Beliefs, practices and knowledge of community pharmacists regarding complementary and alternative medicine: national cross-sectional study in Lebanon

Exploration of herbal medicine practices, perceptions and knowledge among Spanish community pharmacists: A cross-sectional survey study

INTRODUCTION

Herbal medicine has seen remarkable growth in consumption over the past few years. Community pharmacists are health care professionals who have an important role in the dispensing and counselling of these products. The aim of this study was to evaluate perceptions, professional practices and knowledge about herbal medicine among community pharmacists in Tenerife (Canary Islands, Spain).

METHOD

A descriptive cross-sectional study was conducted in community pharmacies in Tenerife using a questionnaire that included demographic data, perceptions, professional practices and knowledge of herbal medicine. Data from 610 community pharmacists was analyzed using SPSS 26.0 software program.

RESULTS

Most of the responders had a positive attitude towards herbal medicine, considering its products useful (80.9%), safe (64.2%) and those sold in pharmacies of high quality and standardized (84.6%). They thought that these products should only be sold in pharmacies (78.0%) and that it was their responsibility to provide information about them (95.5%). However, only 32.1% believed they are well prepared to provide herbal pharmaceutical care services and 36.1% that there are reliable and easily accessible sources of information. Moreover, 60.7% considered lack of training a barrier to recommending herbal medicinal products, being interested in updating their knowledge on it (96.9%).

CONCLUSION

This study showed that community pharmacists have a positive perception of herbal medicines, considering them beneficial and safe. However, participants requested reliable sources of information, easy access, and more training to dispense, counsel, and safely label these products. Education and training programs in herbal medicine are needed to enhance their ability to provide herbal pharmaceutical care.

Community pharmacy professionals' knowledge, attitude, and practice toward nutrition and lifestyle counseling in Gondar City, Ethiopia

Background

Community pharmacy professionals play a vital role in health care, have a greater impact on public health programs, and play a critical role in patient counseling for both non-pharmacological and pharmacological management. This study aimed to evaluate the knowledge, attitude, and practice of community pharmacy professionals toward nutrition and lifestyle counseling in Gondar City, Ethiopia.

Methods

A cross-sectional survey was undertaken in Northwestern Ethiopia from May to June 2021. Face-to-face structured interviews were performed to collect data using a specially created questionnaire. Descriptive, independent t-test, and one-way ANOVA analyses were used. A significant difference was defined as a p-value of less than 0.05.

Results

This survey drew 100 community pharmacy professional from a pool of 105 participants, with a 95.2% response rate. More than a third of the participants (n = 43, 43%) defined medical nutrition therapy as the use of food to prevent disease, and almost half of the participants (n = 51, 51%) viewed therapeutic nutrition to be part of their job responsibilities. More than half (64%) believe that patients should be provided a combination of nutritional and pharmacological treatments in the majority of cases. The majority of participants (75%) gave patients counseling on drug-food interactions.

Conclusion

The majority of community pharmacy professionals said they knew a lot about medical nutrition therapy and were enthusiastic about nutrition evaluation and medical nutrition therapy, they see these tasks as part of their job, and they practiced dietary counseling that was limited to pregnancy and chronic diseases.

Beyond pillbox: a national cross-sectional study on the attitudes, practices, and knowledge of community pharmacists regarding complementary and alternative medicine

BACKGROUND

While community pharmacists are uniquely positioned to promote the safe and effective use of complementary and alternative medicine, their potential role remains largely untapped. The objective of this study was to assess the knowledge, attitudes, and practices related to complementary and alternative medicine products among community pharmacists in the United Arab Emirates and explore the correlates of knowledge in the study sample.

METHODS

Using a stratified random sampling frame, a national survey of community pharmacists was conducted in the United Arab Emirates. In a face-to-face interaction, participants completed a multi-component questionnaire consisting of four sections: sociodemographic and general characteristics; knowledge of complementary and alternative medicine products and usage; attitudes towards complementary and alternative medicine and practices related to complementary and alternative medicine. Based on participants' answers, scores were calculated with higher scores indicating more positive knowledge, attitudes, and practices.

RESULTS

373 community pharmacists participated in the study (response rate: 83%). For the knowledge questions, more than 50% of community pharmacists correctly answered the functions of complementary and alternative medicine, however lower percentages were noted for the side effects and drug interactions questions. Most community pharmacists had positive attitudes towards complementary and alternative medicine, except for particular aspects such as efficacy, where 40% agreed that complementary and alternative medicine is only effective in treating minor complaints. As for practices, while more than 70% of participants counseled patients on complementary and alternative medicine use, only 47% reported the toxic effects when encountered. Multiple linear regressions showed that community pharmacists working in independent pharmacies, those with fewer years of experience, and those who did not receive complementary and alternative medicine education during their academic degree had lower knowledge scores (p < 0.05).

CONCLUSIONS

The findings of this study showed that community pharmacists in the United Arab Emirates have good knowledge of complementary and alternative medicine functions and generally positive attitudes and practices, with few gaps identified in each. Together, these findings provide critical evidence for the development of targeted interventions to promote the role of community pharmacists towards safe and effective complementary and alternative medicine use in the country.

Knowledge, attitude, and perceptions of healthcare professionals towards complementary and alternative medicine: a cross-sectional survey from twin cities of Pakistan

BACKGROUND

The growing popularity and use of complementary and alternative medicine (CAM) products among the general public worldwide has been well documented. This study aimed to investigate the knowledge, attitude, and perceptions (KAP) of Pakistani healthcare professionals (HCP) toward CAM and to document their views on integrating CAM education with the curriculum of undergraduate health science programs.

METHOD

A cross-sectional study using simple random sampling was conducted for a duration of ten months among HCPs from Pakistan's twin cities: Islamabad and RawalpindiThe data were collected using a self-administered and validated (Cronbach's alpha: 0.71) questionnaire. This questionnaire consisted of five sections, namely; demographic, attitude, perception, integration and knowledge.

RESULT

The response rate was 91.20% (500/456). The participants included 160 physicians, 155 nurses,and 141 pharmacists. The majority of the respondents were females, 67.50%, and unmarried (60.50%).The majority of HCPs participating in this study agreed that CAM modalities may benefit conventional medicine system. Likewise, most HCPs perceived different CAM therapies aseffective treatment options. More than 50% HCPs suggested CAM elective courses in the curriculum of the health sciences program.Overall, 79.17% of the HCPs have poor knowledge of CAM. Physicians have the highest knowledge score 25.63%, followed by pharmacists 21.99%, and nurses 12.26%. Knowledge status was significantly associated with age, profession, and experience of practice (p = 0.001,0.001 & 0.019).

CONCLUSION

This study revealed that despite the overall positive attitude of HCPs toward CAM, the score of knowledge is low. Therefore, the survey recommends evidence-based guidelines for the rationale use of CAM and updated syllabi of undergraduate health programs which will assist the future HCPs in increasing professionals' knowledge toachieve better health outcomes for the general public.

Pharmacy education in traditional and complementary medicines - A systematic review

BACKGROUND

Traditional and complementary medicines (T&CMs) are not typically covered in medical curricula despite 80% of the world's population using some form of herbal product as part of their healthcare. Concurrent use of T&CMs with conventional therapies is common, and both are primarily accessed in pharmacies. There is an expectation that pharmacists should be knowledgeable about T&CMs. Therefore, this review aimed to investigate what is currently known about pharmacists' T&CMs education and training to inform developments in pharmacy education.

METHODS

Eligible studies published between 01/01/2016 and 28/02/2023 were identified across six databases (PubMed, Scopus, Web of Science, EMBASE, ScienceDirect and MEDLINE). Data were extracted from included studies and categorized into key themes and sub-themes and reported descriptively.

FINDINGS

Fifty-eight studies were identified, conducted across 30 countries, that included information about pharmacists' T&CMs education and training. Within the four main themes extracted, six subthemes were identified including: T&CMs education and training received; inadequate education and training opportunities; knowledge, and confidence towards T&CMs in the pharmacy setting; professional practice behaviour associated with T&CM; university education for pharmacy students; and continuing professional development for practicing pharmacists, including T&CM-drug interactions, interpreting T&CM research, T&CM-specific communication skills, T&CM use in pregnancy and breastfeeding, and efficacy and safety of T&CM in specific conditions.

CONCLUSION

Overall pharmacists are receiving limited T&CM education in undergraduate and continuing professional training and report a lack of resources to inform the advice they provide to consumers. The findings of this review can inform developments in T&CMs curriculum and accreditation standards that support the training needs of pharmacists who play a role in fostering the safe and appropriate use of these products.

Towards defining and supporting pharmacists' professional role associated with traditional and complementary medicines - A systematic literature review

BACKGROUND

A review conducted in 2015 reported community pharmacists are willing to adopt a professional role in counselling consumers about the appropriate and safe use of traditional and complementary medicines (T&CM) but faced multiple barriers in doing so; including the role being poorly defined. This current review aimed to update and extend these findings, by identifying studies published since 2015 that reported on pharmacists across any setting.

METHODS

Eligible studies published between January 01, 2016 and December 31, 2021 were identified across six databases (PubMed, Scopus, Web of Science, EMBASE, ScienceDirect and MEDLINE). A grounded theory approach was used to thematically synthesize the data extracted.

FINDINGS

A total 64 studies representing pharmacists across 30 countries were included for review. Study designs varied including cross-sectional surveys (n = 36), qualitative studies (n = 14), and pseudo-patient studies (n = 3). Eight studies reported on practice and/or bioethical responsibilities and 19 studies reported on factors that would enable pharmacists to fulfill these responsibilities, while 37 studies reported about both.

CONCLUSION

These findings indicate research about pharmacists' responsibilities associated with T&CM is evolving from gap analysis towards research that is proactive in advocating for change in multiple areas. These findings can be used to inform a consensus discussion among pharmacists and key stakeholders regarding a set of professional responsibilities that would serve in the development of: a clearly defined role and associated practice standards, and competency requirements that inform educational learning objectives for inclusion in undergraduate, post-graduate and continuing professional pharmacy education.

Complementary and alternative medicine use during the COVID-19 pandemic: Community pharmacists' knowledge, attitudes, and practices

BACKGROUND

The challenges in COVID-19 treatment have driven patients to seek Complementary and Alternative Medicine (CAM) for the prevention and/or treatment of the disease. Pharmacists are uniquely positioned to promote the effective and safe use of CAM.

OBJECTIVE

Assess the beliefs, practices, and knowledge of community pharmacists in Lebanon about existing evidence for the use of CAM for the prevention and/or treatment of COVID-19.

METHODS

A national cross-sectional survey was conducted among community pharmacists during the COVID-19 pandemic in Lebanon (n = 310 respondents). Participants completed an online questionnaire addressing, in addition to the socio-demographic characteristics; the beliefs, practices, and knowledge of pharmacists regarding the existing evidence of CAM use for COVID-19 prevention and/or treatment.

RESULTS

Pharmacists (70%) received frequent inquiries about CAM for COVID-19 prevention or treatment. Only 25.5% of the pharmacists reported having enough time to get information about CAM and COVID-19. Almost all participants believed that pharmacists have a major role in the fight against COVID-19 (98%) and that they have enough information to counsel patients in that regard (75%). For practices, the majority of pharmacists reported counseling their patients on proper use (98%) and possible adverse reactions (93%) of CAM, but only 51% reported toxic or undesirable effects. Regarding knowledge, although most pharmacists answered correctly the questions on the role of CAM in preventing COVID-19, few knew about its role in treating the infection. Pharmacists who trust the WHO website as a credible source had a higher knowledge score (β = 0.52, 95%CI: 0.05-0.986).

CONCLUSIONS

The positive beliefs and practices of pharmacists towards CAM during the pandemic were coupled with a few gaps, especially in their knowledge about existing evidence for CAM use. Concerted efforts ought to be dedicated to supporting pharmacists in playing a more prominent role during health crises such as the COVID-19 pandemic.

A triangulated perspective for understanding CAM use in Lebanon: a qualitative study

Background

Existing evidence marked a prevalent use of Complementary and Alternative Medicine (CAM) therapies in Lebanon that is concomitant with low rates of disclosure to health care providers and limited knowledge among the general public of safety and side effects of CAM use.

Objectives

To examine the perspectives of Lebanese CAM users, CAM providers, and health care providers (HCPs) regarding their understanding of CAM and of the Push and Pull factors that drive its use.

Methods

A qualitative research study was conducted using in-depth interviews, targeting Lebanese adults (CAM users; 18-65 years) (n=14), CAM providers such as yoga instructors, owners of CAM product outlets, herbalists, and religious figures (n=13); and HCPs including physicians, nurses, dietitians, and pharmacists (n=14). The topic guide covered, in addition to the understanding of CAM, the Push and Pull factors driving CAM use. The adults were recruited by convenient sampling, and CAM providers and HCPs using a purposive sampling approach. Interviews were audiotaped, transcribed, and translated into English. Analysis was performed using a qualitative thematic approach. Similarities and differences in the perceptions of the participants with regards to factors that influence CAM use were charted and contrasted, using a triangulated approach.

Results

The three study groups exhibited a similar understanding of CAM, referring to non-conventional therapies used to prevent/treat diseases or to enhance wellbeing. CAM users and CAM providers identified “distrust in HCPs”, “lack of patient-centered care in CM”, and “limitations and side effects of CM” as important Push factors. All study groups highlighted the limited CAM knowledge of HCPs as a main reason for the lack of patient-centered care. All three groups also underscored the affordability and the social and cultural support for CAM as main enablers of its prevalent use. Unlike HCPs who were skeptical about the safety and effectiveness of CAM, CAM users and CAM providers indicated that most of CAM therapies are safe and efficient.

Conclusions

The triangulation of perspectives (CAM users, CAM providers, and HCPs) in this study allowed a comprehensive appraisal of CAM use and its drivers. Improving the HCPs’ CAM-related knowledge, promoting patient-centered care and fostering an open dialogue between HCPs and CAM providers are among the recommendations of the study.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12906-022-03685-z.

Herbal Medicine (HM) among pharmacy professionals working in drug retail outlets in Asmara, Eritrea: knowledge, attitude and prevalence of use

Background

Globally, the usage of herbal medicines (HMs) is increasingly growing in treating and preventing various ailments. Although, HMs play a vital role in healthcare, concerns have been raised over their safety. Since pharmacy professionals are at the right position to provide patients with evidence-based information on herbals, they should be knowledgeable enough on the subject matter. Thus, the aim of the study was to assess the knowledge, attitude and prevalence of HMs use and its associated factors among pharmacy professionals.

Method

An analytical cross-sectional study was conducted among pharmacy professionals working in drug retail outlets in Asmara (the capital city of Eritrea). A census design was employed and data were collected through face-to-face interview. Data were entered and analyzed using Census and Survey Processing System (version-7.2) and IBM Statistical Package for Social Sciences (version 26), respectively. Descriptive and analytical statistics including Mann-Whitney U test/Kruskal-Wallis test and logistic regression were employed. P-values less than 0.05 were considered as significant.

Results

A total of 50 pharmacy professionals (90.9% response rate) were enrolled in the study. Majority of them (62%) were males and two-thirds had a bachelor’s degree. The overall median (Interquartile range, IQR) knowledge score was found to be 24 (12.16) out of 100 with a minimum score of 8 and maximum score of 53. Generally, the median (IQR) attitude score was 70.4 (4.2) out of 100. Majority (78%) of them had used HM for self-treatment. Only religion was found to be a significant determinant of knowledge on indication of HMs (p = 0.015), while attitude score was independent of the potential determining factors. Moreover, prevalence of use was significantly associated with pharmacy ownership (Adjusted Odds Ratio (AOR) =14.44, 95%Confidence Interval (CI): 1.67, 124.52) as well as with the percentage attitude score (AOR = 0.632, 95%CI: 0.41, 0.96) at multivariable level.

Conclusion

Generally, the overall knowledge score of pharmacy professionals was low. However, they possessed positive attitude towards herbal medicines. Besides, there was prevalent usage of herbal medicine for self-treatment. This outcome triggers the need for educational courses and workshops centered on herbal medicine.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12906-022-03698-8.

Herbal supplements in Jordan: a cross-sectional survey of pharmacists' perspectives and knowledge

OBJECTIVES

Pharmacists are ideal partners for engaging with the needs and expectations of patients. They can play a vital role by providing information and supplying herbal medicines. In some community settings, pharmacists are also the main first point of care. This study explored Jordanian community pharmacists' perspectives and knowledge of herbal medicines available in pharmacies.

DESIGN

A cross-sectional study using an online survey was developed, and it was distributed via social media platforms. The one-way analysis of variance (ANOVA) test was used to compare the mean knowledge scores between different demographic groups. Multiple linear regression analysis was used to identify predictors of herbal medicines knowledge.

SETTING

Jordanian community pharmacies.

PARTICIPANTS

401 Jordanian community pharmacists.

RESULTS

Herbal supplements are sold in practically all pharmacies (98.5%). Slimming aids (14.7%), followed by sexual and sports enhancements (14%) and maintaining general health (12.1%) were most requested by Jordanian customers. While supplements for maintaining general health (12%), followed by slimming aids (11.4%) and skin conditions (9.3%) were most recommended by Jordanian pharmacists. 63.1% were not aware of potential herb-drug interactions, 95.6% did not receive complaints from customers about herbal medicines and 41.2% would not report adverse reactions to the national pharmacovigilance services. The mean knowledge score for knowledge of use, regulation, adverse reactions, and drug interactions was 3.7 (SD: 0.7), 3.5 (SD: 0.8), 3.6 (SD: 0.8), and 3.6 (SD: 0.8) (out of 5), respectively. ANOVA test showed that total pharmacists' knowledge scores significantly differed based on the length of time practising pharmacy (p<0.05).

CONCLUSION

This study highlights some key concerns relating to recommendations, awareness and reporting of herbal medicines among Jordanian community pharmacists. Pharmacists need enhanced education to provide objective and evidence-based information on the benefits-risks of herbal medicines. Future studies need to be carried out to confirm whether our findings are transferable to other Middle Eastern countries.

A systematic review of community pharmacist practices in complementary medicine

Background

The people who use complementary medicines (CMs) believe that these medicines are safe and harmless. They could easily access CMs like herbal or traditional medicines in community pharmacies. Therefore, community pharmacists are important professionals in advising the safe choices of CMs and providing evidence-based information for customers to decrease adverse effects of CMs.

Objectives

To systematically review knowledge, attitude, and practices of community pharmacists about CMs, and the factors associated with CM practices of dispensing, recommending and counseling patients, and answering the patients' queries.

Method

An electronic search was performed with four databases: PubMed, Scopus, SpringerLink and ScienceDirect, from 1990 to 19th May 2022. The inclusion criteria were studies 1) about knowledge, attitude, and/or practices of community pharmacists about CMs, 2) written in English, 3) conducted with quantitative methods, and 4) able to retrieve full text.

Results

Twenty-three studies were included in this systematic review. Some studies showed that less than half of the pharmacists asked or counselled about CMs to their patients and answered the patients' queries about CMs. Only 20% of the pharmacists did report CM side-effects. Training or education about CMs was a common factor associated with the CM practice of dispensing, recommending, counseling, and answering the patients' queries about CMs. CMs recommended most by community pharmacists were vitamins & minerals, food or dietary supplements, fish oil and probiotics. The most common dispensed CMs were vitamins & minerals, herbs, food or dietary supplements, fish oil and essential oils. Lacks of reliable information sources and scientific evidence were common barriers for the CM practices. Being less expensive than conventional medicines motivated the pharmacists to recommend and discuss about CMs. The community pharmacists that participated in included studies suggested strengthening CM trainings and highlight the pharmacist role in CM therapy.

Conclusion

A high percentage of community pharmacists did dispense CMs to their patients, while a low percentage of the pharmacists did report CM side effects. Pharmacists were most comfortable recommending and responding the patients' CM queries. Training or education about CMs associated with CM dispensing, recommending, discussing, and answering the patients' queries about CMs was recommended.

Pharmacists’ perspectives on traditional, complementary, and integrative medicine in Japan with special reference to Kampo medicines: an internet survey with preliminary interviews

Background

Pharmacists guide patients in their use of traditional, complementary, and integrative medicine (TCIM). The present study aimed to evaluate the opinions of Japanese pharmacists regarding TCIM, and to evaluate the usability of the evidence-based Japanese Integrative Medicine (eJIM) website from the pharmacists’ point of view.

Methods

We conducted a two-stage, mixed-method study using interviews and an internet-based survey. In-person interviews were conducted with 20 pharmacists working in hospitals, dispensing pharmacies, or retail pharmacies. We analyzed their perspectives on TCIM and the usability of the eJIM. Based on the interviews, questionnaires for an internet survey conducted in February 2019 were developed.

Results

In the interviews, 55% of pharmacists acknowledged TCIM as a supportive measure for modern medicine, and 45% responded that TCIM was efficacious. However, pharmacists’ evaluation levels of Kampo medicine were high, whereas pharmacists’ attitudes towards dietary supplements were primarily negative. There have been various proposals to improve the eJIM, such as highlighting important information and providing more specific information on TCIM in Japan. An internet survey of 365 pharmacists showed that 67.4% were consulted by patients regarding TCIM. Of these TCIM, pharmacists’ evaluation levels of Kampo medicines were high. Only 5% of the respondents had visited the eJIM website prior to the survey, and the overall usability score of each web page was high.

Conclusions

Kampo medicines and dietary supplements are common TCIMs that pharmacists use or advise on in Japan. Pharmacists’ evaluation levels of Kampo medicine were high, whereas pharmacists’ attitudes towards dietary supplements were generally negative.

Knowledge, use and practices of licensed dietitians related to dietary supplements in Lebanon

OBJECTIVE

To evaluate Lebanese licensed dietitians' knowledge, prevalence of use and recommendation of dietary supplements (DS), and their associated factors.

DESIGN

Cross-sectional survey.

SETTING

Dietitians across Lebanon were contacted through the telephone and were asked to participate in the study. An online self-administered questionnaire was designed and sent to dietitians either by email or by WhatsApp, between 4 March and 4 May 2020.

PARTICIPANTS

This study included 319 dietitians randomly selected from the dietitians' list that was provided by the Lebanese Ministry of Public Health.

RESULTS

Around 75 % of dietitians had a knowledge score above 50 %. Overall, 73·7 % of them have used DS and 46·1 % have recommended them. Higher knowledge score was associated with less years of experience, using scientific articles as source of information on DS, and participating in research. Resorting to pharmacists was significantly associated with both nutrient supplements (NS) and herbal supplements (HS) use, whereas referring to health food stores was associated with HS use only. NS recommendation to patients was associated with personal NS use (OR = 3·38, P < 0·001), considering pharmacists as a source of information on DS (OR = 2·29, P = 0·01) and discussing DS with patients (OR = 3·82, P = 0·01). Having personally used HS (OR = 12·23, P < 0·001) and having discussed DS with patients (OR = 8·51, P = 0·01) increased the likelihood of recommending HS.

CONCLUSIONS

A proper DS education, the elaboration of national scientific guidelines and the implementation of concise laws regarding the regulations of DS would play a crucial role in supporting dietitians' practices and improving the quality of patient care with respect to DS.

Traditional and Complementary Medicine use and beliefs during COVID-19 outbreak: A cross-sectional survey among the general population in Turkey

Objective

Coronavirus disease 2019 (COVID-19) caused a universal psychosocial impact, with many individuals exposed to threats preferring to try self-care interventions and non-conventional approaches such as traditional and complementary medicine (T&CM) for preventive purposes. This study was conducted to determine the use of and beliefs about T&CM among a subset of the general Turkish population during the COVID-19 outbreak.

Method

A cross-sectional online survey was carried out among the general population (aged ≥ 18 years) of Adana, Turkey during the strict lockdown period (April 11 to April 30, 2020). The survey instrument included details about sociodemographic characteristics, general information, T&CM use and beliefs. It was distributed among eligible participants via social media channels (Instagram, WhatsApp and Facebook accounts).

Results

Out of a total 389 participants, 39.3% (n = 153) used T&CM and 60.7% were non-T&CM users during COVID-19. Of those using T&CM, 61 (39.8%) reported the usage of more than one form of T&CM, mostly herbal medicine (30.8%), followed by nutritional supplements/vitamins (23.8%). 33.9% (n = 52) of participants using T&CM did not report T&CM use to theirmedical physicians. A statistically significant difference was observed between T&CM users and non-T&CM users in gender, age, marital status, level of education, income, and prior use of T&CM (p < 0.05). Social media (n = 204; 52.4%) was the primary source of information for T&CM use. Overall, 33.7%, 54.8% and 39% of participants in this stduy believed that T&CM therapies are effective, have fever side-effects/safe and should be use for COVID-19, respectively.

Conclusion

During the outbreak of COVID-19, a significant proportion of the population reported the use of T&CM, with different beliefs about T&CM being observed. Better-structured T&CM-specific educational programs, enhanced physician-patient communication and access to reliable information are needed to ensure appropriate T&CM use during pandemics in Turkey.

Barriers, knowledge, and training related to pharmacists' counselling on dietary and herbal supplements: a systematic review of qualitative studies

Background

Pharmacists are recognized as one of the most accessible healthcare providers and are licensed to advise patients on drugs and health products including dietary and herbal supplements (DHSs). The objective of this study was to identify barriers, knowledge, and training that pharmacists report related to DHSs counselling.

Methods

MEDLINE, EMBASE, AMED and CINAHL were systematically searched from database inception to May 8th, 2020. Eligible articles contained qualitative data with a specific focus on pharmacists’ perceived knowledge, training, and barriers to DHSs counselling. Relevant data were extracted, and a thematic analysis was conducted.

Results

Nineteen articles met the inclusion criteria. The following three main themes were identified: challenges to pharmacists obtaining DHSs education, postgraduate workplace challenges surrounding DHSs, and pharmacists’ perceived role and importance on DHSs. Low knowledge of DHSs and the limited regulations surrounding DHSs acting as a barrier to counselling were common findings supported by the eligible articles.

Conclusions

A lack of pharmacists’ knowledge and awareness of DHSs stems from a variety of factors including a lack of education and training in the field, limited regulations surrounding DHSs, and inadequate availability of DHS information resources in the pharmacy. Pharmacists were unable to confidently counsel patients due to these aforementioned factors in addition to reporting that they lacked time. Further research that reviews pharmacy education and workplace training, and improving DHS regulations are warranted future directions.

The role of pharmacists in complementary and alternative medicine in Lebanon: users' perspectives

Background

Customers’ expectations and satisfaction are critical to ensure a more effective role of the community pharmacists in promoting the safe use of Complementary and Alternative Medicine (CAM). The aim of this study is to examine the perceptions and practices of customers buying their CAM products from pharmacies and explore their satisfaction with CAM-related services offered by the community pharmacists in Lebanon.

Methods

A national cross-sectional study was conducted among users of CAM (age > =18 years) who obtained their CAM from community pharmacies in Lebanon (n = 832). Within the proximity of the pharmacy, subjects were invited to complete a multi-component questionnaire. The latter consisted of four sections related to CAM: general beliefs, perception of pharmacists’ role, practices, satisfaction with services offered by the pharmacists. In addition, the questionnaire included questions about sociodemographic characteristics of participants.

Results

The majority of participants agreed to an active role of the pharmacists’ in guiding CAM use, however over half of the participants (61.3%) did not agree that the pharmacist is more knowledgeable in this field than other healthcare providers. As for practices, one in two surveyed customers (47%) did not always give feedback to their pharmacists about the outcomes after using CAM, 20% did not often ask the pharmacists about the safe and effective mode of use of the products and 28.1% did not discuss their medical history. For services offered by the pharmacist, the majority of participants reported receiving good education about the CAM product (87.1%), its side effects (87.1%) and mode of use (93.4%), while significant proportions of participants reported that pharmacists were not asking questions about their medical history before dispensing CAM products (22%) nor were they providing information on CAM-drug interactions (30%).

Conclusions

The results of this study highlighted important gaps between the perceptions of customers and the services they received from the pharmacists about CAM use. These findings could be used by concerned stakeholders, including public health authorities and educational bodies, to develop evidence-based interventions aimed at promoting the role of pharmacists in ensuring a safe and effective CAM use Lebanon.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12906-021-03256-8.

The perception of Jordanian population towards concomitant administration of food, beverages and herbs with drugs and their possible interactions: A cross-sectional study

BACKGROUND

Many people are used to administering their drugs with food, beverages or herbs. These substances may contain chemicals that interfere with the prescribed drugs and could potentially lead to changes in their efficacy or safety, and could result in alterations in their pharmacokinetic properties.

OBJECTIVE

To assess the extent of the perception and consumption of food, beverages and herbs alongside conventional drugs, along with their potential interactions, specifically in Jordanian society.

METHODS

A descriptive cross-sectional survey was conducted in Jordan (20 April - 5 May 2020). The survey was developed using Google Forms, then validated and distributed via social media platforms. Data were analysed using Statistical Package for Social Sciences-24.

MAIN OUTCOME MEASURE

Use and perception of food, beverages, herbs and how they interact with drugs among Jordanians.

RESULTS

Of all the participants (n = 789), 77.8% were females, 46.2% were 50-year-olds, 69.7% were married, 70.8% were medically insured, and 51.1% had bachelor's degrees. 70% of the study participants reported use of medicinal plants. About 66% of participants agreed that medicinal plants or herbs could treat diseases and 58.6% thought that medications could interact with drugs. In general, the participants' knowledge about food/beverage/herb-drug interactions was considered poor. However, a linear regression analysis showed that the level of knowledge was significantly affected (P < .05) by gender, marital status, social status, educational level and employment sector.

CONCLUSION

Jordanians have a positive perception towards herbs and their ability to treat diseases. However, their knowledge about food/beverage-drug interactions was poor. There is therefore a need to enhance the community awareness of food/beverage/herb-drug interactions.

Knowledge, attitudes, and practice of community pharmacists towards providing counseling on vitamins, and nutritional supplements in Saudi Arabia

Background

Pharmacists play an important role in the healthcare system and have a greater impact on the outcome of public health programs. Patients who seek nutrition and vitamin advice presume the role of community pharmacists including the recommendation of effective vitamin and nutritional products.

Objective

To determine the knowledge, attitudes, and practice of community pharmacists towards providing counseling on vitamins and nutritional supplements in Saudi Arabia.

Setting

All community pharmacies in all cities in Saudi Arabia.

Methods

A cross-sectional study methodology. The study was conducted between September 2019 and April 2020. Google survey was used to collect the samples from community pharmacists across Saudi Arabia.

Main outcome measure

Main outcome measure knowledge, attitudes, and practice of community pharmacists towards providing counseling on vitamins and nutritional supplements.

Results

A total of 1199 questionnaires were distributed electronically. Only 1041 were obtained to representing an 86.8% success rate. A significant majority of the respondents in this study were males (98.7%) and aged between 23–34 years (80.7%). Most of the community pharmacists in this study were non-Saudi residents 96.4%. Only 24.0% had certification from the Saudi National Board. Daily, the majority of the pharmacists attended to an estimated 100–200 patients 62.3% with only 22.7% attending to more than 200 customers per day. Most of the community pharmacists 86.4% have received a form of training on vitamins and nutritional supplements. Most of the community pharmacists counsel their patients about the side effects of vitamins and nutritional supplements.

Conclusion

Community pharmacists in Saudi Arabia have adequate knowledge and a positive attitude about vitamins and nutritional supplements. Our findings indicate that training courses are needed to improve pharmacists' communication skills to play more roles in counseling and enhancing their practice.

Role of community pharmacists in weight management: results of a national study in Lebanon

BACKGROUND

Ideally situated within the community, pharmacists can be involved in a broad range of health promotion campaigns including prevention of obesity. Limited evidence is available regarding their involvement in weight management in Lebanon, a country with escalating prevalence rate of obesity.

OBJECTIVE

To examine the role of community pharmacists in weight management in Lebanon, specifically studying their beliefs, current practices, services, and knowledge.

METHODS

Using a stratified random sampling approach, a cross sectional national survey of community pharmacists was conducted (n = 341, response rate 89%). At the pharmacy, and through a face-to-face interview, pharmacists completed a multi-component questionnaire that addressed, in addition to socio-demographic and work characteristics, their beliefs, practices, knowledge in relation to weight management. Frequencies and proportions were used to describe the data. Simple and multiple linear regression analyses were used to examine the determinants of knowledge in the study population.

RESULTS

Over 80% of study participants agreed that they have an important role to play in weight management. However, 50% of pharmacists did not agree that weight loss products are well regulated and 81.1% thought that companies marketing weight loss products are making false promises. The majority of pharmacists always/often sold weight loss products (84.7%) and counseled their patients for diet (86.3%) and physical activity (91.7%). Despite taking weight and height measurements, 50% of pharmacists rarely/never calculated BMI. Among the pharmacists who reported side effects of weight loss products (46.5%), the majority (91.3%) did so to the pharmaceutical company. The knowledge of pharmacists was better for the use of weight loss products as opposed to their side effects and interactions. Significant predictors of knowledge were holding a Masters/ PhD degree in Pharmacy, graduating from a university inside Lebanon, obtaining weight management training within the academic degree, and receiving inquiries about weight management in the pharmacy more than once daily.

CONCLUSIONS

The results of the study provided important insights on the beliefs, practices and knowledge of community pharmacists in weight management in Lebanon. These findings could be used to inform the development of future evidence-based community pharmacists led weight management service provision nationally and internationally.