Australian community pharmacists’ knowledge of popular herbal/nutrient weight‐loss complementary medicines

Abstract

Background Herbal/nutrient weight‐loss complementary medicines (WLCMs) are widely available in community pharmacies and are popular with Australian consumers. Pharmacists have an obligation to ensure they provide appropriate advice to consumers about complementary medicines as they do with registered prescription medicines. Aims (i) To assess community pharmacists’ knowledge regarding current evidence for the efficacy, potential side effects, and drug interactions of commonly sold/recommended WLCMs. (ii) To ascertain whether self‐reported level of knowledge is a reliable predictor of WLCM knowledge. Method Pharmacists from a randomly selected sample of 214 community pharmacies in the Greater Brisbane region, Australia, were invited to complete a knowledge‐based questionnaire relating to three commonly sold/recommended WLCMs – garcinia, green tea and chromium. Results Ninety‐nine pharmacists completed the questionnaire (51% response rate). Approximately 20% selected the appropriate efficacy ratings for garcinia and green tea, with only 10% selecting the appropriate response for chromium. A mismatch was observed between what pharmacists recognised as adverse effects and interactions for the three common WLCMs compared to published findings, with a bias toward nervous system (i.e. insomnia and headache) and gastrointestinal side effects, and interactions with warfarin. Pharmacists who reported a good working knowledge were statistically able to identify only one of 14 adverse effects (insomnia associated with green tea) more than those reporting knowing little/don't remember/never heard of these WLCMs, yet were more likely to recommend the WLCMs green tea and chromium. Conclusion Irrespective of pharmacists’ perceived levels of WLCM knowledge, there is a need for targeted education interventions focusing on commonly sold WLCMs that have potential safety concerns. Pharmacists should also understand the regulatory landscape for listing CMs in the Australian Register of Therapeutic Goods (ARTG) and its implications relating to product efficacy, which may affect their decision to supply WLCM products.

<p>Assessment of Knowledge, Attitudes, and Practice of Community Pharmacists Regarding Weight Reduction Agents and Supplements in Aseer Region, Saudi Arabia</p>

“…These results concur with the results of a study of community pharmacists in Australia, in which the participants were not able to identify the adverse effects and drug interactions of commonly used weight reduction products (green tea, chromium, and garcinia). 22 These findings could be due to the lack of continuous education for community pharmacists. Furthermore, community pharmacists should be aware of the herbal drug interactions when they prescribe/ provide advice regarding any weight reduction agents, especially for patients with concomitant chronic diseases such as hypertension and diabetes.…”

A systematic review of community pharmacist practices in complementary medicine

“…The pharmacists’ attitudes towards CM products and CM practices had been evaluated in sixteen studies from nine countries which were four studies from U.S, four studies from Australia, two studies from Saudi Arabia and other remaining studies individually from Lebanon, Jordan, Palestine, Malaysia, Egypt, and South Africa (shown in table 1 ). 1 , 6 , 10 , 19 , 20 , 22 - 29 , 31 , 32 , 36 …”

“… 1 , 19 , 20 , 27 However, only 27% of community pharmacists in U.S were positive towards CM effectiveness. Numerous studies also showed community pharmacists have a positive attitude toward side effects or safety, 1 , 6 , 19 , 24 , 26 , 28 , 29 , 36 quality, 1 , 6 , 27 impact on health, 24 , 25 holistic approach, 28 and therapeutic benefits. 6 , 25 , 28 , 29 Australian community pharmacists were more likely to believed that CMs were harmless or had fewer side effects and had good quality and therapeutic benefit than the pharmacists in Lebanon, Saudi Arabia, Palestine, Egypt, and South Africa.…”

“… 23 Less than 50% of community pharmacists in an Australian study would recommend garcinia, green tea, and chromium to their patients for weight loss. 36 …”