title: Use of complementary and alternative medicine by children in Europe: published data and expert perspectives.
abstract: BACKGROUND
  Few data document the use of complementary and alternative medicine (CAM) in Europe, with even fewer investigating use by children.
  
  
  METHODS
  A narrative, non-systematic review of CAM use in Europe was performed by combining data from published surveys with expert perspectives. Limitations created by a lack of representative studies, varying definitions of CAM use, and what qualifies as CAM in different countries was partially overcome by integrating local experts to summarise information available only in the national language and provide their perspectives about CAM availability, quality, use and popularity in their countries using a semi-structured questionnaire. Local and international published surveys were summarised, and the prevalence of CAM use was extrapolated.
  
  
  RESULTS
  Data from 20 European countries were available, representing 69% of the European population. Some data about CAM use by the general population were available for 90% of the examined countries, whereas peer-reviewed published surveys were available for only 60%. We extrapolated that 56% (range: 10-90%, adjusted for population size) of the European population in general had used CAM at least once in the past year. Surveys in CAM use by children were available for 55% of the investigated countries. The extrapolated prevalence of CAM use by children in Europe was 52% (range: 5-90%, adjusted for population size). Paediatric CAM experts reported an increasing awareness for and use of CAM in healthcare institutions.
  
  
  CONCLUSIONS
  This precursor for further surveys indicates that CAM appears to be popular not only among adults in Europe, but also for children. Development of a pan-European definition of CAM use and CAM therapies are required to achieve surveys comparable between European countries. Additionally, more research investigating the efficacy and potential adverse effects of CAM therapies is needed because of increasing CAM use by children in Europe.
authors.affiliation: Department of Pediatric Oncology and Hematology, University Children's Hospital Essen, Hufelandstr. 55, D-45147 Essen, Germany. tycho.zuzak@uk-essen.de
authors.forename: Tycho J
authors.initials: TJ
authors.lastname: Zuzak
authors.forename: Johanna
authors.initials: J
authors.lastname: Boňková
authors.forename: Domenico
authors.initials: D
authors.lastname: Careddu
authors.forename: Miklós
authors.initials: M
authors.lastname: Garami
authors.forename: Adamos
authors.initials: A
authors.lastname: Hadjipanayis
authors.forename: Janez
authors.initials: J
authors.lastname: Jazbec
authors.forename: Joav
authors.initials: J
authors.lastname: Merrick
authors.forename: Joyce
authors.initials: J
authors.lastname: Miller
authors.forename: Candan
authors.initials: C
authors.lastname: Ozturk
authors.forename: Ingrid A L
authors.initials: IA
authors.lastname: Persson
authors.forename: Guenka
authors.initials: G
authors.lastname: Petrova
authors.forename: Pablo
authors.initials: P
authors.lastname: Saz Peiró
authors.forename: Simon
authors.initials: S
authors.lastname: Schraub
authors.forename: A Paula
authors.initials: AP
authors.lastname: Simões-Wüst
authors.forename: Aslak
authors.initials: A
authors.lastname: Steinsbekk
authors.forename: Karin
authors.initials: K
authors.lastname: Stockert
authors.forename: Assena
authors.initials: A
authors.lastname: Stoimenova
authors.forename: Jan
authors.initials: J
authors.lastname: Styczynski
authors.forename: Alexandra
authors.initials: A
authors.lastname: Tzenova-Savova
authors.forename: Søren
authors.initials: S
authors.lastname: Ventegodt
authors.forename: Arine M
authors.initials: AM
authors.lastname: Vlieger
authors.forename: Alfred
authors.initials: A
authors.lastname: Längler
mesh_terms: D000367:Age Factors; D001364:Awareness; D002648:Child; D000529:Complementary Therapies / Q000706:statistics & numerical data*; D005060:Europe; D019538:Health Care Surveys; D006801:Humans; D010342:Patient Acceptance of Health Care; D010372:Pediatrics