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Stayduhar JM, Covvey JR, Schreiber JB, Witt-Enderby PA. Pharmacist and Student Knowledge and Perceptions of Herbal Supplements and Natural Products. PHARMACY 2023; 11:96. [PMID: 37368422 DOI: 10.3390/pharmacy11030096] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 05/31/2023] [Accepted: 06/06/2023] [Indexed: 06/28/2023] Open
Abstract
We aimed to collect parallel perspectives from pharmacists and pharmacy students on their use, knowledge, attitudes, and perceptions about herbal supplements/natural products. Two cross-sectional descriptive survey questionnaires-one focusing on pharmacists and the other focusing on pharmacy students-were administered from March to June 2021 via Qualtrics. The surveys were sent out to preceptor pharmacists and pharmacy students currently enrolled at a single U.S. school of pharmacy. The questionnaires were composed of five main sections, including (1) demographics; (2) attitudes/perceptions; (3) educational experience; (4) resource availability; and (5) objective knowledge of herbal supplements/natural products. Data analysis primarily utilized descriptive statistics with relevant comparisons across domains. A total of 73 pharmacists and 92 pharmacy students participated, with response rates of 8.8% and 19.3%, respectively. A total of 59.2% of pharmacists and 50% of pharmacy students stated they personally used herbal supplements/natural products. Most respondents (>95% for both groups) considered vitamins/minerals safe, although a lower percentage agreed on this for herbal supplements/natural products (60% and 79.3% for pharmacists and pharmacy students, respectively). Patient inquiries in the pharmacy setting were most seen for vitamin D, zinc, cannabidiol, and omega-3. A total of 34.2% of pharmacists reported having training in herbal supplements/natural products as a required part of their Pharm.D. training, and 89.1% of pharmacy students desired to learn more. The median score on the objective knowledge quiz was 50% for pharmacists and 45% for pharmacy students. Ultimately, herbal supplements/natural products are recognized by pharmacists/pharmacy students as a consistent and embedded part of pharmacy practice, although there is a need to enhance knowledge and skills in this area.
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Affiliation(s)
- Jacey M Stayduhar
- Division of Pharmaceutical, Administrative, and Social Sciences, School of Pharmacy, Duquesne University, 600 Forbes Ave, Pittsburgh, PA 15282, USA
| | - Jordan R Covvey
- Division of Pharmaceutical, Administrative, and Social Sciences, School of Pharmacy, Duquesne University, 600 Forbes Ave, Pittsburgh, PA 15282, USA
| | | | - Paula A Witt-Enderby
- Division of Pharmaceutical, Administrative, and Social Sciences, School of Pharmacy, Duquesne University, 600 Forbes Ave, Pittsburgh, PA 15282, USA
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Hübner J, Ciarlo G, Dubois C, Münstedt K, Micke O, Büntzel J, Klein M, Josfeld L, Keinki C. [Complementary and Alternative Medicine Offers of Teaching Practices for General Medicine]. DAS GESUNDHEITSWESEN 2023; 85:158-164. [PMID: 35016252 DOI: 10.1055/a-1690-6631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Germany's new medical licensure act has increased the importance of general practice in academic medical education. This study gives an overview of complementary and alternative medicine in general teaching practices in Germany and their adherence to evidence-based criteria which is required in order to qualify as a teaching practice. METHODS After a systematic search for German teaching practices, we assessed their diagnostic and therapeutic offers via their websites. We calculated the various frequencies of treatments and differentiated between evidence-based complementary medicine and alternative medicine with little to no evidence. RESULTS Of 4102 practices, more than half offered complementary and/or alternative treatment. Most of those were treatments approved of by the German medical association. Alternative medicine was offered by 18.2% of the practices. CONCLUSION Collective terms and conflicting evidence complicate the classification of treatments. Teaching practices offering non-evidence-based treatment raise the question whether recruitment of additional teaching practices stands at odds with the quality of medical education. Explicit offers of alternative treatment should disqualify a teaching practice as such. Controversial treatment may be taught academically and during residency with a focus on evidence-based guidelines and communication skills in order to prepare young medical practitioners for talks with their patients about the subject.
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Affiliation(s)
- Jutta Hübner
- Klinik für Innere Medizin II, Jena University Hospital, Jena, Deutschland
| | - Gianluca Ciarlo
- Klinik für Innere Medizin II, Jena University Hospital, Jena, Deutschland
| | - Clara Dubois
- Klinik für Innere Medizin II, Jena University Hospital, Jena, Deutschland
| | - Karsten Münstedt
- Klinik für Gynäkologie und Geburtshilfe, Ortenau Klinikum, Offenburg, Deutschland
| | - Oliver Micke
- Klinik für Strahlentherapie, Franziskus Hospital Bielefeld, Bielefeld, Deutschland
| | - Jens Büntzel
- Klinik für Hals-Nasen-Ohren Krankheiten, Südharz Klinikum Nordhausen gGmbH, Nordhausen, Deutschland
| | - Michael Klein
- Klinik für Innere Medizin II, Jena University Hospital, Jena, Deutschland
| | - Lena Josfeld
- Klinik für Innere Medizin II, Jena University Hospital, Jena, Deutschland
| | - Christian Keinki
- Klinik für Innere Medizin II, Jena University Hospital, Jena, Deutschland
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Konigsberg E. Integrative Medicine in the Canadian Medical Profession: Certificate of Added Competence Proposal for Physicians. GLOBAL ADVANCES IN INTEGRATIVE MEDICINE AND HEALTH 2023; 12:27536130231182426. [PMID: 37426337 PMCID: PMC10326368 DOI: 10.1177/27536130231182426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 05/12/2023] [Accepted: 05/15/2023] [Indexed: 07/11/2023]
Abstract
Most Canadians use some form of Complementary and Alternative Medicine (CAM) and most Canadian physicians are not able to address their patients' use due to inadequate training. Integrative Medicine (IM) in the medical profession has grown over the last 20 years and is now recognized as a sub-specialty in the United States. Canada is lagging behind. The current state of CAM and IM education for physicians in Canada is described, using the United States' experience in comparison. The landscape and obstacles for Integrative Medicine for Canadian physicians is reviewed. A case is made for recognition of Integrative Medicine by Canadian Medical Colleges in order to advance this field in Canada.
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Affiliation(s)
- Esther Konigsberg
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada
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Wen PS, Vora A, Mortera M, Sasson N, Reed WR, Ehsanian R, Galantino ML, Erb M, Hu X, Kim S. Perceptions and use of complementary and integrative health practices among rehabilitation professionals: a survey. Eur J Integr Med 2022. [DOI: 10.1016/j.eujim.2022.102173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Toward a logical integrative medicine: beyond data accumulation. Integr Med Res 2020; 9:100414. [PMID: 32760650 PMCID: PMC7390856 DOI: 10.1016/j.imr.2020.100414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Indexed: 11/21/2022] Open
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Liem A. The possibilities and challenges of integrative medicine implementation in clinical psychology: a qualitative study in Indonesia. BMC Complement Med Ther 2020; 20:223. [PMID: 32664917 PMCID: PMC7362562 DOI: 10.1186/s12906-020-03019-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 07/08/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Integrative medicine (IM), which is the integration of complementary and alternative medicine (CAM) into conventional health services, has been applied in some nations. Despite its highly relevant holistic approach with the improvement of mental health care using person-centred approach, there are limited studies that discuss IM, specifically in clinical psychology. Therefore, this qualitative study aimed to explore the perspectives of Indonesian clinical psychologists (CPs) on the possibilities and challenges of IM implementation in clinical psychology. METHODS Semi-structured interviews with 43 CPs who worked in public health centres were conducted between November 2016 and January 2017. A maximum variation sampling was used. Thematic analysis of interview transcripts was applied considering its flexibility to report and examine explicit and latent contents. RESULTS Three themes were identified from the analysis. First, the possibility of IM implementation in clinical psychology, which revealed two possible options that were centred on creating co-located services. Second, the challenges that covered (a) credibility, (b) acceptance, (c) procedure and facility, and (d) understanding and skill. Lastly, participants proposed four strategies to overcome these challenges, including: (a) certification, (b) facilities, (c) dialogue, and (d) regulations. CONCLUSION Participants recognised the possibility of IM implementation in clinical psychology, particularly in clinical psychology services. This IM implementation may face challenges that could be overcome by dialogue between CPs and CAM practitioners as well as clear regulation from the government and professional psychology association.
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Affiliation(s)
- Andrian Liem
- Department of Psychology, University of Macau, Macao (SAR), China.
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia.
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Liem A, Newcombe PA. Development of complementary and alternative medicine (CAM) education for clinical psychologists: An example from Indonesia. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2020. [DOI: 10.1080/00207411.2019.1680079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Andrian Liem
- School of Psychology, University of Queensland, Brisbane, Australia
- Global and Community Mental Health Research Group, Department of Psychology, Faculty of Social Sciences, University of Macau, Macao (SAR), China
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"I've Only Just Heard About It": Complementary and Alternative Medicine Knowledge and Educational Needs of Clinical Psychologists in Indonesia. ACTA ACUST UNITED AC 2019; 55:medicina55070333. [PMID: 31277309 PMCID: PMC6681206 DOI: 10.3390/medicina55070333] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 06/25/2019] [Accepted: 07/02/2019] [Indexed: 11/16/2022]
Abstract
Background and objectives: The inadequate knowledge of complementary and alternative medicine (CAM) among health professionals may put their clients at risk because clients would then find information about CAM from unreliable sources. Clinical psychologists (CPs), as health professionals, also have the opportunity to provide psychoeducation on the latest scientific CAM research for their clients. The current study aimed to explore knowledge and educational needs regarding CAM among CPs in Indonesia because previous studies on exploring CAM knowledge and educational needs regarding CAM were primarily conducted in Western countries. Materials and Methods: Data were collected through semi-structured face-to-face interviews with 43 CPs in public health centers (PHCs) in Indonesia. Most interviews were conducted at the PHCs where the participants worked and lasted for 55 minutes on average. The interview recordings were transcribed and were analyzed using deductive thematic analysis. Results: Five main themes emerged within participants' responses regarding CAM knowledge and educational needs. First (CAM understanding), participants' responses ranged from those with little or no prior knowledge of CAM treatments and uses, to those with much greater familiarity. Second (source of knowledge), participants' access ranged widely in terms of references, from popular to scientific literature. Third (why is it important?), participants identified CAM as an essential part of Indonesian culture and considered it therefore crucial to have this cultural knowledge. Fourth (the challenges and what is needed?), the challenges for improving participants' knowledge came from personal and institutional levels. Fifth (what and how to learn?), participants advised that only CAM treatments that fit in brief psychotherapy sessions should be introduced in professional training. Conclusions: This qualitative study discovered that CAM was neither well-known nor understood widely. Participants advised that professional associations and health institutions should work together in enhancing knowledge of CAM and incorporating CAM education into psychology education.
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Cutshall SM, Khalsa TK, Chon TY, Vitek SM, Clark SD, Blomberg DL, Mustafa R, Bhagra A. Curricular Development and Implementation of a Longitudinal Integrative Medicine Education Experience for Trainees and Health-Care Professionals at an Academic Medical Center. Glob Adv Health Med 2019; 8:2164956119837489. [PMID: 30967973 PMCID: PMC6444766 DOI: 10.1177/2164956119837489] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 12/19/2018] [Accepted: 01/02/2019] [Indexed: 11/16/2022] Open
Abstract
A growing number of patients and consumers are seeking integrative medicine (IM)
approaches as a result of increasing complex medical needs and a greater
emphasis on prevention and health promotion. Health-care professionals need to
have knowledge of the evidence-based IM resources that are safe and available to
patients. Medical institutions have acknowledged the need for education and
training in various IM modalities and whole-health approaches in medical
curricula. There is a strong need to develop and incorporate well-structured IM
curricula across all levels of learning and practice within medicine. This
article provides an example of the development, implementation, impact, and
assessment of IM education curricula across all learner levels at a large
academic medical center.
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Affiliation(s)
- Susanne M Cutshall
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Tejinder K Khalsa
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Tony Y Chon
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Sairey M Vitek
- Quality Management Services, Mayo Clinic, Rochester, Minnesota
| | - Stephanie D Clark
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Debra L Blomberg
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Rafid Mustafa
- Department of Neurology, Mayo Clinic, Rochester, Minnesota
| | - Anjali Bhagra
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota
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Hasler DLME, Leggit JC. Complementary and Integrative Health Education in the Medical School Curriculum: An Interest Survey. Med Acupunct 2018; 30:298-307. [PMID: 30671149 DOI: 10.1089/acu.2018.1311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objective: The use of complementary and integrative health (CIH) modalities continues to increase; yet, there is limited instruction in these methods in undergraduate medical-school curricula. The objective of this research was to evaluate interest in developing a CIH curriculum at the Uniformed Services University of the Health Sciences (USUHS), in Bethesda, MD. Materials and Methods: Students and faculty of the USUHS were emailed a 10-question online survey and responded via a Likert scale and open-ended questions. Results: There was interest in learning more about CIH; 65% of student survey respondents and 61% of faculty survey respondents indicated that they "probably" or "definitely" believe that a curriculum in CIH should be instituted at the USUHS. Conclusions: The addition of a curriculum in CIH would be beneficial to future patients who will benefit from the students' additional knowledge and experiences. This curriculum would also benefit the students who would be able to use their knowledge of CIH practices to relieve stress and mitigate burnout.
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Affiliation(s)
| | - Jeffrey C Leggit
- School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD
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Anheyer D, Kern C, Dobos G, Cramer H. "I think you can achieve quite a lot if all of the staff stands behind it"-A qualitative study about the experience, knowledge and application of complementary therapies and integrative medicine in pediatrics. Complement Ther Med 2018; 41:186-191. [PMID: 30477837 DOI: 10.1016/j.ctim.2018.09.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 09/26/2018] [Accepted: 09/26/2018] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND In the United States there is an increasing use of complementary and alternative medicine (CAM) as well as integrative medicine (IM) in pediatrics. This study investigates the extent of knowledge and practical application of and attitudes towards the use and integration of CAM/IM therapies in two German pediatric clinics. METHODS A semi-standardized qualitative interview study was conducted in a rural children's hospital in Bavaria and in a children's clinic in the metropolitan area of Ruhr. Sixteen employees (7 nurses, 9 medical doctors, 68.8% female), who had volunteered through a local contact, were questioned during their shift on CAM/IM therapies. The data collected were analyzed with MAXQDA 12 using a qualitative technique for content analysis (by Mayring). RESULTS On average all respondents had little to superficial knowledge about the possibilities or evidence base of the therapies concerned, but did believe that CAM/IM could be an enhancement. In addition, many took interest in learning more about CAM/IM medical options. Nurses desired more practical and theoretical knowledge; while medical doctors focused on standardization and evidence base. All of them agreed that self-care strategies could enhance parental independence when treating symptoms of minor illnesses. They further agreed, that a symbiosis of conventional medicine and CAM/IM has great potential for patients and employees. It was stated that training of staff would be indispensable in order to implement standardized procedures. CONCLUSIONS There is great potential and interest in CAM/IM among pediatric care employees. Regardless of the challenges, this investigation did find that implementing CAM/IM might be a promising extension to the daily care routine.
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Affiliation(s)
- Dennis Anheyer
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany.
| | - Christine Kern
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Gustav Dobos
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Holger Cramer
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
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Lee JK, Hume AL, Willis R, Boon H, Lebensohn P, Brooks A, Kligler B. Pharmacy Competencies for Interprofessional Integrative Health Care Education. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2018; 82:6302. [PMID: 30181670 PMCID: PMC6116872 DOI: 10.5688/ajpe6302] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 07/03/2017] [Indexed: 05/27/2023]
Abstract
Objective. To address the gap in evidence-based knowledge among pharmacy students and practicing pharmacists regarding complementary and integrative health approaches due to insufficient education and a lack of standardized training. Methods. The National Center for Integrative Primary Healthcare (NCIPH) developed 22 pharmacy competencies linked to a set of 10 interprofessional "metacompetencies" in integrative health care. Results. The NCIPH pharmacy competencies are well-aligned with the current educational standards and Center for the Advancement of Pharmacy Education (CAPE) outcomes for pharmacy programs. Therefore, the NCIPH competencies may provide a foundation for the incorporation of interprofessional integrative health care education into pharmacy curricula. Conclusion. The NCIPH pharmacy competencies in integrative health care, linked to the interprofessional "metacompetencies," are aligned with educational standards and outcomes, and may serve as a basis for pharmacy curriculum.
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Affiliation(s)
- Jeannie K Lee
- University of Arizona College of Pharmacy, Tucson, Arizona
| | - Anne L Hume
- University of Arizona College of Pharmacy, Tucson, Arizona
| | - Robert Willis
- University of Arizona College of Pharmacy, Tucson, Arizona
| | - Heather Boon
- University of Arizona College of Pharmacy, Tucson, Arizona
| | | | - Audrey Brooks
- University of Arizona College of Pharmacy, Tucson, Arizona
| | - Ben Kligler
- University of Arizona College of Pharmacy, Tucson, Arizona
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Ogbogu U, Necyk C. Community Pharmacists' Views and Practices Regarding Natural Health Products Sold in Community Pharmacies. PLoS One 2016; 11:e0163450. [PMID: 27661618 PMCID: PMC5035072 DOI: 10.1371/journal.pone.0163450] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2016] [Accepted: 09/08/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Reports of regulatory and evidentiary gaps have raised concerns about the marketing and use of natural health products (NHPs). The majority of NHPs offered for sale are purchased at a community pharmacy and pharmacists are "front-line" health professionals involved in the marketing and provision of NHPs. To date, the involvement of pharmacists in pharmacy care involving NHPs and the degree to which concerns over the safety, efficacy, marketing and regulation of NHPs are addressed in pharmacy care in Canada have not been studied. METHODS Using Qualtrics, a web-based data collection and analysis software, and a study instrument made up of fifteen (15) open-ended, closed and rating scale questions, we surveyed the attitudes and practices of 403 community pharmacists in the Canadian province of Alberta regarding NHPs offered for sale in community pharmacies. RESULTS The majority of pharmacists surveyed (276; 68%) recommend NHPs to clients sometimes to very often. Vitamin D, calcium, multivitamins, prenatal vitamins, probiotics and fish oil and omega-3 fatty acids were the most frequently recommended NHPs. The most common indications for which NHPs are recommended include bone and musculoskeletal disorders, maintenance of general health, gastrointestinal disorders and pregnancy. Review articles published in the Pharmacist's Letter and Canadian Pharmacists Journal were the primary basis for recommending NHPs. The majority of pharmacists surveyed (339; 84%) recommend the use of NHPs concurrently with conventional drugs, while a significant number and proportion (125; 31%) recommend alternative use. Pharmacists in the study overwhelmingly reported providing counselling on NHPs to clients based on information obtained mainly from the Natural Medicines Comprehensive Database. CONCLUSIONS The study findings indicate a high prevalence of pharmacy care relating to NHPs among study participants. Although pharmacists' practices around NHPs are consistent with the existing licensing framework, we found some involvement in problematic practices that necessitate further research and potential policy scrutiny. The study also uncovered patterns of recommendations, including sources relied on in recommending NHPs and in providing counselling to patients, that raise concerns about the quality and credibility of NHP-related care provided to pharmacy patrons.
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Affiliation(s)
- Ubaka Ogbogu
- Faculty of Law, University of Alberta, Edmonton, Alberta, Canada
- Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Candace Necyk
- Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta, Canada
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