Abstract:
OBJECTIVES:To determine the use and potential interactions of natural health products (NHPs) with conventional medications in children with life-limiting illnesses. METHODS:The present study was a retrospective medical record review of palliative care patients <18 years of age who were admitted for respite care to a Canadian paediatric hospice between January 1, 2008 and December 31, 2013. The NHPs were identified according to Health Canada's inclusion criteria. RESULTS:A total of 106 children were included in the present study. Eighty-two (77.4%) had used one or more NHPs: 60 (56%) used vitamins and minerals; 45 (42.5%) used other products including probiotics, omega-3, organic acids and essential fatty acids; 34 (32.1%) used everyday consumer products; 12 (11.3%) used herb or plant-based remedies; and one (0.9%) used homeopathic remedies. Thirty-nine potential NHP-medication and 10 potential NHP-NHP interactions were identified. A considerable number of patients (n=54) used at least one medication and NHP, or two NHPs with potential interactions. The most common type of interaction was pharmacokinetic: decreasing blood concentrations of the medication, NHP or both (43.9% of NHP users); and enhancing the blood concentration of an NHP for NHP-NHP interactions (22% of NHP users). CONCLUSION:A high proportion of patients in respite care use NHPs. Most used NHPs and medications that have potential interactions, although there were no adverse clinical manifestations in the present study. It is important to educate health care professionals about NHPs, the evidence available and lack thereof. This could reduce the most serious interactions and improve the alliance between parents and health care providers to balance the potential risks and benefits of NHPs. OBJECTIFS:Déterminer l’utilisation et les interactions potentielles des produits de santé naturels (PSN) avec la médication habituelle chez des enfants ayant une maladie limitant l’espérance de vie. MÉTHODOLOGIE:La présente analyse rétrospective de patients en soins palliatifs de moins de 18 ans admis en soins de répit dans un centre canadien de soins palliatifs en pédiatrie s’étalait du 1er janvier 2008 au 31 décembre 2013. Les PSN ont été établis d’après les critères d’inclusion de Santé Canada. RÉSULTATS:Au total, 106 enfants ont fait partie de la présente étude. Quatre-vingt-deux (77,4 %) ont utilisé au moins un PSN : 60 (56 %), des vitamines et des minéraux, 45 (42,5 %), d’autres produits y compris des probiotiques, des acides gras oméga 3, des acides organiques et des acides gras essentiels, 34 (32,1 %), des produits de consommation courante, 12 (11,3 %), des remèdes à base d’herbes ou de plantes et un (0,9 %), des remèdes homéopathiques. Trente-neuf interactions potentielles entre des PSN et des médicaments et dix interactions potentielles entre des PSN et des PSN ont été recensées. Un nombre considérable de patients (n=54) a utilisé au moins un médicament et un PSN ou deux PSN ayant des interactions potentielles. Le principal type d’interaction était d’ordre pharmacocinétique : réduire les concentrations du médicament, du PSN ou des deux dans le sang (43,9 % d’utilisateurs de PSN) et accroître la concentration sanguine d’un PSN en cas d’interactions entre deux PSN (22 % des utilisateurs de PSN). CONCLUSION:Une forte proportion de patients en soins de répit utilisait des PSN. La plupart des enfants en soins de répit utilisait des PSN et des médicaments susceptibles d’interagir les uns avec les autres, même si la présente étude ne révélait pas de manifestations cliniques indésirables. Il est important d’informer les professionnels de la santé en matière de PSN, des données probantes disponibles ou de l’absence de telles données. Ces mesures pourraient réduire les interactions les plus graves et améliorer l’alliance entre les parents et les dispensateurs de soins pour équilibrer les risques et avantages potentiels des PSN.
journal_name
Paediatr Child Healthjournal_title
Paediatrics & child healthauthors
Beringer A,Vaillancourt R,Villarreal G,Vadeboncoeur Cdoi
10.1093/pch/20.1.23subject
Has Abstractpub_date
2015-01-01 00:00:00pages
23-9issue
1eissn
1205-7088issn
1918-1485journal_volume
20pub_type
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