title: Complementary and alternative medicines use among pediatric patients with epilepsy in a multiethnic community.
abstract: Prior studies highlighted that patients on chronic medications who used complementary and alternative medicines (CAMs) did not share this information with their healthcare providers. Furthermore, there might be potential adverse interactions between CAMs and antiepileptic drug (AED) therapy. However, there are no studies that investigate the effect of religion or race on CAM use in a multiethnic community. Therefore, we aimed to investigate CAM usage among pediatric patients with epilepsy (PPE) and identify predictors of CAM usage in our multiethnic setting.
  
  
  
  This was a cross-sectional study where caregivers of recruited at an outpatient epilepsy clinic between September 2013 and July 2014 completed a self-administered survey. Those who declined participation, lacked understanding of English or Mandarin, or missed the clinic appointments were excluded. Those caring for more than one patient participated only once.
  
  
  
  Of the 195 surveys collected, 178 were used for analysis. The PPE used an average of 1.50 AEDs (range: 0-4). Forty-nine (27.5%) caregivers reported giving CAMs to their PPE. Commonly used CAMs were multivitamins (44.4%), traditional herbs (42.2%), and acupuncture (17.4%). Multivitamins were mostly given by Christian/Catholic caregivers while Buddhist caregivers mostly gave traditional herbs or acupuncture. The majority of the CAM users were Chinese. Univariate analysis showed that caregivers with secondary school (high school) education were 3.52 times more likely to use CAMs compared to those with primary school (elementary school) education.
  
  
  
  While some caregivers gave CAMs to their PPE, they had various misconceptions and did not discuss the usage with their healthcare providers. We propose that the predictors identified in this study can help to identify potential CAM users. Healthcare providers should routinely probe about the usage of CAMs by PPE, and thereafter, the suitability of CAM use could be evaluated. The caregivers will benefit from open discussion with healthcare professionals on the safe use of AEDs with or without CAMs.
authors.affiliation: KK Women's and Children's Hospital, Department of Pharmacy, 100 Bukit Timah Road, Singapore 229899, Singapore.
authors.forename: Chunliang
authors.initials: C
authors.lastname: Chen
authors.affiliation: National University of Singapore, Faculty of Science, Department of Pharmacy, Blk S4A Level 3, 18 Science Drive 4, Singapore 117543, Singapore.
authors.forename: Ying Jie
authors.initials: YJ
authors.lastname: Chong
authors.affiliation: KK Women's and Children's Hospital, Department of Pharmacy, 100 Bukit Timah Road, Singapore 229899, Singapore.
authors.forename: Szu Liang
authors.initials: SL
authors.lastname: Hie
authors.affiliation: Duke-NUS Medical School, Centre for Quantitative Medicine, 20 College Road, The Academia, Level 6, Singapore 169856, Singapore.
authors.forename: Rehena
authors.initials: R
authors.lastname: Sultana
authors.affiliation: KK Women's and Children's Hospital, Department of Pharmacy, 100 Bukit Timah Road, Singapore 229899, Singapore.
authors.forename: Sze Huay Dorothy
authors.initials: SHD
authors.lastname: Lee
authors.affiliation: KK Women's and Children's Hospital, Department of Paediatrics, Neurology Service, 100 Bukit Timah Road, Singapore 229899, Singapore.
authors.forename: Wei Shih Derrick
authors.initials: WSD
authors.lastname: Chan
authors.affiliation: National University of Singapore, Faculty of Science, Department of Pharmacy, Blk S4A Level 3, 18 Science Drive 4, Singapore 117543, Singapore.
authors.forename: Sui Yung
authors.initials: SY
authors.lastname: Chan
authors.affiliation: KK Women's and Children's Hospital, Department of Pharmacy, 100 Bukit Timah Road, Singapore 229899, Singapore; National University of Singapore, Faculty of Science, Department of Pharmacy, Blk S4A Level 3, 18 Science Drive 4, Singapore 117543, Singapore. Electronic address: hanhui_cheong@nus.edu.sg.
authors.forename: Han Hui
authors.initials: HH
authors.lastname: Cheong
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D017028:Caregivers; D002648:Child; D002675:Child, Preschool; D000529:Complementary Therapies / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use; D004827:Epilepsy / Q000628:therapy*; D005006:Ethnicity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012846:Singapore / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014815:Vitamins / Q000627:therapeutic use
chemical_list: D000927:Anticonvulsants; D004365:Drugs, Chinese Herbal; D014815:Vitamins
keywords: Complementary and alternative medicines; Epilepsy; Pediatric; Perception