BackgroundComplementary medicines (CMs) are popular amongst Australians and community pharmacy is a major supplier of these products. This study explores pharmacy customer use, attitudes and perceptions of complementary medicines, and their expectations of pharmacists as they relate to these products.MethodsPharmacy customers randomly selected from sixty large and small, metropolitan and rural pharmacies in three Australian states completed an anonymous, self administered questionnaire that had been pre-tested and validated.Results1,121 customers participated (response rate 62%). 72% had used CMs within the previous 12 months, 61% used prescription medicines daily and 43% had used both concomitantly. Multivitamins, fish oils, vitamin C, glucosamine and probiotics were the five most popular CMs. 72% of people using CMs rated their products as 'very effective' or 'effective enough'. CMs were as frequently used by customers aged 60 years or older as younger customers (69% vs. 72%) although the pattern of use shifted with older age.Most customers (92%) thought pharmacists should provide safety information about CMs, 90% thought they should routinely check for interactions, 87% thought they should recommend effective CMs, 78% thought CMs should be recorded in customer's medication profile and 58% thought pharmacies stocking CMs should also employ a complementary medicine practitioner. Of those using CMs, 93% thought it important for pharmacists to be knowledgeable about CMs and 48% felt their pharmacist provides useful information about CMs.ConclusionsCMs are widely used by pharmacy customers of all ages who want pharmacists to be more involved in providing advice about these products.

BackgroundPreoperative anxiety and physical unfitness have been shown to have adverse effects on recovery from cardiac surgery. This study involving cardiac surgery patients was primarily aimed at assessing the feasibility of delivering physical conditioning and stress reduction programs within the public hospital setting. Secondary aims were to evaluate the effect of these programs on quality of life (QOL), rates of postoperative atrial fibrillation (AF) and length of stay (LOS) in hospital.MethodsElective patients scheduled for coronary artery bypass graft and/or valve surgery at a public hospital in Melbourne, Australia were enrolled. Patients were randomized to receive either holistic therapy (HT) or usual care (UC). HT consisted of a series of light physical exercise sessions together with a mental stress reduction program administered in an outpatient setting for the first two weeks after placement on the waiting list for surgery. A self-administered SF-36 questionnaire was used to measure QOL and hospital records to collect data on LOS and rate of postoperative AF.ResultsThe study population comprised 117 patients of whom 60 received HT and 57 received UC. Both programs were able to be delivered within the hospital setting but ongoing therapy beyond the two week duration of the program was not carried out due to long waiting periods and insufficient resources. HT, as delivered in this study, compared to UC did not result in significant changes in QOL, LOS or AF incidence.ConclusionsPreoperative holistic therapy can be delivered in the hospital setting, although two weeks is insufficient to provide benefits beyond usual care on QOL, LOS or postoperative AF. Further research is now required to determine whether a similar program of longer duration, or targeted to high risk patients can provide measurable benefits.Trial registrationThis trial was conducted as part of a larger study and according to the principles contained in the CONSORT statement 2001.

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The widespread use of complementary medicines (CMs) within the general community, the health benefits and risks, and the role of pharmacists as advocates of appropriate use of medicines make it imperative to identify how pharmacists' meet customers CM information needs and lead quality use of medicine practices in regards to CMs within the pharmacy setting. A selfadministered questionnaire was completed by 736 Australian pharmacists as part of a larger study on the use of CM within pharmacy practice. Personal use of CMs was common (76%). Most pharmacists saw CM counselling as their professional obligation, however, mainly regarding safety aspects. Only 24% of pharmacists always asked customers presenting with prescription medicines about concomitant CM use. Only 34% of pharmacists personally recommended CMs and less than 20% notified the respective Australian agency about an adverse drug reaction. On average, pharmacists only achieved about 50% of the knowledge score in a CM knowledge test on clinically proven benefit of CMs and CM-drug interactions. Most pharmacists supported undergraduate (76%) and additional CM education for pharmacists (85%). Many differences between hospital and community pharmacists, pharmacists working in pharmacies with or without an employed naturopath and pharmacists with and without CM training were noted and discussed.

The consumption of an organic diet for one week significantly reduced OP pesticide exposure in adults. Larger scale studies in different populations are required to confirm these findings and investigate their clinical relevance.

Massage therapy significantly reduced the pain, anxiety, and muscular tension and improves relaxation and satisfaction after cardiac surgery.

The available evidence suggests that use of ACE inhibitors and angiotensin 2 receptor antagonists or thiazide diuretics have the potential to reduce zinc levels in hypertensive patients. Additional research using larger participant numbers and accounting for dietary zinc intakes are required.

A better understanding of organic consumers may help to serve the long-term interests of the organic industry and other stakeholders of food marketing. Clearer definitions of organic consumers may also inform research evaluating the purported health benefits of organic foods.