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Ng JY, Tahir U, Dhaliwal S. Barriers, knowledge, and training related to pharmacists' counselling on dietary and herbal supplements: a systematic review of qualitative studies. BMC Health Serv Res 2021; 21:499. [PMID: 34034710 PMCID: PMC8147056 DOI: 10.1186/s12913-021-06502-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 05/10/2021] [Indexed: 12/23/2022] Open
Abstract
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.
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Affiliation(s)
- Jeremy Y Ng
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Michael G. DeGroote Centre for Learning and Discovery, Room 2112, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.
| | - Umair Tahir
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Michael G. DeGroote Centre for Learning and Discovery, Room 2112, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada
| | - Simran Dhaliwal
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Michael G. DeGroote Centre for Learning and Discovery, Room 2112, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada
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Schloss J, Ryan K, Reid R, Steel A. A randomised, double-blind, placebo-controlled clinical trial assessing the efficacy of bedtime buddy® for the treatment of nocturnal enuresis in children. BMC Pediatr 2019; 19:421. [PMID: 31706286 PMCID: PMC6842251 DOI: 10.1186/s12887-019-1797-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 10/21/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Nocturnal enuresis (NE), or 'bedwetting', is a form of night-time urinary incontinence occurring in younger children. A diagnosis of NE can be socially disruptive and psychologically stressful for a child. The most common strategies used by parents to manage NE are waking the child during the night to use the bathroom and limiting the child's water intake before going to bed. Behavioural or educational therapies for NE such as urotherapy or bladder retraining are widely accepted and considered as a mainstream treatment option for non-neurogenic lower urinary tract dysfunction in children. Pharmacotherapy also plays an ancillary role. However, there is no gold standard therapy or intervention to effectively manage NE. METHODS This study aims to determine the efficacy of a herbal combination in the treatment of NE in children. The target population for this study is 80 children aged between 6 and 14 years old (males and females) who have primary nocturnal enuresis ≥3 per week (wet nights). The active group will receive one or two capsules per day containing 420 mg of a proprietary blend of Urox® (Seipel Group, Brisbane, Australia) containing Cratevox™ (Crataeva nurvala L; Capparidaceae; Varuna) stem bark extract standardised for 1.5% lupeol: non-standardised Equisetum arvense L. (Equisetaceae; Horsetail) stem extract; and, non-standardised Lindera aggregata Sims. The primary outcome for this study is the frequency of nocturia. Secondary outcomes include safety, quality of life, and daytime incontinence. Each participation will be involved in the trial for 32 weeks including contact with the research team every 2 weeks for the first 8 weeks and then every 8 weeks until trial completion. DISCUSSION This study examines a novel treatment for an under-researched health condition affecting many children. Despite the availability of several therapies for NE, there is insufficient evidence to support the use of any one intervention and as such this randomised placebo-controlled phase II trial will be an important contribution to understanding potential new treatments for this condition. TRIAL REGISTRATION Australian and New Zealand Clinical Trials Registration Number: 12618000288224. PROTOCOL 23 February 2018, version 1.1.
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Affiliation(s)
- Janet Schloss
- Office of Research, Endeavour College of Natural Health, Brisbane, Australia
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Kimberley Ryan
- Office of Research, Endeavour College of Natural Health, Brisbane, Australia
| | - Rebecca Reid
- Office of Research, Endeavour College of Natural Health, Brisbane, Australia
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Amie Steel
- Office of Research, Endeavour College of Natural Health, Brisbane, Australia
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Sydney, Australia
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Ung COL, Harnett JE, Hu H, Desselle SP. Barriers to pharmacists adopting professional responsibilities that support the appropriate and safe use of dietary supplements in the United States: Perspectives of key stakeholders. Am J Health Syst Pharm 2019; 76:980-990. [DOI: 10.1093/ajhp/zxz079] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Carolina Oi Lam Ung
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macao
| | - Joanna E Harnett
- University of Sydney School of Pharmacy, Faculty of Medicine and Health, Sydney, New South Wales, Australia, and Australian Centre in Complementary and Integrative Medicine, University of Technology Sydney, New South Wales, Australia
| | - Hao Hu
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macao
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Salman Popattia A, Winch S, La Caze A. Ethical responsibilities of pharmacists when selling complementary medicines: a systematic review. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2018; 26:93-103. [DOI: 10.1111/ijpp.12425] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 11/22/2017] [Indexed: 01/24/2023]
Abstract
Abstract
Objective
The widespread sale of complementary medicines in community pharmacy raises important questions regarding the responsibilities of pharmacists when selling complementary medicines. This study reviews the academic literature that explores a pharmacist’s responsibilities when selling complementary medicines.
Methods
International Pharmaceutical Abstracts, Embase, PubMed, Cinahl, PsycINFO and Philosopher’s index databases were searched for articles written in English and published between 1995 and 2017. Empirical studies discussing pharmacists’ practices or perceptions, consumers’ expectations and normative studies discussing ethical perspectives or proposing ethical frameworks related to pharmacists’ responsibilities in selling complementary medicines were included in the review.
Key findings
Fifty-eight studies met the inclusion criteria. The majority of the studies discussing the responsibilities of pharmacists selling complementary medicines had an empirical focus. Pharmacists and consumers identified counselling and ensuring safe use of complementary medicines as the primary responsibilities of pharmacists. No formal ethical framework is explicitly employed to describe the responsibilities of pharmacists selling complementary medicines. To the degree any ethical framework is employed, a number of papers implicitly rely on principlism. The studies discussing the ethical perspectives of selling complementary medicines mainly describe the ethical conflict between a pharmacist’s business and health professional role. No attempt is made to provide guidance on appropriate ways to resolve the conflict.
Conclusion
There is a lack of explicit normative advice in the existing literature regarding the responsibilities of pharmacists selling complementary medicines. This review identifies the need to develop a detailed practice-specific ethical framework to guide pharmacists regarding their responsibilities when selling complementary medicines.
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Affiliation(s)
| | - Sarah Winch
- Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Adam La Caze
- School of Pharmacy, The University of Queensland, Brisbane, QLD, Australia
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Herbal Medicines: Personal Use, Knowledge, Attitude, Dispensing Practice, and the Barriers among Community Pharmacists in Gondar, Northwest Ethiopia. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 2017:6480142. [PMID: 28904558 PMCID: PMC5585575 DOI: 10.1155/2017/6480142] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 06/24/2017] [Accepted: 07/19/2017] [Indexed: 12/19/2022]
Abstract
Background Herbal medicine use is increasing and the global market is estimated to be US$107 billion by the year 2017. Objectives This study aimed at assessing community pharmacists' personal use, knowledge, attitude, dispensing practice, and the barriers regarding herbal medicines. Methods Institution based cross-sectional study was conducted among 47 community pharmacists in Gondar, Northwest Ethiopia, using a structured interviewing questionnaire. Results Nearly half of the respondents (n = 22, 46.8%) sometimes use herbal medicines. Although knowledge related to such preparations was self-rated as poor/acceptable (n = 34, 72.4%), majority (n = 44, 93.7%) of community pharmacists agree/strongly agree that herbal medicines have beneficial effects. Only 6 (12.7%) of them are sometimes/often engaged in dispensing herbal medicines and most of them (n = 34, 72.3%) rarely/never counseled clients regarding these preparations. Limited knowledge on and access to information regarding herbal medicines are the main barriers to the pharmacists' practice. Conclusion Although community pharmacists in Gondar, Northwest Ethiopia, commonly use and demonstrated good attitude towards herbal medicines, they are less involved in dispensing such products. They are also challenged with limited knowledge on and access to herbal medicine information. Thus, pharmacy educators, professional organizations, and the government shall pay more attention to solve the problem. Regulatory provisions on herbal medicine dispensing must be enacted and communicated very well.
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Development of a strategic model for integrating complementary medicines into professional pharmacy practice. Res Social Adm Pharm 2017; 14:663-672. [PMID: 28784591 DOI: 10.1016/j.sapharm.2017.07.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 07/29/2017] [Indexed: 01/18/2023]
Abstract
BACKGROUND Traditional medicine (TM) and complementary medicine (CM) products have played an increasingly important role in the business of pharmacy for over two decades in a number of countries. With a focus on the quality use of all medicines including complementary medicines, there have been a number of initiatives to encourage the integration of TM/CM products into professional practice. Recent studies report that many of the barriers that prevent such integration remain. OBJECTIVES To explore the pharmacists' perspective regarding how barriers to the integration of TM/CM products into the professional practice of pharmacy could be resolved. METHODS Purposive sampling and snowballing were used to recruit 11 registered pharmacists who had worked in community pharmacy for a minimum of 6 months to participate in one of 3 focus groups. Focus group questions informed by previous studies, explored participants' perspectives on the actions required to support professional services related to TM/CM products. RESULTS Pharmacists proposed that five key stakeholders (professional pharmacy organizations, universities, government, pharmacy owners, and pharmacists) enact 4 developments that require a collaborative effort ("education and training", "building the evidence base", "developing reliable and accessible information resources", and "workplace support for best practice"). Manufacturers of TM/CM products were not identified by pharmacists as collaborators in these developments. CONCLUSION Collectively, the findings from this study support a strategic model to guide the integration of TM/CM products into the professional practice of pharmacy.
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Ung COL, Harnett J, Hu H. Community pharmacist's responsibilities with regards to traditional medicine/complementary medicine products: A systematic literature review. Res Social Adm Pharm 2017; 13:686-716. [DOI: 10.1016/j.sapharm.2016.08.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2016] [Accepted: 08/08/2016] [Indexed: 12/28/2022]
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Anwar M, Norris P, Green J, Au S, Li G, Ma M, Prentice R, Shum A, Siaw LA, Yoo S, Zhang S. Pharmacy students' use of and beliefs about traditional healthcare. J Immigr Minor Health 2016; 17:895-904. [PMID: 24711106 DOI: 10.1007/s10903-014-0013-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Health professional students come from many different cultural backgrounds, and may be users of traditional healthcare (also known as ethnomedicine or folk medicine). This study aimed to explore New Zealand pharmacy students' knowledge and beliefs about traditional healthcare, and to examine whether these changed during the course. A questionnaire was administered to students in 2011 and again in 2013. Students were from a wide range of ethnic groups. Their reported use of traditional healthcare increased (from 48% in 2011 to 61% in 2013) and was usually for minor illness or prevention. Non New Zealand European students were more likely to use traditional healthcare. Use of traditional healthcare was relatively common, and after exposure to a biomedical curriculum students seemed to be more, rather than less likely to report using traditional healthcare. Education about traditional healthcare should not be based on the assumption that all healthcare students are unfamiliar with, or non-users of, traditional healthcare.
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Affiliation(s)
- Mudassir Anwar
- School of Pharmacy, University of Otago, Box 56, Dunedin, 9054, New Zealand
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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: 11] [Impact Index Per Article: 1.4] [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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Lorenc A, Blair M, Robinson N. Personal and professional influences on practitioners' attitudes to traditional and complementary approaches to health in the UK. JOURNAL OF TRADITIONAL CHINESE MEDICAL SCIENCES 2014. [DOI: 10.1016/j.jtcms.2014.09.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Robinson N. Personal budgets for patient centred care. Eur J Integr Med 2013. [DOI: 10.1016/j.eujim.2013.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Abstract
PURPOSE OF REVIEW Although many publications have documented the use of complementary and alternative medicine (CAM) in children and adolescents, most have lacked the scientific rigor to establish clear benefits over so-called conventional medicine. We reviewed the literature published in the past year to identify the types of CAM most often studied in children, the variety of conditions to which these modalities are applied, and the methodologies used in the articles exploring the most prevalent CAM modalities. RECENT FINDINGS We identified 111 published articles on CAM use in children in 2011. The most common modalities were herbal/dietary supplements, acupuncture, massage, chiropractic, and homeopathy. The most commonly studied conditions were pain, headache, attention deficit hyperactivity disorder (ADHD), asthma, and colic. Although a majority of the articles consisted of reviews, case reports, and other nonhypothesis-driven methodologies, we did find that several were randomized controlled trials, meta-analyses, or systematic reviews. These methodologies, however, rarely accounted for the majority of publications on a particular therapy or condition. SUMMARY The use of CAM in children continues to occupy a niche area of interest for many providers and families, but only a minority of articles published in the past year utilized methods of sufficient rigor to provide a useful comparison to more conventional therapies.
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