Source:

Bethell
C
,
Kemper
K
,
Gombojav
N
, et al
.
Complementary and conventional medicine use among youth with recurrent headaches
.
Pediatrics
.
2013
;
132
(
5
):
e1173
e1183
; doi:
https://doi.org/10.1542/peds.2013-1816

Investigators from multiple institutions sought to determine the use of complementary and alternative medicine (CAM) therapies among youth with recurrent headache (RHA) and how conventional care expenditures compare between those with RHA who use and don’t use CAM. For the study, they linked data from the 2007 National Health Interview Survey (NHIS), which provides data on youth using CAM, with the 2008 Medical Expenditure Panel database, which provides data on conventional medical care expenditures. Investigators restricted their analysis of the linked database to only 10- to 17-year-old children.

The presence of RHA was determined by a positive response to 1 of 2 NHIS questions that asked whether in the past 12 months the participant had (1) frequent or severe HA, including migraine, or (2) RHA, other than migraine. The primary outcome variable was CAM use, determined by participant response to an NHIS question that asked whether the participants used 1 or more of 39 types of CAM in the past year. CAM modalities were subsequently categorized in 2 ways. The first grouping reflected National Center for Complementary and Alternative Medicine categories: biologically-based, mind-body, manipulative/body-based, alternative medical systems, and energy healing therapies. The second grouping categorized CAM as either products (eg, herbs), practices (eg, yoga), or services (eg, acupuncture). Investigators also extracted demographics as well as additional variables from NHIS responses regarding non-HA chronic conditions and functional status, such as presence of emotional difficulties, problems with behavior or concentration, limited daily activities, and school absenteeism. Rates of CAM use in children with and without RHA were compared, and variables associated with CAM use among those with RHA identified.

There were 1,070 children 10 to 17 years of age included in the analysis. The proportion of the sample that had RHA was 10.6%, of whom 29.6% had used CAM. Among the sample who had both RHA and emotional difficulties, problems with behavior or concentration, limited daily activities, or school absenteeism, CAM use was 41%. Compared to children with RHA who didn’t use CAM, CAM users were significantly more likely to be older, white, live in homes with higher income, have private insurance, have higher maternal education, have at least 1 other chronic condition, and have higher conventional medical care expenditures. Compared to children without RHA, children with RHA had 2.13 times greater odds of using CAM (95% CI, 1.61–2.91), after controlling for demographic variables.

The most frequently used CAM modalities were biological-based products (16%) and mind-body therapies (13%). CAM products (17%) and practices (15%) were more commonly used than services. The most common CAM modalities used by those with RHA were vitamins/minerals (17%), herbal supplements (10%), deep-breathing exercises (9%), chiropractic or osteopathic manipulation (5%), yoga or tai chi (5%), meditation (3%), and massage (3%).

The investigators conclude that CAM use is common...

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