hospital, Helsinki, Finland

Background

Concept of complementary and alternative medicine (CAM) comprehends practices and products that aren't considered conventional medicine. Physicians are often unaware of CAM use, despite potential side effects and interactions with conventional therapy. CAM use is less studied in paediatric populations. The aim of this study was to determine the extent and features of CAM use in a Finnish adolescent IBD and juvenile idiopathic arthritis (JIA) population.

Methods

CAM use during last 12 months was assessed by a questionnaire in consecutive outpatient IBD and JIA patients (9.6–18.3 years) in Children's Hospital, Helsinki. Vitamin D, Ca2++ preparations and supplement nutritional drinks were excluded, being prescribed by the physician. Study protocol was approved by the Ethical Committee of Helsinki University Hospital. Statistical analysis was performed on Prism GraphPad 6.

Study ID: T104G0010 Children's Hospital, Helsinki University

Financial support: Finnish Pediatric Research Foundation and Helsinki University Central Hospital Fund

Results

147 out of 225 questionnaires were completed (65%, 97 IBD and 50 JIA patients). Response rate of IBD patients was significantly higher than of JIA patients (76% and 51% respectively, p = 0.0001). Of all patients, 48% regularly used CAM (54% and 38% of IBD and JIA patients respectively, p = 0.08) and 81% had at least tried CAM. Most common forms of regularly used CAM are shown in Table 1.

In previous studies mind-body and manipulative CAM have been popular among adolescent IBD and JIA patients. However, in our study use was rare: acupuncture had been used by 4 patients and osteopathy, energy treatments and zone therapy by only one patient each.

Among IBD patients CAM-users were younger than non-users (14.9 vs. 15.8 years, p = 0.022). Medication (steroids, TNF α blockers, other immunosuppressants) or gender didn't associate with CAM use. It is notable that 52% of CAM users had special diets, significantly more often than non-users (32%, p = 0.012).

Table 1. The most common forms of regularly used CAM
 IBD (n = 52)JIA (n = 19)
Probiotics62%58%
Multivitamin products54%42%
Minerals and trace elements37%21%
Omega 3&6 products23%37%
Supplementary products for athletes12%0%

Conclusion

CAM use is frequent also among Finnish adolescent IBD and JIA patients. Paediatricians should actively ask about CAM use and special diets, since they may influence the treatment or outcome of the disease. Paediatricians would most likely benefit from familiarising themselves with the basic concepts of CAM.