Pharmacists' Personal Use Regarding Herbal Products
Pharmacists' Personal Use Regarding Herbal Products
Objectives: To characterize pharmacists' personal and family use of, professional practice behaviors regarding, and perceptions of herbal and other natural products (H/NPs), and to ascertain whether these characteristics differ by pharmacists' education, practice setting, and other demographic characteristics.
Design: Descriptive study.
Setting: Minnesota.
Intervention: Cross-sectional questionnaire mailed in June 2000.
Participants: A random sample of 1,017 pharmacists with active Minnesota licenses.
Results: Of the 533 respondents, 282 (53%) reported personal use of H/NPs, and 240 (45%) reported having recommended H/NPs to a family member. Pharmacists working in community/outpatient settings and pharmacists living in nonurban areas were more likely to report H/NP use. Patients' requests, consumer demand, manufacturer's reputation, and manufacturer's ability to provide product quality data were key factors influencing respondents' decisions to purchase and stock H/NPs in the pharmacy. Trade journals/professional newsletters, continuing education coursework, reference texts, and reports of randomized clinical trials were considered very important sources of information about H/NPs. However, almost all respondents (95%) felt available information on H/NPs was "not adequate" or only "somewhat adequate." Half the pharmacists (51%) believed that H/NPs were safe, but only 19% believed they were effective. Slightly more than half of the respondents (56%) reported suggesting to a patient that he or she try an H/NP. The amount of government oversight of H/NPs was considered "not adequate" by 78% of pharmacists. On average, pharmacists reported that patients ask them questions regarding H/NPs 7 times per 40-hour workweek; other health care practitioners ask an average of 1.3 times per week.
Conclusion: Pharmacists' personal use of H/NPs is as high or higher than that of other groups of Americans, and they use similar products. Decisions to stock H/NPs in a pharmacy are influenced by consumer demand and concern for product quality. Pharmacists desire more information on H/NPs and more government oversight of these products, and pharmacists are increasingly being sought out as sources of information regarding H/NPs.
Various forms of folk and alternative medicine have always existed in this country. However, in recent years, the availability and use of many complementary and alternative medicine (CAM) treatments have grown explosively in the United States. By 1990, when Eisenberg and colleagues conducted the first large-scale study documenting the widespread use of these treatments by the general public, CAM had become a multibillion dollar industry. Following that study's publication in 1993, numerous other studies, including a repeat study by Eisenberg et al. published in 1998, have further documented, described, and analyzed Americans' growing use of CAM.
Herbal and other natural products (H/NPs) are among the most popular CAM therapies. Eisenberg et al. reported a 380% increase in the use of herbal remedies and a 130% increase in high-dose vitamin use between 1990 and 1997. Sales of dietary supplements (the collective regulatory term for vitamins, minerals, and H/NPs) increased from $3.3 billion to $12 billion during the same time period. Gordon and Lin reported a 350% increase in the use of herbal supplements between 1996 and 1999 among patients in a large health maintenance organization (HMO). Many other studies have characterized the use of herbal and other dietary supplements by the general public and by various patient subpopulations. However, few researchers have documented the use of these products, on a personal or professional basis, by mainstream health care practitioners.
Although the formal study of medicinal plants largely disappeared from colleges of pharmacy in the last quarter of the 20th century, pharmacists continue to receive considerable training in understanding and assessing the safety and efficacy of pharmacologically active products. Indeed, pharmacists are often called upon to make professional recommendations to patients, other health care practitioners, and managed care organizations regarding the use of therapeutic agents, including dietary supplements and other over-the-counter (OTC) products. Thus, understanding pharmacists' personal use of and professional behaviors regarding H/NPs is pertinent to the discussion of the appropriate (or inappropriate) roles these products play in health care today.
Objectives: To characterize pharmacists' personal and family use of, professional practice behaviors regarding, and perceptions of herbal and other natural products (H/NPs), and to ascertain whether these characteristics differ by pharmacists' education, practice setting, and other demographic characteristics.
Design: Descriptive study.
Setting: Minnesota.
Intervention: Cross-sectional questionnaire mailed in June 2000.
Participants: A random sample of 1,017 pharmacists with active Minnesota licenses.
Results: Of the 533 respondents, 282 (53%) reported personal use of H/NPs, and 240 (45%) reported having recommended H/NPs to a family member. Pharmacists working in community/outpatient settings and pharmacists living in nonurban areas were more likely to report H/NP use. Patients' requests, consumer demand, manufacturer's reputation, and manufacturer's ability to provide product quality data were key factors influencing respondents' decisions to purchase and stock H/NPs in the pharmacy. Trade journals/professional newsletters, continuing education coursework, reference texts, and reports of randomized clinical trials were considered very important sources of information about H/NPs. However, almost all respondents (95%) felt available information on H/NPs was "not adequate" or only "somewhat adequate." Half the pharmacists (51%) believed that H/NPs were safe, but only 19% believed they were effective. Slightly more than half of the respondents (56%) reported suggesting to a patient that he or she try an H/NP. The amount of government oversight of H/NPs was considered "not adequate" by 78% of pharmacists. On average, pharmacists reported that patients ask them questions regarding H/NPs 7 times per 40-hour workweek; other health care practitioners ask an average of 1.3 times per week.
Conclusion: Pharmacists' personal use of H/NPs is as high or higher than that of other groups of Americans, and they use similar products. Decisions to stock H/NPs in a pharmacy are influenced by consumer demand and concern for product quality. Pharmacists desire more information on H/NPs and more government oversight of these products, and pharmacists are increasingly being sought out as sources of information regarding H/NPs.
Various forms of folk and alternative medicine have always existed in this country. However, in recent years, the availability and use of many complementary and alternative medicine (CAM) treatments have grown explosively in the United States. By 1990, when Eisenberg and colleagues conducted the first large-scale study documenting the widespread use of these treatments by the general public, CAM had become a multibillion dollar industry. Following that study's publication in 1993, numerous other studies, including a repeat study by Eisenberg et al. published in 1998, have further documented, described, and analyzed Americans' growing use of CAM.
Herbal and other natural products (H/NPs) are among the most popular CAM therapies. Eisenberg et al. reported a 380% increase in the use of herbal remedies and a 130% increase in high-dose vitamin use between 1990 and 1997. Sales of dietary supplements (the collective regulatory term for vitamins, minerals, and H/NPs) increased from $3.3 billion to $12 billion during the same time period. Gordon and Lin reported a 350% increase in the use of herbal supplements between 1996 and 1999 among patients in a large health maintenance organization (HMO). Many other studies have characterized the use of herbal and other dietary supplements by the general public and by various patient subpopulations. However, few researchers have documented the use of these products, on a personal or professional basis, by mainstream health care practitioners.
Although the formal study of medicinal plants largely disappeared from colleges of pharmacy in the last quarter of the 20th century, pharmacists continue to receive considerable training in understanding and assessing the safety and efficacy of pharmacologically active products. Indeed, pharmacists are often called upon to make professional recommendations to patients, other health care practitioners, and managed care organizations regarding the use of therapeutic agents, including dietary supplements and other over-the-counter (OTC) products. Thus, understanding pharmacists' personal use of and professional behaviors regarding H/NPs is pertinent to the discussion of the appropriate (or inappropriate) roles these products play in health care today.
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