Phytotherapic compounds: the consumer-pharmacist relationship

Knowledge, attitude and dispensing practice of the pharmacists related to complementary alternative medicines in the Riyadh region of Saudi Arabia: a cross-sectional descriptive study

BACKGROUND

The use of complementary alternative medicines (CAMs) has risen globally in recent times. Such medications are exclusively and readily available in the Riyadh region of Saudi Arabia through community pharmacies and other retail outlets, exposing the consumers to various risks like harmful drug interactions. These situations take pharmacists to a responsible position where they should provide evidence-based information to help consumers make safe consumption. The consumption of CAMs can be ensured safe if pharmacists have appropriate knowledge and training about their use, dosing, side effects, etc. This study aimed to investigate and evaluate the pharmacist's factual knowledge, perception and dispensing practice related to various aspects of CAMs based on gender and experience.

METHODS

The study followed a structured self-administered questionnaire-based cross-sectional survey design. Out of 200, with a response rate of 89.5%, 179 pharmacists (115 males; 64 females) from the Riyadh region of Saudi Arabia participated in this study. The knowledge scores of male and female pharmacists were compared using an unpaired t-test. The correlation between pharmacists' knowledge and their work experience was determined using Pearson's correlation coefficient test, keeping the significance value at p < 0.05.

RESULTS

Almost all the respondents (99%) reported that they had never attended any lecture or course related to CAMs. Results show low knowledge scores, indicating poor respondents' knowledge concerning the use of CAMs. No significant difference was observed in knowledge scores based on gender, and no significant correlation between pharmacists' knowledge scores and their work experiences.

CONCLUSION

Therefore, the study concluded that both male and female pharmacists possess equal knowledge concerning the use of CAMs, and their work experience doesn't differentiate in their knowledge. Various factors like lack of time, etc., prevented respondents from interacting with patients. Regular organization of mandatory continuing education programs about the safe use of CAMs that can improve their knowledge is recommended. In addition, establishing a pharmacy connection network system can enhance patient monitoring and CAMs vigilance. This study lays a foundation for further work to assess pharmacists' knowledge and practice patterns in Saudi Arabia.

TRIAL REGISTRATION

Not applicable.

A comparison of the frequency, risk factors, and type of self-medication in pregnant and nonpregnant women presenting to Shahid Akbar Abadi Teaching Hospital in Tehran

Background

Self-medication is a serious health problem that leads to an increased per capita consumption of medications, drug resistance, lack of optimal treatment, drug poisoning, and other unwanted complications. This study was conducted to compare self-medication in pregnant and nonpregnant women presenting to Shahid Akbar Abadi Teaching Hospital in Tehran, Iran.

Materials and Methods

To conduct this cross-sectional study, 210 pregnant women and 210 nonpregnant women aged 15-45 years presenting to Shahid Akbar Abadi Teaching Hospital, Tehran, Iran, were selected through random sampling. Data were collected through interviews using a semi-structured questionnaire. The Chi-square test, t-test, and logistic regression model were used to analyze the data.

Results

The prevalence of self-medication was 34.8% in the pregnant and 77.1% in the nonpregnant women. The age group in which the most frequent instances of self-medication were observed (53.4%) was the 21-30 age group in the pregnant women and the 31-40 age group (44.4%) in the nonpregnant women, suggesting a statistically significant intergroup difference in terms of age (P = 0.0001). Medicinal plants were the most common medications used by the pregnant women (19.6%) and synthetic medications were the most common used by the nonpregnant women (38.1%). The reasons for using medications without a prescription included believing in the illness being mild (22.8%), not having health insurance (9%), easy access in the pregnant women, a previous history of the illness, and easy access in the nonpregnant women.

Conclusions

As medicinal plants are the most common medications used by pregnant women and since assessing the risk of herbal substances is difficult, pregnant women should be advised against the arbitrary use of these substances.

Prevalence, knowledge and attitudes toward herbal medication use by Saudi women in the central region during pregnancy, during labor and after delivery

Background

Herbal medication usage is prevalent in both developing and developed countries. The low level of awareness of the possible dangers of some herbs during pregnancy increases the risk of unwarranted sequelae. This manuscript describes the first study of herbal medication use among pregnant women in Saudi Arabia. It aims to determine the prevalence of herbal medication use during pregnancy, during labor and after delivery in the central region of Saudi Arabia.

Methods

A cross-sectional descriptive study was conducted over a 5-month period from May 15 to October 15, 2016. A self-administered questionnaire was distributed at 4 main hospitals and 3 primary care centers in Riyadh and Al Kharj. Data from 612 participants were collected and analyzed. Descriptive statistics in the form of frequency and percentage were determined, and Chi-squared tests were performed.

Results

Of the 612 participants, 25.3%, 33.7% and 48.9% used herbs during pregnancy, during labor, and after delivery, respectively. The primary motives for using herbal medication during pregnancy, during labor and after delivery were to boost general health, ease and accelerate labor and clean the womb, respectively. There was a significant association between use during pregnancy and prior use (P = 0.001). Most pregnant women used herbs based on advice from family and friends (52.9%). Only 40.7% of pregnant women disclosed their herbal use to their doctors.

Conclusion

The prevalence of herbal medication use among pregnant Saudi women in Riyadh and Al Kharj is relatively high. Doctors should be aware of evidence regarding the potential benefits or harm of herbal medication use during pregnancy.

HERBAL PRODUCT USE BY THE CANCER PATIENTS IN BOTH THE PRE AND POST SURGERY PERIODS AND DURING CHEMOTHERAPY

BACKGROUND

The aim of this study was to evaluate of the use of herbal products in patients in both pre- and post- surgery periods and during chemotherapy, and to determine the factors behind it.

MATERIALS AND METHODS

This study was conducted as a descriptive study with 281 patients in 4 centers. The data of the study were collected by using a survey form prepared by the researcher, depending on literature and interview with the participants face-to-face.

RESULTS

While the average age of the patients involved in the study is 49.1±12.8, 51.6% of them were females, 34.6% graduate of elementary school, and 34.5% were housewives. While the prevelance of the use of herbal product prior to surgical treatment is 38.9%, it was observed that this rate increased to 54.1% during chemotherapy. It was observed that the most frequently used product was garlic prior to surgical treatment (19.2%), that it was urtica dioica (13.8%) during chemotherapy. Before the surgical treatment, 94.3% of the patients, and during chemotherapy treatment, 81.7% of the patients, stated that the use of herbal product had not been questioned by the physician or nurse.

CONCLUSION

Analysis of the results indicates that health professionals need to obtain information regarding the use of herbal products by cancer patients during both pre- and post- surgery periods, as well as during chemotherapy. Patients should be provided with information and guidance about the advantages and disadvantages of using herbal products.

The African Pitocin - a midwife's dilemma: the perception of women on the use of herbs in pregnancy and labour in Zimbabwe, Gweru

Introduction

The use of natural health products is gradually increasing all over the world with up to 50% of the general population having tried at least one herbal product. This becomes a dilemma to the midwife who has limited or no knowledge on their effects in pregnancy, hence the need to explore the perceptions of women on the use herbs in pregnancy and labour.

Methods

The research, which was a case study of a Claybank Private Hospital in Gweru, Zimbabwe, adopted a qualitative approach with a triangulation of data from interviews, observations and analysis of maternal records. A sample of 20 women, admitted to using herbs, was purposively selected from the labour and post natal wards.

Results

A variety of substances, but mainly the elephant's dung, was used. The family, (mother) prescribed the herbs. The women did not have knowledge on how the substances work but believed in them, as they have stood the test of time.

Conclusion

The African women in Zimbabwe cannot be stopped from taking herbs as it is engraved in their culture and have absolute faith in them. Whilst the herbs are assumed by the women to be effective, their safety is questionable, especially in women with underlying obstetric complications. It is therefore recommended to scientifically explore the safety and effectiveness of the most commonly used herbs if pregnancy is to be safe. Whilst the women can not be stopped from taking these herbs, it is important to build a trusting relationship between the midwife and the mother so that communication about the use of herbs can be done freely without fear or judgement.

What attitudes and needs do citizens in Europe have in relation to complementary and alternative medicine?

BACKGROUND

Surveys from several European countries suggest a European-wide increase in the use of Complementary and Alternative Medicine (CAM). To safeguard citizens' rights concerning their healthcare, it is critical to gain an overview of citizens' attitudes and to understand their expectations and needs regarding CAM.

METHODS

A review of literature was undertaken, based on systematic searches of the following electronic databases: PubMed, Web of Science, CINHAL, AMED, PsycINFO and PsycArticles; 189 articles met inclusion criteria. Articles were analysed thematically and their reporting quality assessed.

RESULTS

Despite the limited availability of research-based knowledge about citizens' attitudes and needs concerning CAM in many European countries, some trends can be noted. Many citizens hold positive attitudes to CAM and wish for increasing access to CAM provision. Citizens call for impartial, reliable and trustworthy information to support informed decision-making, and some citizens wish for greater support and involvement of biomedical healthcare professionals in facilitating their healthcare choices. While citizens value distinct aspects of CAM practice, they are also critical consumers and support clear regulatory and educational frameworks to ensure the quality and safety of CAM provision and medicinal products.

CONCLUSION

To gain knowledge on citizens' needs and attitudes to CAM across Europe further research is required on 3 main issues: i) how citizens across Europe obtain information about CAM and the needs they may have for trustworthy information sources, ii) the local situations for accessing CAM and iii) citizens' perspectives on the quality of care and safety of CAM provision and products.

Use of herbal preparations during pregnancy: focus group discussion among expectant mothers attending a hospital antenatal clinic in Norwich, UK

BACKGROUND

The extent of herbal medicine use in pregnancy has been widely researched throughout the world but little research has been published about the motivations for this use.

METHODS

Focus group discussion. Women who participated in a survey at an antenatal clinic were asked to participate in a focus group discussion to elaborate further on some of the results from the survey. Six women participated.

RESULTS

The major themes identified were: the "underground" nature of taking herbal remedies, reliance on family and friends for information, perceived safety of herbal remedies whilst acknowledging the lack of trial evidence and a desire for the NHS to be more open minded.

CONCLUSION

Herbal medicines are pharmacologically active and pregnant women frequently take these without informing their pregnancy care provider. If doctors want to obtain a full medical picture which includes herb use then non-judgemental responses to such behaviour is required.