Qualitative exploration of pharmacist care for herbal and dietary supplement users in Thai community pharmacies

Abstract

Objectives Herbal and dietary supplements (HDS) can cause adverse effects or interact with diseases and medications. Community pharmacists have a role in ensuring the safe use of HDS, but they have been reported to not being proactive in providing pharmacist care (PCare) for HDS users. The reasons for this warranted investigation. The study aimed to explore pharmacists’ understanding of PCare for HDS users, and to investigate the underlying beliefs or factors influencing its provision by community pharmacists, guided by the theory of planned behaviour. Methods A qualitative study using a semi‐structured interview guide was conducted in a purposive sample of community pharmacists working in Bangkok, Thailand, from December 2016 to June 2017. All interviews were audio‐recorded, transcribed and analysed using qualitative content analysis. Key findings Twenty‐two pharmacists were interviewed. Several professional pharmacy activities were regarded as PCare for HDS users. The pharmacists reported that the provision of such care was advantageous in terms of promoting rational use of HDS, ensuring safety of users, enhancing own knowledge and promote customers’ loyalty. Facilitators for PCare included the initiation of conversation about HDS by the users, professional training and the availability of reference materials. The reluctance of HDS users to accept pharmacists’ opinions, insufficient education in HDS and limited sources of information were identified as barriers. Most pharmacists believed that PCare for HDS users is part of their responsibilities. Conclusions The pharmacists expressed their views on the meaning of PCare for HDS users, and described the beliefs and factors that facilitate or impede its provision. Information from this study can be used to inform strategies that can promote pharmacists to become more proactive in providing PCare for HDS users.

Why Did I Consult My Pharmacist about Herbal and Dietary Supplements? An Online Survey Amid the COVID-19 Pandemic in Malaysia

“…The survey instrument was developed based on an extensive literature review. Research articles discussing the reasons for consultation with pharmacists around HDS use [ 40 , 41 , 44 , 45 , 46 , 47 ], pharmacist- or HCP-patient communication and relationship [ 48 , 49 ], and complementary medicine disclosure to HCPs [ 50 , 51 , 52 ] were used. Based on the literature review, the consultation and non-consultation with CPs about HDSs can be influenced by the consumers’ perceptions of the consultative roles of CPs with respect to HDSs, facilitators (e.g., having a good relationship with CPs, having adequate time to consult CPs, willingness of CPs to spend time providing consultation, etc.…”

“…), and barriers to consult CPs (e.g., feeling uncomfortable discussing HDSs with CPs, not being asked by CPs about HDS use, not having time to consult CPs, etc. ), the health concerns, beliefs of the outcomes of the consultation, and perceived-need of the consultation [ 40 , 41 , 44 , 45 , 46 , 47 , 48 , 49 ].…”

“…Additionally, multiple studies have reported that the communication on HDSs among consumers and HCPs including pharmacists is generally low [ 35 , 36 , 37 ]. On the other hand, other studies have suggested that the initiation of conversation by consumers or the act of consulting CPs about HDSs through inquiries could promote consumer–CP discussion around these products [ 38 , 39 , 40 ]. A conversation or consultation about HDSs initiated by consumers would signal to CPs that their participation in consumer decision-making is being solicited, thus facilitating a healthy consultation session [ 40 , 41 ].…”

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

“…Pharmacists are expected to encounter HDS frequently at all levels of care due to the accessibility and availability of HDS in retail pharmacies [ 16 , 17 ], and the widespread use of these products among patients. Pharmacists play an important role in educating consumers to ensure appropriate and safe use of HDS [ 18 ], so it is pertinent for them to be equipped with adequate knowledge regarding HDS. Nonetheless, previous studies have reported that many pharmacists perceived their knowledge of HDS as inadequate, thus affecting their confidence in discussing these products with consumers or patients [ 19 ].…”

Integrating traditional Chinese medicines into professional community pharmacy practice in China – Key stakeholder perspectives

“…Research in the US, Australia, Canada and Thailand, have been initiated to explore, define and review pharmacists' duty of care (if any) with respect to T&CM products. [24][25][26][27][28]. Despite the high level of integration of TCM that includes HMs, and modern medicine in China, few studies have explored this area in depth.…”