Complementary and conventional medicine use among youth with recurrent headaches

Abstract

Objective: To identify prevalence and patterns of complementary and alternative medicine (CAM) use among youth with recurrent headaches (HA) and evaluate associations with co-occurring health problems and limitations as well as with the use and expenditures for conventional medical care.

Methods: Variables were constructed for youth aged 10 to 17 by using linked data from the 2007 National Health Interview Survey and the 2008 Medical Expenditures Panel Survey. Bivariate, logistic, and 2-part regression analyses were used.

Results: Of the 10.6% of youth experiencing HA, 29.6% used CAM, rising to 41% for the many HA sufferers who also experienced difficulties with emotions, concentration, behavior, school attendance, or daily activities. Biologically based products (16.2%) and mind-body therapies (13.3%) were most commonly used, especially by the 86.4% of youth with HA experiencing at least 1 other chronic condition. Compared with non-CAM users, youth with HA who used CAM also had higher expenditures for and use of most types of conventional care.

Conclusions: CAM use is most common among youth with HA experiencing multiple chronic conditions and difficulties in daily functioning. Associations among CAM use, multiple chronic conditions, and higher use of conventional care highlight the need for medical providers to routinely ask about CAM use to meet the complex health needs of their patients and facilitate the optimal integration of care. Research is needed to identify models for coordinating complementary and conventional care within a medical home and to understand the health benefits or risks associated with CAM use in conjunction with conventional treatments for patients with HA.

Keywords: adolescents; complementary and alternative medicine; headache; medical expenditures; multiple chronic conditions.

FIGURE 1

Prevalence of CAM use among youth, by multiple chronic condition and HA status. Data Source: 2007 NHIS. AORs are adjusted for age, gender, race/ethnicity, household income, and US region in which the child lives. Note: HA as measured in this study is considered a chronic condition.

FIGURE 2

Prevalence of CAM use among youth aged 10 to 17 across 10 health condition categories, by co-occurring HA status. Data Source: 2007 NHIS. Note: Percents shown in the parentheses are percentages of children with condition type who experience headache. Non-HA, Pain-Related: arthritis, abdominal pain, back/neck pain, other chronic pain. EMB: anxiety/stress, depression, attention-deficit disorder/attention-deficit/hyperactivity disorder, phobia/fears, insomnia/trouble sleeping, bedwetting/incontinence. Gastroenterologic Related: food/digestive allergies, frequent diarrhea/colitis, acid reflux/heartburn, nausea/vomiting, recurring constipation. Respiratory/pulmonary: asthma, hay fever, respiratory allergies; other lung/breathing problem, sinusitis, other allergies. Common acute: 3 or more ear infections, fever, head/chest cold, influenza/pneumonia, strep sore throat, other sore throat, urinary tract infection, nausea/vomiting. Developmental: autism, cerebral palsy (only last 2 quarters of data due to data validity issue noted by the NCHS), Down syndrome, muscular dystrophy, mental retardation, speech problems, developmental delay, learning disability. Non-HA Neurologic: seizure, other neurologic problems. Sensory Related: hearing problems, vision problems. Dermatologic: eczema/skin allergy, severe acne, warts, skin problems other than eczema. Any Other: cancer, congenital heart disease, chickenpox, cystic fibrosis, diabetes, other heart problems, problems with being overweight, menstrual problems, fatigue/lack of energy, gum disease, anemia, and sickle cell anemia.

FIGURE 3

Prevalence of CAM use among youth with HA, by presence of difficulties with emotions, concentration or behavior, school attendance, or daily activities.*Data Source: 2007 NHIS. CI, 95% CI. *Includes definite or severe difficulties in emotions, concentration, or behavior; missing more than 2 weeks of school during the year and limitations in performing daily activities, such as personal care, movement, cognitive ability, and memory. **Adjusted for age, gender, race/ethnicity, family income, and US region child lives.