COMPLEMENTARY AND ALTERNATIVE MEDICINE USE IN CHILDREN AND ADOLESCENTS IN THE UNITED STATES Susan M Yussman ¹, Peggy Auinger ¹, Michael Weitzman ² and Sheryl A Ryan ¹. ¹Division of Adolescent Medicine, University of Rochester School of Medicine, Rochester, NY; and ²Center for Child Health Research, American Academy of Pediatrics.

BACKGROUND: Little is known about complementary and alternative medicine (CAM) use in pediatric populations.

OBJECTIVE: To determine the prevalence, patterns, costs, and predictors of CAM provider visits and subsequent remedy use in a nationally representative pediatric sample.

DESIGN/METHODS: The 1996 Medical Expenditure Panel Survey (MEPS), a nationally representative household sample, provided data on 7,371 subjects 21 years of age. The primary outcome variable was CAM use as defined by parental report of consulting a CAM provider "for health reasons." Predictors included sociodemographic factors, health insurance status, and parental CAM use, as well as perceptions and use of conventional medical care. Bivariate analyses using c2 tests, followed by logistic regression using SUDAAN, determined independent factors associated with CAM use.

RESULTS: Overall, 2.0% used CAM; of those, only 10.0% disclosed this use to their usual source of care (USC). The most common CAM providers were chiropractors (36.0%), clergy or spiritualists (23.5%), and massage therapists (14.0%). The most common types of therapies were spiritual healing (27.2%) and herbal remedies (16.9%). Of those with CAM use, mean number of visits in the last year to a CAM provider was 8.5 (SD=1.6), mean dollars spent on CAM visits was $73.40 (19.82) and on remedies was $13.06 (3.54). Weighted estimates to the national pediatric population of annual expenditures on CAM visits and remedies were $127 million and $22 million respectively. Significant factors independently associated with a greater likelihood of CAM use were: female gender (OR=1.7, 95%CI=1.1-2.7), older age (2.7, 1.3-5.8 for 15-17 years; 3.2, 1.6-6.6 for 18-21 years), parental CAM use (47.2, 23.7-94.0 by both parents; 8.8, 4.5-16.9 by mother only), and greater number of conventional medical office visits in the last year (4.4, 2.1-9.0 for 6 visits). For those with a USC, parental dissatisfaction with quality of care was also associated (3.0, 1.0-8.8). All p values <0.05.

CONCLUSIONS: Two percent of parents report that their children and adolescents consult a CAM provider "for health reasons,'' and parents rarely disclose this use to their USC. Higher utilization of and dissatisfaction with conventional medical care, as well as parental CAM use, are most predictive of pediatric CAM use in the United States.