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Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
RESEARCH ARTICLE

Australian pharmacists’ knowledge of the efficacy and safety of complementary medicines

Freya Waddington A D , Mark Naunton A , Greg Kyle B , Gabrielle O’Kane C , Gabrielle Cooper A and Jackson Thomas A
+ Author Affiliations
- Author Affiliations

A Discipline of Pharmacy, University of Canberra, Bruce, ACT 2615, Australia.

B School of Clinical Sciences, Queensland University of Technology, Brisbane, Qld 4000, Australia.

C Health Research Institute, University of Canberra, Bruce, ACT 2615, Australia.

D Corresponding author. Email: freya.waddington@canberra.edu.au

Australian Journal of Primary Health 24(3) 273-279 https://doi.org/10.1071/PY17023
Submitted: 21 February 2017  Accepted: 20 November 2017   Published: 8 May 2018

Abstract

Global usage and expenditure on complementary medicines is increasing. Over 50% of consumers purchase these products from pharmacies and expect pharmacists to provide them with appropriate information regarding efficacy and safety of these products. Internationally, pharmacists have identified their lack of detailed knowledge of the efficacy and safety of these products as a barrier to recommending these products. Currently, little is known about the actual knowledge Australian pharmacists have of these products. This research seeks to determine Australian pharmacists’ knowledge of the efficacy and safety of complementary medicines. An online survey was validated and distributed by three professional pharmacy bodies in Australia and online social media to survey Australian pharmacists’ knowledge of a selection of complementary medicines that are defined as having therapeutic benefits as per the Australian Therapeutic Guidelines. In total, 535 complete surveys were returned and included in the final analysis. Surveys were predominantly completed by community pharmacists. The mean knowledge score obtained was 62%. There were no statistically significantly different results from pharmacists with a nutritional qualification. Australian pharmacists appear to have a basic knowledge of complementary medicines with a defined clinical effect. Specialised and targeted education focussing on relevant and efficacious complementary medicines with strong clinical evidence base is required.

Additional keywords: CAM, online survey.


References

Australian Bureau of Statistics (2016) Australian health survey: nutrition – supplements, 2011–12. (ABS: Canberra, ACT, Australia) Available at http://www.abs.gov.au/websitedbs/d3310114.nsf/home/home?opendocument [Verified 10 September 2017]

Australian Government Department of Health and Aging, National Health and Medical Research Council (2006) Nutrient Reference Values for Australia and New Zealand. (National Health and Medical Research Council: Canberra, ACT, Australia) Available at http://www.moh.govt.nz/NoteBook/nbbooks.nsf/0/FD14C5E898B74265CC2574BE007DACF6/$file/n35.pdf [Verified 24 October 2017]

Australian Institute of Health and Welfare (2012) Health expenditure Australia 2010–2011. Health and welfare expenditure series number 47, catalogue number HWE 56. AIHW, Canberra, ACT, Australia.

Bailey RL, Gahche JJ, Lentino CV, Dwyer JT, Engel JS, Thomas PR, Betz JM, Sempos CT, Picciano MF (2011) Dietary supplement use in the United States, 2003–2006. The Journal of Nutrition 141, 261–266.
Dietary supplement use in the United States, 2003–2006.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3MXhsVemu7s%3D&md5=a801eda1b79f7049d84b27be6643469aCAS |

Barnes PM, Bloom B, Nahin RL (2008) Complementary and alternative medicine use among adults and children: United States, 2007. National Health Statistics Reports 2008, 1–23.

Boggs SAC, Massey LK, Armstrong JE, Lassey WR, Joseph JC (1996) Education of rural community pharmacists to provide nutrition information. American Journal of Pharmaceutical Education 60, 353–358.

Bolland MJ, Grey A, Avenell A, Gamble G (2011) Calcium supplements with or without vitamin D and risk of cardiovascular events: reanalysis of the Women’s Health Initiative limited access dataset and meta-analysis. BMJ (Clinical Research Ed.) 342, d2040
Calcium supplements with or without vitamin D and risk of cardiovascular events: reanalysis of the Women’s Health Initiative limited access dataset and meta-analysis.Crossref | GoogleScholarGoogle Scholar |

Boon H, Hirschkorn K, Griener G, Cali M (2009) The ethics of dietary supplements and natural health products in pharmacy practice: a systematic documentary analysis. International Journal of Pharmacy Practice 17, 31–38.
The ethics of dietary supplements and natural health products in pharmacy practice: a systematic documentary analysis.Crossref | GoogleScholarGoogle Scholar |

Braun LA, Tiralongo E, Wilkinson JM, Spitzer O, Bailey M, Poole S, Dooley M (2010) Perceptions, use and attitudes of pharmacy customers on complementary medicines and pharmacy practice. BMC Complementary and Alternative Medicine 10, 38
Perceptions, use and attitudes of pharmacy customers on complementary medicines and pharmacy practice.Crossref | GoogleScholarGoogle Scholar |

Chang ZG, Kennedy DT, Holdford DA, Small RE (2000) Pharmacists’ knowledge and attitudes toward herbal medicine. The Annals of Pharmacotherapy 34, 710–715.
Pharmacists’ knowledge and attitudes toward herbal medicine.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3cvpt1KksQ%3D%3D&md5=9471232dac893a102bc1fcc4a1c91a7aCAS |

Culverhouse SE, Wohlmuth H. (2012) Factors affecting pharmacists’ recommendation of complementary medicines – a qualitative pilot study of Australian pharmacists. BMC Complementary and Alternative Medicine 12, 183
Factors affecting pharmacists’ recommendation of complementary medicines – a qualitative pilot study of Australian pharmacists.Crossref | GoogleScholarGoogle Scholar |

Hermann R, von Richter O. (2012) Clinical evidence of herbal drugs as perpetrators of pharmacokinetic drug interactions. Planta Medica 78, 1458–1477.
Clinical evidence of herbal drugs as perpetrators of pharmacokinetic drug interactions.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC38Xhs1eis7jO&md5=820025383039c297efef056bf6255135CAS |

Izzo AA, Ernst E. (2009) Interactions between herbal medicines and prescribed drugs: an updated systematic review. Drugs 69, 1777–1798.
Interactions between herbal medicines and prescribed drugs: an updated systematic review.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD1MXhtlehtbbF&md5=fac46c5d5f5f438039fe24039dbdf14aCAS |

Koh HL, Teo HH, Ng HL (2003) Pharmacists’ patterns of use, knowledge, and attitudes toward complementary and alternative medicine. Journal of Alternative and Complementary Medicine 9, 51–63.
Pharmacists’ patterns of use, knowledge, and attitudes toward complementary and alternative medicine.Crossref | GoogleScholarGoogle Scholar |

Macdiarmid JI, Gatenby SJ (1993) The pharmacist as a nutrition educator? An assessment of nutritional knowledge and undergraduate training of community. Journal of Human Nutrition and Dietetics 6, 39–47.
The pharmacist as a nutrition educator? An assessment of nutritional knowledge and undergraduate training of community.Crossref | GoogleScholarGoogle Scholar |

National Center for Complementary and Integrative Health (2017) Herbs at a glance. (US Department of Health & Human Services: Bethesda, MD, United States of America. Available at https://nccih.nih.gov/health/herbsataglance.htm [Verified 6 February 2017]

National Institute of Complementary Medicine (2017) Understanding complementary and integrative medicine. (National Institute of Complementary Medicine: Sydney, NSW, Australia) Available at http://www.nicm.edu.au/health_information/information_for_consumers/under standing_cm [Verified 6 February 2017]

Posadzki P, Watson LK, Ernst E (2013a) Adverse effects of herbal medicines: an overview of systematic reviews. Clinical Medicine 13, 7–12.
Adverse effects of herbal medicines: an overview of systematic reviews.Crossref | GoogleScholarGoogle Scholar |

Posadzki P, Watson LK, Ernst E (2013b) Contamination and adulteration of herbal medicinal products (HMPs): an overview of systematic reviews. European Journal of Clinical Pharmacology 69, 295–307.
Contamination and adulteration of herbal medicinal products (HMPs): an overview of systematic reviews.Crossref | GoogleScholarGoogle Scholar |

Stoddard GJ, Archer M, Shane-McWhorter L, Bray BE, Redd DF, Proulx J, Zeng-Treitler Q (2015) Ginkgo and warfarin interaction in a large veterans administration population. AMIA Annual Symposium Proceedings 2015, 1174–1183.

Therapeutic Goods Administration (2013) An overview of the regulation of complementary medicines in Australia. Department of Health: Canberra, ACT, Australia) Available at https://www.tga.gov.au/overview-regulation-complementary-medicines-australia [Verified 6 February 2017]

Therapeutic Guidelines Limited (2016) eTG complete, March. (TGA: Melbourne, Vic., Australia) Available at https://tgldcdp.tg.org.au/etg [Verified 24 October 2017]

Vannacci A, Ravaldi C, Cosci F (2005) Publication bias in complementary and conventional medicine. European Journal of Clinical Pharmacology 61, 161–162.
Publication bias in complementary and conventional medicine.Crossref | GoogleScholarGoogle Scholar |

Waddington F, Naunton M, Kyle G, Thomas J, Cooper G, Waddington A (2015) A systematic review of community pharmacist therapeutic knowledge of dietary supplements. International Journal of Clinical Pharmacy 37, 439
A systematic review of community pharmacist therapeutic knowledge of dietary supplements.Crossref | GoogleScholarGoogle Scholar |

Waddington F, Naunton M, Kyle G, Thomas J, Cooper G, Waddington A (2017) Erratum to: A systematic review of community pharmacist therapeutic knowledge of dietary supplements. International Journal of Clinical Pharmacy 39, 492
Erratum to: A systematic review of community pharmacist therapeutic knowledge of dietary supplements.Crossref | GoogleScholarGoogle Scholar |

Williamson M, Tudball J, Toms M, Garden F, Grunseit A (2008) Information use and needs of complementary medicines users. (National Prescribing Service: Sydney, NSW, Australia) Available at www.nps.org.au/research_and_evaluation/current_research/ [Verified 24 October 2017]

Xue CC, Zhang AL, Lin V, Da Costa C, Story DF (2007) Complementary and alternative medicine use in Australia: a national population-based survey. Journal of Alternative and Complementary Medicine 13, 643–650.
Complementary and alternative medicine use in Australia: a national population-based survey.Crossref | GoogleScholarGoogle Scholar |