Use of Complementary and Alternative Medical Practices in a Pediatric Sickle Cell Population.

There is a substantive body of literature on the use of Complementary and Alternative Medicine (CAM) therapies among adult populations generally, and chronically ill populations specifically, however less is known about its utilization with sick children. The use of CAM approaches to the treatment of sickle cell (SC)disease and the associated pain crises has focused largely on the use of hypnosis, musculoskeletal manipulations, or relaxation techniques for acute pain relief. The more general use of CAM therapies in the treatment of sickle disease by families is less well surveyed. Numerous studies have found utilization of CAM therapies in up to 70% in both general and sick adult populations, with somewhat lower incidence in pediatric populations. Adults attending sickle cell clinics with their children were asked to participate in structured interviews detailing the use of vitamins and supplements, physical and somatic therapies, and spiritual/holistic therapies, working from a standard list of interventions used in other studies. 47% of the sample regard treatment with CAM therapies as harmless, however the majority of respondents indicated they were aware of the potential for a potential interaction between prescriptive medication and CAM practices. Most believed that CAM therapies were widely used by adults, and both healthy and physically ill children. In this sample, 80% of those sampled reported the use of CAM therapies in the home, but only 53% reported using CAM therapies with the chronically ill child. The most frequently endorsed CAM approaches included prayer (70%), relaxation (55%) and general vitamins (45). Removing prayer as an alternative failed to significantly reduce the incidence of CAM usage with either the family or the physically ill child. Of the various supplements considered in the treatment of SC disease and discussed in the literature, none of the families reported use of Niprisan, one family reported use of aged garlic, two families reported use of Noni Juice, and 17% of the families reported the use of iron supplements for their child with SC. Further research with other chronically ill pediatric populations is underway, with additional data to be gathered on the use of cultural or regional folk remedies, typically not sampled in other CAM surveys.