Longitudinal analysis of complementary and alternative health care use in children with juvenile idiopathic arthritis

Objectives: The aims were to determine the frequency of use of different types of complementary and alternative health care (CAHC) in children with juvenile idiopathic arthritis (JIA), to evaluate their effectiveness from the parents' point of view and to explore the factors associated with utilization and with continued use. Methods: A cohort of children with JIA (n = 182, mean age: 10 years) who attended out-patient clinics were followed for 1 year. Parents responded to questionnaires every 3 months. We used generalized estimating equations to analyze factors associated with CAHC use and polytomous regression to evaluate factors associated with continued use of CAHC. Results: Use of CAHC ranged between 10% and 24% for the various 3-month intervals and 36.4% of participants used at least one type of CAHC over the 12-month period. Seventy-two percent of parents who used CAHC for their children felt that it was at least somewhat beneficial. Predictors of continued use of CAHC included previous use of CAHC by parents for their own health problems and lower perceived helpfulness of prescribed medications. Neither children's demographic and socioeconomic characteristics nor disease status were associated with CAHC use. Conclusions: CAHC use in children with JIA is common and considered to be moderately beneficial by most parents who used it. Lower parents' perceived helpfulness of medications and previous use of CAHC are associated with a longer use of CAHC by their child. These facts should be taken into account by health professionals involved in the care of these children. (C) 2009 Elsevier Ltd. All rights reserved.