Previous studies from Nigeria, Kuwait, United Arab Emirates, Oman, and Australia have shown that most community pharmacists did not possess adequate knowledge of potential interaction profiles and side effects of the herbal medicines they supplied.9-13 There is also evidence to suggest that the knowledge of community pharmacists is inadequate with regards to counselling patients on herbal medicines.14 Herbal medicines are integral part of complementary medicines (CMs).15 Studies in Australia, the United Kingdom, the United States of America and Singapore have all indicated that pharmacists rate their knowledge and ability to counsel consumers on CMs as inadequate.13,16-19 Many factors are responsible for this lack of knowledge. Among the factors is non- mandatory implementation of CM teaching into pharmacy courses and variation in the extent to which it is thought.20,21 A high positive correlation between educational exposure and perceived usefulness of CMs has been documented in the literature.22 Despite varied teaching, there is a strong interest in learning more about CMs by both undergraduate pharmacy and medical students.22-24 Other compounding factors include lack of accurate and easily accessible information, including good patient resources.14 Pharmacists are interested in integrated non-biased and evidence-based information about herbal medicines14,25, but available resources may not be accurate to provide this information. Studies have indicated leaflet or package insert of herbal medicines, undergraduate pharmacognosy lecture notes, textbooks, magazine, drug sales representatives, and internet as the likely sources of information about herbal medicines for community pharmacists.9-13
The participants relied mostly on the leaflet or package insert of the herbal medicines. This is an inappropriate practice as the safety information provided may be inadequate or inaccurate. Raynor et al. evaluated the information provided with herbal medicines (garlic, ginkgo and Asian ginseng, St. Johns wort, and Echinacea) available over the counter in the United Kingdom to know if they can enable safe use.40 They found that 75% of the 68 herbal medicines contained none of the important safety information needed by consumers for safe use. Internet and the herbal pharmacopoeias were the other sources of information used by the participants in this study. This was in contrast to the many pharmacists in Oman12 and Kuwait10 who relied mostly on their undergraduate pharmacognosy lecture notes, followed by textbooks and magazines for herbal medicine information. Our findings also were in contrast to the pharmacists in the United Arab Emirates who mostly sourced herbal medicine information from drug sales representatives.11 Fewer participants (20%) in the current study than in the Omani study (30%) made use of the internet as a source of herbal medicine information. This may have resulted from inadequate access to the internet in Nigeria. Internet and Monthly Index of Medical Specialties13; Physicians' Desk Reference for Herbal Medicines and The Review of Natural Products41; and internet, package inserts, pamphlets or brochures, and pharmacology textbooks42 were the sources of herbal medicine information utilised by the pharmacists in the previous studies. Some of these information resources were less utilised in the current study. The herbal medicine safety information most frequently sought in this study included drug interactions, contraindications and adverse effects. These were similar to the safety information sought by the community pharmacists in Australia13, south-western Nigeria9, and the United States.17
Pharmacognosy Lecture Notes 45.pdf
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