The use of natural health products by paediatric patients in respite care.
OBJECTIVE
To determine the use and potential interactions of natural health products (NHPs) with conventional medications in children with life-limiting illnesses.


METHODS
The present study was a retrospective medical record review of palliative care patients <18 years of age who were admitted for respite care to a Canadian paediatric hospice between January 1, 2008 and December 31, 2013. The NHPs were identified according to Health Canada's inclusion criteria.


RESULTS
A total of 106 children were included in the present study. Eighty-two (77.4%) had used one or more NHPs: 60 (56%) used vitamins and minerals; 45 (42.5%) used other products including probiotics, omega-3, organic acids and essential fatty acids; 34 (32.1%) used everyday consumer products; 12 (11.3%) used herb or plant-based remedies; and one (0.9%) used homeopathic remedies. Thirty-nine potential NHP-medication and 10 potential NHP-NHP interactions were identified. A considerable number of patients (n=54) used at least one medication and NHP, or two NHPs with potential interactions. The most common type of interaction was pharmacokinetic: decreasing blood concentrations of the medication, NHP or both (43.9% of NHP users); and enhancing the blood concentration of an NHP for NHP-NHP interactions (22% of NHP users).


CONCLUSIONS
A high proportion of patients in respite care use NHPs. Most used NHPs and medications that have potential interactions, although there were no adverse clinical manifestations in the present study. It is important to educate health care professionals about NHPs, the evidence available and lack thereof. This could reduce the most serious interactions and improve the alliance between parents and health care providers to balance the potential risks and benefits of NHPs.
Pharmaceutical and Biological Sciences Institute, Claude Bernard Lyon, University of Pharmacy, Lyon, France; ; Department of Clinical Pharmacy;
Audrey
A
Beringer
Department of Clinical Pharmacy;
Régis
R
Vaillancourt
Department of Clinical Pharmacy;
Gilda
G
Villarreal
Palliative Care Program, Children's Hospital of Eastern Ontario, Ottawa, Ontario.
Christina
C
Vadeboncoeur
Complementary medicine; Hospice; Interactions; Natural health products; Paediatric