title: Correlates of complementary and alternative medicine use in a pediatric tertiary pain center.
abstract: OBJECTIVE
  To examine correlates of complementary and alternative medicine (CAM) use in a pediatric population with chronic pain, and to determine whether CAM use is positively correlated with adaptive coping skills.
  
  
  METHODS
  We examined patient data from 1175 children aged 7 to 18 years with chronic pain who completed the intake assessment at the time of initial evaluation at Boston Children's multidisciplinary Pain Treatment Service between 2003 and 2011. The intake assessment included validated measures of anxiety, depression, pain coping skills, and functional disability. Parents were also asked whether their child had tried CAM modalities in the past. We used a multivariable logistic regression model to determine correlates of CAM use and a multivariable linear regression model to determine the relationship between biobehavioral CAM (relaxation training, hypnosis, and biofeedback) and accommodative coping.
  
  
  RESULTS
  In our multivariable model, we found that female gender (odds ratio [OR] 1.48, 95% confidence interval [95% CI] 1.07-2.02), level of parental education (OR 1.11 per year, 95% CI 1.06-1.16), greater pain intensity (OR 1.06 per point on an 11-point numerical analog scale, 95% CI 1.01-1.11), and more functional disability (OR 1.19 per 10-point increment on the Functional Disability Inventory, 95% CI 1.06-1.34) were independently associated with CAM use. Biobehavioral CAM was found to have a statistically significant correlation with accommodative coping skills (β = 0.2, P = .004).
  
  
  CONCLUSIONS
  In a pediatric chronic pain center, CAM users tended to have higher pain intensity and greater functional disability. Exposure to biobehavioral CAM techniques was associated with adaptive coping skills.
authors.affiliation: Department of General Pediatrics, Boston Children's Hospital, Boston, Mass. Electronic address: rvmd2007@gmail.com.
authors.forename: Rachel
authors.initials: R
authors.lastname: Vinson
authors.affiliation: Department of Internal Medicine, Beth Israel Deaconess Medical Center, Boston, Mass.
authors.forename: Gloria
authors.initials: G
authors.lastname: Yeh
authors.affiliation: Department of Internal Medicine, Beth Israel Deaconess Medical Center, Boston, Mass.
authors.forename: Roger B
authors.initials: RB
authors.lastname: Davis
authors.affiliation: Department of Pain Treatment Service, Boston Children's Hospital, Boston, Mass.
authors.forename: Deirdre
authors.initials: D
authors.lastname: Logan
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D001007:Anxiety / Q000523:psychology; D001676:Biofeedback, Psychology; D002648:Child; D059350:Chronic Pain / Q000523:psychology / Q000628:therapy*; D000529:Complementary Therapies; D003863:Depression / Q000523:psychology; D004522:Educational Status; D005260:Female; D006801:Humans; D006990:Hypnosis; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D018710:Pain Clinics; D010147:Pain Measurement; D012064:Relaxation Therapy; D012720:Severity of Illness Index; D012737:Sex Factors; D062606:Tertiary Care Centers
keywords: chronic pain; complementary and alternative medicine; integrative medicine; pediatrics