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CARE-ing in Alberta
The Stollery Children's Hospital at the University of Alberta is home to Canada's
first academic program in pediatric integrative medicine. The Complementary and
Alternative Research and Education, or CARE program, was created a little more
than a year ago, primarily to address the lack of information around the safety
and efficacy of complementary and alterative health care (CAHC) and children.
Headed by Dr. Sunita Vohra, a pediatrician with a background in pharmacology
and epidemiology, CARE will help close the pediatric CAHC information gap through
program developments in three areas:
- Clinical activity, beginning this year, will focus on a multi-disciplinary
team of both conventional and complementary practitioners.
- Research, both current and projected, intended to objectively assess
complementary and alternative therapies and products, to study Canadian childrens'
use of complementary and alternative health care and identify herb-drug interactions.
- Education programs, including physicians' fellowships in pediatric
integrative medicine, and continuing education opportunities in pediatric CAHC
for other health care professionals.
Growing at a rapid pace, CARE has already taken the lead in a study that may
eventually help those shuddering parents defeat their children's winter sniffles.
CARE's study of the herbal medicine Echinacea looked at the chemical makeup
and biological activity in a number of top-selling liquid extracts.
With more than 260 different Echinacea products currently available on the Canadian
market - each one a different formulation - finding a high quality product that
is similar from bottle to bottle, batch to batch, was a necessary step. Now
researchers can begin the phase of their work of greatest interest to parents
- a clinical trial intended to determine whether Echinacea is, in fact, a safe
and effective treatment for children with upper respiratory infections.
By generating high quality evidence about complementary and alternative therapies
and products, studies like this one help realize CARE's mission - "to be
a leading pediatric research and education program promoting the safe, effective
and informed use of Complementary and Alternative Medicine (CAM)."
CAHC Pediatric Research—Moving
Forward
Almost two-thirds of children with chronic and acute illness or disability are
using complementary and alternative health care (CAHC). Even after careful fact-finding,
parents of many of these children may still not realize that wise use of CAHC
is not as simple as 'guesstimating' the dosage of a natural health product (NHP)
based on adult dosages, according to Gwen Burrows, director of Sick Kids Foundation's
National Grants Program, whose organization plays a key role in supporting pediatric
studies looking at CAHC.
Not enough is known about the safety and efficacy of complementary and alternative
therapies in children. Ultimately, Ms. Burrows and Dr. Sunita Vohra of University
of Alberta's CARE program agree, it is evidence that will pave the way for a
wider range of treatment options, and better communication between children
and all their potential caregivers - parents, doctors, and complementary
and alternative practitioners. This is one of the primary reasons why Dr. Vohra's
CARE program was launched, and why Sick Kids Foundation began funding pediatric
complementary and alternative health care research.
"It's important to keep in mind that we're not starting with a blank slate,"
observes Dr. Vohra. "The first assumption people make about pediatric evidence
in complementary and alternative health care, is that there isn't any. In fact,
there are about 1,400 randomized, controlled trials (considered the gold standard
in medical research). "Still," she adds, "the field is in its
infancy. There are so many therapies, and so many conditions . . . there's a
vast amount of work to be done."
Ms. Burrows concurs. "Interest in this area has been steadily rising for
the last five to 10 years," she says, but until recently, very few researchers
have gotten involved.
Sick Kids Foundation began taking an active role in the fall of 2001, when,
in partnership with Health Canada's Natural Health Products Directorate (NHPD),
it convened a the first of two annual meetings intended to promote networking,
as well as the training and knowledge base necessary for meaningful research
in the field.
On December 3, 2004, Sick Kids Foundation will host a special one-day forum
to showcase the research funded by the Foundation in 2002 and in 2003, according
to Ms. Burrows. "This will be the first time we bring together the researchers,
to have other people hear about the work, to network, and to consolidate the
knowledge that's been gained by providing a forum where people can talk to each
other," she says. While researchers are the target audience for the forum,
interested parents are welcome, Ms Burrows emphasizes. "We want as many
people to come as are interested. The more diverse the audience is, the richer
it will be."
Ms. Burrows hopes the forum will be the first in a bi-annual series of gatherings
that further the development of pediatric CAHC research. "My vision,"
she says, "is a better understanding between the biomedical community,
and the various alternative communities. We're not going to get a perfect accord
between them, but the more they know about each other's issues, the better it
is for parents and their children."
Sampson M, Campbell K, et al. Randomized controlled trials in pediatric
complementary and alternative medicine: Where can they be found? BMC Pediatr.
2003; 3 (1): 1
Personal Communication, Dr. Sunita Vohra August, 2004
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This article was prepared by The Consumer Health Information Service (Toronto
Public Library) with the assistance of the CHN 
