title: Complementary and alternative medicine in paediatrics in daily practice--a European perspective.
abstract: BACKGROUND
  Complementary and alternative medicine (CAM) is used by both adults and children in Europe. Diverse cultural, ethnic and historical preconditions in European countries result in broad differences between the types of CAM practiced, prevalence of CAM use and integration in the health system. To date, no survey of CAM availability to paediatric patients in Europe exists.
  
  
  METHODS
  We present an overview of CAM integration within the different levels of the European paediatric health systems as a narrative review. Paediatric CAM specialists in 20 European countries provided information about CAM integration in their countries in semi-structured interviews.
  
  
  RESULTS
  Data from 20 European countries were available, representing 68% of the European population. CAM is offered in private practices in all 20 (100%) countries, and 80% described some form of CAM training for health professionals. While CAM is offered in outpatient clinics treating adults in 80% of these countries, only 35% offer CAM in paediatric outpatient clinics. Dedicated CAM inpatient wards exist in 65% of the countries for adults, but only in Germany and the Netherlands for children. Groups conducting some CAM research or CAM research focussed on paediatrics exist in 65% and 50% of the 20 countries, respectively. Homeopathy, acupuncture and anthroposophic medicine were most often named.
  
  
  CONCLUSIONS
  Every child in Europe has access to CAM treatment, mainly in private practices, whereas CAM outpatient clinics and inpatient services for children are rare. This is in contrast to adult treatment facilities, many of which offer CAM services, and the high percentage of European children using CAM.
authors.affiliation: Gemeinschaftskrankenhaus, Department for Integrative Paediatric and Adolescent Medicine, Herdecke, Germany. a.laengler@gemeinschaftskrankenhaus.de
authors.forename: Alfred
authors.initials: A
authors.lastname: Längler
authors.forename: Tycho J
authors.initials: TJ
authors.lastname: Zuzak
mesh_terms: D000554:Ambulatory Care Facilities; D000529:Complementary Therapies / Q000193:education / Q000706:statistics & numerical data*; D005060:Europe; D019538:Health Care Surveys; D006302:Health Services Research; D006760:Hospitalization; D006761:Hospitals; D006801:Humans; D007297:Inpatients; D055048:Integrative Medicine; D007407:Interviews as Topic; D010045:Outpatients; D010372:Pediatrics; D010818:Practice Patterns, Physicians'; D011331:Private Practice