Exploring the Integration of Complementary Medicines into Australian Pharmacy Practice with a Focus on Different Practice Settings and Background Knowledge

Abstract

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.

Factors affecting pharmacists’ recommendation of complementary medicines – a qualitative pilot study of Australian pharmacists

“…All Group 3 respondents were owners or managers of their stores, which may have influenced their emphasis on business-related benefits. Previous research has reported that profit is not an important motive for pharmacists [6,7,15], although there is an understanding that CM products are an important contributor to the business of pharmacy [16]. …”

“…This professional behaviour of pharmacists has only recently been described. A 2010 Australian survey investigating the integration of CMs into pharmacy practice found that nearly half of the respondents described their practice as providing ‘integrative care’, which was defined as ‘recommending CMs together with conventional medicines as part of standard practice’ [16]. …”

“…Three Group 3 respondents, who were store managers and had employed naturopaths, felt that the presence of a naturopath had not changed their recommendation behaviour, although they would often refer to the naturopath for more information about a CM. A previous Australian survey found that pharmacists who work alongside naturopaths find the service provided by naturopaths valuable, while the presence of a naturopath made pharmacists less likely to recommend CMs themselves [16]. …”

“…These include an understanding of the benefits of CMs for maintenance of general health, prevention of disease and treatment of minor conditions [7,8,13,14], patient demand [7], personal usage of CM [10,11], knowledge of a particular CM product and its proven mechanism of action [6,7], and the profile of the CM company [7]. Whilst profit is not stated as an important motive [6,7,14,15], most pharmacists believe they should sell CMs [7], and that CMs can enhance the image of the pharmacy, increase annual sales and be an important part of the financial business of retail pharmacy [6,16]. The major barrier to the recommendation of CMs by pharmacists is reported to be a lack of evidence [4,6,11,12,17-20].…”

“…The major barrier to the recommendation of CMs by pharmacists is reported to be a lack of evidence [4,6,11,12,17-20]. Other barriers include lack of training, lack of accurate and easily accessible information, lack of subsidies or reimbursement, legal concerns, time constraints, and the fact that other staff in a pharmacy may recommend these products [4,14,16,18,20]. …”