title: Use of complementary and alternative medicine in children with recurrent acute otitis media in Italy.
abstract: Controlling environmental factors, chemoprophylaxis, immunoprophylaxis and surgery are considered possible means of preventing recurrent acute otitis media (RAOM), but there are no available data concerning the paediatric use of complementary and alternative medicine (CAM). We evaluated the uses of CAM (homeopathy and/or herbal medicine) as means of preventing AOM in children with a history of RAOM. Eight hundred and forty Italian children with RAOM (≥3 episodes in six months) aged 1-7 years were surveyed in 2009 using a face-to-face questionnaire, filled by parents or caregivers, that explored the prevalence, determinants, reasons, cost, and perceived safety and efficacy of CAM. About one-half (46%) of the children used CAM, significantly more than the number who used immunoprophylaxis (influenza vaccine 15%; p<0.05), PCV-7 34%; p<0.05) or chemoprophylaxis (2%; p<0.001). Use of CAM in the family was the only important factor positively associated with the use of CAM in children (adjusted OR 7.94; 95% CI: 5.26-11.99). The main reasons for using CAM were a fear of the adverse effects of conventional medicine (40%) and to increase host defences (20%). CAM was widely seen as safe (95%) and highly effective (68%). CAM prescribers were paediatricians in 50.7% of cases; self-initiation was reported by 23% of respondents. CAM expenditure was between Euro 25 and Euro 50/month in 27.6% of cases and ≥ Euro 50/month in 16%. Children with RAOM should be considered among the categories of subjects likely to be using CAM. Together with the fact that paediatricians are the main prescribers, this is worrying because of the current lack of evidence regarding the efficacy, safety and cost-effectiveness of CAM in the prevention of RAOM.
authors.affiliation: Department of Maternal and Paediatric Sciences, Università degli Studi di Milano and Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Marchisio
authors.forename: S
authors.initials: S
authors.lastname: Bianchini
authors.forename: C
authors.initials: C
authors.lastname: Galeone
authors.forename: E
authors.initials: E
authors.lastname: Baggi
authors.forename: E
authors.initials: E
authors.lastname: Rossi
authors.forename: G
authors.initials: G
authors.lastname: Albertario
authors.forename: S
authors.initials: S
authors.lastname: Torretta
authors.forename: L
authors.initials: L
authors.lastname: Pignataro
authors.forename: S
authors.initials: S
authors.lastname: Esposito
authors.forename: N
authors.initials: N
authors.lastname: Principi
mesh_terms: D001291:Attitude of Health Personnel; D001294:Attitude to Health; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D019317:Evidence-Based Medicine; D005260:Female; D017048:Health Care Costs; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006705:Homeopathy / Q000009:adverse effects / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D010033:Otitis Media / Q000191:economics / Q000453:epidemiology / Q000628:therapy*; D010465:Perception; D028321:Plant Preparations / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D010818:Practice Patterns, Physicians'; D012008:Recurrence; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D028321:Plant Preparations