Pediatricians' recommendations for complementary and alternative medical (CAM) therapies

Objectives-Increasing numbers of children use complementary and alternative medicine (CAM). The purpose of this project was to assess pediatricians' attitudes and recommendations regarding CAM. Methods.-This was a national survey sent to a random sample of active members of the American Academy of Pediatrics (AAP). The survey was 8 pages long and included questions on demographic and practice characteristics, attitudes about CAM, and 3 clinical vignettes asking what therapies physicians recommended in these situations. Results.-The 745 eligible respondents were demographically similar to the national AAP membership. Most (87%) had been asked about CAM by a patient/parent in the 3 months prior to the survey and 34% said they or an immediate family member had used CAM in the past year. Most (66%) believed that CAM therapies could enhance recovery or relieve symptoms, but even more were concerned about possible side effects (75%) or that CAM use might delay mainstream care (74%). Only 20% routinely asked patients/parents about their use of herbs, and fewer asked about other CAM therapies. Fewer than 5% felt very knowledgeable about individual CAM therapies. For the clinical vignettes, pediatricians were far more likely to recommend medications than any CAM therapy. Over 80% of pediatricians desired additional information on CAM; the highest priorities were information about herbs, dietary supplements, nutritional therapies, and therapeutic exercise. Conclusions.-Pediatricians recognize that many patients are interested in using CAM therapies, but do not feel comfortable discussing or recommending CAM therapies. Pediatricians are very interested in learning more about CAM.