title: Provider Perspective on Integrative Medicine for Pediatric Sickle Cell Disease-related Pain.
abstract: OBJECTIVE
  Integrative medicine (IM) approaches are sometimes used to manage sickle cell disease (SCD)-related pain. The purpose of this research is to (1) understand provider perspective towards the use of IM for pain in children with SCD at a large urban children's hospital and (2) provide recommendations on how to better promote IM for children and adolescents with SCD.
  
  
  METHODS
  After approval from the institutional review board, a qualitative case study approach was used with criterion-type purposeful sampling to select providers from the division of hematology to adequately inform the study. Semistructured interviews were completed using audiotape to facilitate transcription. NVivo 10 analytic software (QSR International Pty Ltd, Doncaster, Victoria, Australia) was used to organize data into themes to answer the study questions.
  
  
  RESULTS
  Ten provider interviews were completed. Attitudes were generally positive, and most providers felt that IM is generally helpful. All providers reported that they do not optimally use integrative therapies for children with SCD. The barriers uncovered focused on lack of process for integration of IM, specifically that IM resources seem transient and based on short-term funding. Provider attitude towards CAM is generally positive, but provider comfort level is highly variable. No providers are completely comfortable with their knowledge base about IM, and increased knowledge is desired.
  
  
  CONCLUSIONS
  Creation of protocols and processes to incorporate IM into management plans for patients with SCD could help to promote its use. Education of providers about utility and efficacy of IM for SCD-related pain and about existing resources would aid in promotion of IM for children with SCD.
authors.affiliation: Division of Pediatric Hematology, Boston Medical Center, Massachusetts; Department of Pediatrics, Boston University School of Medicine (Dr Neri), United States.
authors.forename: Caitlin M
authors.initials: CM
authors.lastname: Neri
authors.affiliation: Department of Physical Education, School & Public Health, Central Washington University, Ellensburg (Dr Beeson), United States.
authors.forename: Tishra
authors.initials: T
authors.lastname: Beeson
authors.affiliation: The George Washington University Milken Institute School of Public Health, Washington, DC (Dr Mead), United States.
authors.forename: Holly
authors.initials: H
authors.lastname: Mead
authors.affiliation: Division of Hematology, Center for Cancer and Blood Disorders, Children's National Medical Center, Washington, DC; The George Washington University School of Medicine and Health Sciences (Dr Darbari), United States.
authors.forename: Deepika S
authors.initials: DS
authors.lastname: Darbari
authors.affiliation: Division of Hematology, Center for Cancer and Blood Disorders, Children's National Medical Center, Washington, DC; The George Washington University School of Medicine and Health Sciences (Dr Meier), United States.
authors.forename: Emily Riehm
authors.initials: ER
authors.lastname: Meier
keywords: Sickle cell disease; complementary and alternative medicine; integrative medicine; pain; pediatrics; qualitative research