title: Is complementary and alternative healthcare use associated with better outcomes in children with juvenile idiopathic arthritis?
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Département 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
authors.forename: Karine
authors.initials: K
authors.lastname: Toupin-April
authors.forename: Debbie Ehrmann
authors.initials: DE
authors.lastname: Feldman
authors.forename: Maria Victoria
authors.initials: MV
authors.lastname: Zunzunegui
authors.forename: Martin
authors.initials: M
authors.lastname: Descarreaux
authors.forename: Peter
authors.initials: P
authors.lastname: Malleson
authors.forename: Ciarán M
authors.initials: CM
authors.lastname: Duffy
mesh_terms: D000293:Adolescent; D001171:Arthritis, Juvenile / Q000175:diagnosis* / Q000628:therapy*; D002170:Canada; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D000529:Complementary Therapies; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D008297:Male; D011379:Prognosis; D011788:Quality of Life; D012720:Severity of Illness Index; D016896:Treatment Outcome