Knowledge, perceptions, and attitudes toward complementary and alternative medicines among pharmacy students of a Malaysian Public University

Attitude and Practice of Pharmacy Students Toward Traditional Herbal Medicines, Sudan

Purpose

Traditional herbal medicines (THMs) are widely used in Sudan, but there is scarcity of research on pharmacy students' attitudes and utilization of THMs. This study aims to assess the attitudes and practices of pharmacy students toward THM.

Methods

A descriptive cross-sectional study was conducted among randomly selected undergraduate pharmacy students at the University of Khartoum (Sudan). Data were collected using a validated self-administered questionnaire adapted from previous studies. A statistical package for the social sciences was used for data analysis.

Results

Among the 264 respondents, the average age was 21.8 years, and 84.8% of them were females. Nearly 85% of respondents were residents of Khartoum. The overall respondent's attitudes towards THMs were positive, it ranged from high (19.7%), moderate (79.9%). About 87.8% of respondents are interested in learning more about THMs. In addition, 36.4%, and 50.4% of respondents strongly agreed or agreed that THMs should be officially licensed and controlled. A 17.8% and 63.3% of respondents, respectively, reported using traditional herbal remedies either always or occasionally. Supermarkets (35.2%) and friends/family (36.4%) were the main sources of THMs for the participants, and oral administration was the most used route (87.1%). More than 90% of respondents said they would suggest THMs to others, and the most common justifications for doing so were their accessibility (46.6%) and affordability (16.3%). The most widely used herbs were Mentha spicata, Zingiber officinale, Acacia nilotica, Hibiscus sabdariffa, and Syzygium aromaticum. Data revealed a significant association between attitude levels and respondents' gender (p=0.046), year of study (p=0.000), and residence (p=0.017).

Conclusion

Most undergraduate pharmacy students had a positive attitude and utilized THMs. Development of effective educational initiatives, research, and regulations are recommended to ensure the appropriate utilization of traditional herbal remedies.

A qualitative study of pharmacists' perceptions and awareness of homoeopathic medicines in Durban, South Africa

BACKGROUND

 There is growing interest in the demand for and use of homoeopathic medicines by the public; however, little is known about the perspectives of pharmacists regarding the use of these medicines, particularly in the South African private health context.

METHODS

 A qualitative approach using an exploratory cross-sectional descriptive design was used. Data were collected from a purposive sample of 15 participants comprising pharmacy managers, pharmacists and pharmacy assistants from six different conveniently selected private pharmacy retail outlets. Data were collected using individual interviews utilising a semi-structured interview guide. An audiotape was used to record the data which were transcribed verbatim and analysed thematically, following Tech's steps of data analysis. Ethical approval to conduct the study was obtained from the Durban University of Technology's Institutional Research Ethics Committee.

RESULTS

 The findings of this study revealed four superordinate themes related to pharmacists' perceptions and self-reported awareness regarding homoeopathic medicines. These are (1) negative perceptions regarding homoeopathic medicines, (2) perceived benefits of homoeopathic medicines, (3) poor knowledge and awareness of homoeopathic medicines and (4) capacity development and curriculum aspects.

CONCLUSION

 The findings highlight the need for an educational intervention on homoeopathic medicines targeting pre-service and in-service pharmacy practitioners, to enable them to provide effective education regarding all types of medicines as the demand for homoeopathic medicines increases.Contribution: The study findings provide evidence to support advocacy for an educational intervention to improve awareness and knowledge of pharmacists to enable provision of effective health education for patients. More research, however, is required to inform the contents of this training intervention for pharmacists.

Self-Learning about Herbal and Dietary Supplements: Perspectives Using the Theoretical Domains Framework

Background: Self-learning (SL) is a process in which individuals take the initiative to acquire knowledge with or without the help of others. Knowledge about herbal and dietary supplements (HDS) is important for pharmacists. Unfortunately, there is limited coverage of topics relating to HDS in the pharmacy curricula. The present focus group study applies the Theoretical Domains Framework (TDF) to explore pharmacy students' practices and beliefs regarding SL about HDS (SL-HDS). Methods: Focus group interviews (FGIs) were conducted between April and May 2019 among a sample of undergraduate pharmacy students at a public university (n = 20). Four FGI sessions were conducted, each lasting about 60 to 75 min, and all the sessions were audio-recorded. The interviews were transcribed verbatim and analysed using thematic content analysis. Results: Beliefs about SL-HDS were categorised into 12 domains based on the TDF. Students showed positive attitudes towards SL-HDS and agreed that their involvement in SL-HDS was instrumental in improving their knowledge about various aspects of HDS including indications, adverse effects, and HDS-drug interactions. Various facilitators and barriers influencing students' participation in SL-HDS were uncovered (e.g., access to the internet, time, availability of reference resources). The students demanded to be equipped with critical appraisal skills, as they had limited confidence in assessing literature or information about HDS. Conclusion: This study revealed that the students saw the benefits of SL-HDS. They also perceived that engaging in SL-HDS is compatible with the role of pharmacy students. The findings showed students' readiness and willingness to conduct SL-HDS.

Awareness, Self-Use, Perceptions, Beliefs, and Attitudes toward Complementary and Alternative Medicines (CAM) among Health Professional Students in King Saud bin Abdulaziz University for Health Sciences Jeddah, Saudi Arabia

Background

Around 75% of the world's population relies on the use of complementary and alternative medicines (CAM) for their healthcare. Thus, we aimed at assessing the attitude and perception of health professional students about CAM and correlate the results with their demographical data.

Methods

An observational cross-sectional study was conducted at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Jeddah, Saudi Arabia, by enrolling 350 students. A self-administered questionnaire was used for data collection. Descriptive and inferential statistical analysis was performed using SPSS.

Results

Results of our data suggested that majority of students were aware of the CAM modalities and considered prayers/spirituality (83.6%), massage (72.5%), nutritional supplements (74.1%), cupping (68.5%), herbal medicine (66.2), and yoga (61.6%) as most effective and least harmful CAM modalities. The students acquired more information about CAM from media (55%), books (56%), friends/relatives (59.7%), and other health professionals (58.4%), however, very little information from formal CAM courses or training (36.7%), which shows the lack of courses and trained health professional in the field of CAM. Despite utilizing nonreliable sources of CAM information, the majority of students had positive attitudes and perceptions about CAM usage. Majority of the students (75.8%) believe in the use of CAM for the mental and spiritual aspect of health and think that CAM providers give good information on maintaining a healthy lifestyle. The data also showed a significant (P < 0.05) association between awareness about CAM and gender. A significantly higher percentage of female students were using yoga and aromatherapy, while cupping was mostly used by male students. Similarly, a significant association was found among the different colleges and level of students in most of the CAM modalities. However, no association was found between the awareness and use of CAM with the educational level of parents or relatives in health sector except for acupuncture and cupping, where student's awareness about acupuncture and cupping was found to have a significant positive association with mother educational level. On the other hand, a significant inverse association was found between acupuncture, yoga, cupping, and aromatherapy with family income.

Conclusion

In conclusion, despite the lack of proper courses and professionally trained healthcare providers in the field of CAM, students demonstrated positive attitudes and beliefs toward the safety and effectiveness of CAM.

Representações sociais de doença, usos e significados atribuídos às Práticas Integrativas e Complementares por universitários

RESUMO O objetivo deste estudo foi apreender as representações sociais de estudantes universitários sobre a doença e analisar os usos e significados conferidos por eles às Práticas Integrativas e Complementares. Para isso, realizou-se uma pesquisa qualitativa apoiada na Teoria das Representações Sociais, utilizando um questionário semiestruturado para a coleta dos dados, que incluiu, em sua estrutura, o Teste de Associação Livre de Palavras. A maior parte dos estudantes declarou estar no primeiro semestre do curso, na faixa etária de 18 a 24 anos e possuir religião. Para eles, a doença esteve mais associada ao desequilíbrio, sendo a massagem a prática mais adotada. Esses estudantes relacionaram as práticas integrativas à produção de benefícios à vida, à saúde e à manutenção ou alcance da qualidade de vida individual. Nesse sentido, as respostas sugerem que os discentes acreditam na eficácia das práticas integrativas, considerando-as como ligadas à promoção, prevenção e recuperação da saúde. Eles mostram-se abertos a outras racionalidades médicas, ainda que também estejam ligados ao modelo biomédico. Compreender como estudantes pensam a doença e a utilização de práticas integrativas colabora para atribuir sentidos aos projetos terapêuticos organizados no sistema de saúde, dirigindo-se a atenção para a construção da integralidade do cuidado.

Improving rating scales: Applying Rasch analysis to student pharmacists' attitudes towards herbal medications

BACKGROUND

This study analyzed the psychometric properties of a cross-sectional survey of student pharmacists' attitudes regarding herbal medications using a polytomous Rasch model. Seven items assessed students' attitudes towards herbal medications using a 6-point agreement scale (0 to 5). Student responses were reviewed to identify outliers and aberrant response patterns, assess scale fit, and perform item analysis. Scale performance was assessed to determine if response categories were independent and equally represented. Items were reviewed for model fit and construct validity with significant item gaps identified using a z-test.

IMPACT

A total of 324 students completed the survey. The initial 6-point scale was analyzed. Student responses with outfit mean-square (MNSQ) values >5 were removed, yet the scale did not have appropriate functionality. The categories were merged to form a 4-point scale with no improvement. Therefore, two different 3-point scale options were analyzed: response categories of 0, 1 to 3, and 4 to 5; and response categories of 0, 1 to 4, and 5. With ten students removed, both 3-point scales met the requirements for functionality and all items exhibited good fit with MNSQ values between 0.6 and 1.4, person-separation value of 1.29, and person-reliability value of 0.62.

RECOMMENDATIONS

Both 3-point scales met the requirements for Rasch analysis. The most optimal scale was the 0, 1 to 4, and 5 option.

DISCUSSION

This study provides findings from the survey validity assessment alongside the survey results, which is useful for readers to have confidence in the quality of the study findings.

Academic education in health profession programs, knowledge and use of Complementary and Alternative Medicine (CAM) by university students

OBJECTIVES

To assess the association of academic education in health professions programs with the knowledge and use of Complementary and Alternative Medicine (CAM) by university students and to determine whether CAM can promote a healthy university environment.

METHODS

A cross-sectional study was carried out with 512 university students enrolled in health professions programs in the city of Fortaleza, Ceará, Brazil, from April to November 2017. The Assessment Tool for Health Promotion at the University was used to collect sociodemographic, academic and CAM data. Bivariate and multivariate analyses were performed considering the outcomes "knowledge of CAM" and "CAM in the promotion of a healthy university environment" using SPSS Statistic version 20.0.

RESULTS

Data from 512 participants were analyzed. Women (n = 357; 69.7%), young students (n = 393; 76.8%) and unemployed students (n = 429; 83.8%) predominated. Knowledge of CAM was associated with health profession program (OR = 0.934; p = 0.047), paternal education (OR = 0.641; p = 0.024), employment (OR = 0.542; p = 0.028) and participation in extracurricular activities (OR = 1.275; p = 0.007). There was a proportional difference between knowledge and use of CAM ranging from 2:1 to 11:1 among the 21 modalities. University students believed that CAM could promote a healthy university environment (p = 0.000), which was influenced by gender (OR = 2.089; p = 0.004) and knowledge of CAM (OR = 16.601; p = 0.000).

CONCLUSIONS

University students' knowledge of CAM was influenced by the health profession program, paternal education, employment and participation in extracurricular activities. The percentage of use of CAM modalities was lower than the percentage of knowledge. University students' belief that CAM could foster a healthy university environment is influenced by gender and knowledge of CAM.

A cross-sectional assessment of knowledge, attitudes and self-perceived effectiveness of complementary and alternative medicine among pharmacy and non-pharmacy university students

Background

Traditional medicine has always been Pakistan’s cultural heritage, providing health care to a large part of its population. Thus, we aimed to assess and compare the knowledge, attitude, and perception about complementary and alternative medicine (CAM) between pharmacy and non-pharmacy students, the results of which may be helpful in devising national health-education policy.

Methods

A cross-sectional study was conducted by enrolling 937 students, pharmacy (437) and non-pharmacy (500), of Punjab University, Lahore. A self-administered questionnaire was used for data collection. Data were analyzed using SPSS. (IBM v22).

Results

Data suggested that majority of students knew about the use of traditional herbs and considered massage (P: 84.4%, NP: 82%, p = 0.099), homeopathy, herbs (P: 86.5%, NP: 81%, p = 0.064], yoga [P: 357 (81.7%), NP: 84%), p = 0.42] and spiritual healing (P: 85.6%, NP: 86.2%, p = 0.55) as effective and least harmful CAM modalities. The pharmacy students had better knowledge about CAM modalities compared to non-pharmacy students. Despite utilizing non-reliable sources of CAM information and their belief that CAM is practiced by quacks, the majority of students had positive attitudes and perceptions about CAM usage. Students also believed that CAM had a positive impact on health outcomes [P: 3.19 ± 1.04, NP: 3.02 ± 1.09, p = 0.008] and acceded to include CAM in the pharmacy curriculum. However, non-pharmacy students scored higher in their beliefs that CAM usage should be discouraged due to the non-scientific basis of CAM (P: 3.04 ± 0.97, NP: 3.17 ± 1.02, p = 0.028) and a possible threat to public health (P: 3.81 ± 1.74, NP: 4.06 ± 1.56, p = 0.02). On the other hand, pharmacy students believed that patients might get benefits from CAM modalities (P: 4.31 ± 1.48, NP: 4.12 ± 1.45, p = 0.02). Majority of students perceived that spiritual healing is the most useful and safer CAM modality, while acupuncture (P: 25.4%, NP: 21.8%, p = 0.0005), hypnosis (P: 26.8%, NP: 19.6%, p = 0.001) and chiropractic (P: 18.8%, NP: 11.6%, p = 0.0005) were among the harmful ones.

Conclusion

In conclusion, despite poor knowledge about CAM, students demonstrated positive attitudes and beliefs regarding CAM. They exhibited better awareness about yoga, spiritual healing/prayer, herbs, and massage. Students also showed willingness to advance their knowledge about CAM and favored its inclusion in the curriculum.

Electronic supplementary material

The online version of this article (10.1186/s12906-019-2503-y) contains supplementary material, which is available to authorized users.

Study on the Perception of Staff and Students of a University on Community Pharmacy Practice in Ipoh, Perak, Malaysia

Background:

In Malaysia, community pharmacies play an important and vital role in both urban and rural areas with approximately 30% of 12,000 registered pharmacists with annual retention certificate practicing in community pharmacies. The main objective of this study was to find the perception of respondents on the value and necessity of pharmacists.

Materials and Methods:

The questionnaire was divided into two sections: the first section assessed the visits to community pharmacies, purpose, interaction with pharmacy staffs, professional fee, and improvements to pharmacy practices; the second section evaluated the characteristics of respondents including an e-consent form. Data were analyzed using the Statistical Package for the Social Sciences software (version 11.5).

Results:

The highest number of respondents (66.1%) consulted with the pharmacists for cough and cold, 33.1% for gastric and stomach ailments, and 28.9% for diarrhea and constipation. Only 34% of cases were handled by the pharmacists, whereas 52.1% by the sales assistant. Approximately 88.5% showed satisfaction with the counseling provided. A total of 46.3% did not know whom they dealt with, whereas 51.2% wanted personal attention of the pharmacists instead of the sales assistants. However, 66.9% of respondents preferred to a private consultation room. Records of only 32.2% of respondents were secured by the pharmacies, whereas 42.1% showed interest to pay a professional fee. Moreover, 83.3% agreed the fee of RM5 only, whereas 20.8% agreed to RM10. Among the respondents, majority agreed to pay a fee willingly, but approximately 30% stayed neutral.

Conclusion:

There is a need for the community pharmacists to play vital roles firsthand at the front desk to serve the patients professionally instead of handing over the responsibilities to the sales assistant.

Assessment of Perception, Experience, and Information-seeking Behavior of the Public of Ras Al-Khaimah, United Arab Emirates, Toward Usage and Safety of Complementary and Alternative Medicine

AIMS AND OBJECTIVES

This study was conducted to identify the different types of complementary and alternative medicine (CAM) used, reasons for the use of CAM, and the perceptions, experience, and information seeking-behavior toward usage and safety of CAM by the general public of Ras Al-Khaimah, UAE.

MATERIALS AND METHODS

This was a prospective cross-sectional study. A validated, self-administered, or interviewer-assisted survey questionnaire was used to collect the data. Data from 403 respondents satisfying inclusion criteria were collected and were analyzed using the Statistical Package for the Social Sciences version 24.0.

RESULTS

A majority of the respondents (218 [54.1%]) were females. The most commonly (210 [52.1%]) used CAM among the study respondents was herbal medicine. A total of 91 (22.6%) of the survey respondents mentioned that they receive conventional medications along with their CAM. Majority (213 [52.9%]) of the survey respondents opted for CAM to prevent illness. Good number (208 [51.6%]) of the survey respondents mentioned that CAM usage was beneficial in improving their health condition, and they (216 [53.6%]) do believe it as safe and effective. However, a small group (26 [6%]) of respondents reported side effects or complications with the use of CAM.

CONCLUSION

Widespread use of CAM for different medical problems was evident in our study. Although majority of the CAM users believe it as safe and effective, CAM usage should be discussed with the health-care providers to understand the safety issues involved in the use of majority of CAM.