Herbal medicines supplied by community pharmacies in Lagos, Nigeria: pharmacists’ knowledge
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Keywords
Phytotherapy, Herbal Medicine, Herb-Drug Interactions, Pharmacies, Pharmacists, Health Knowledge, Attitudes, Practice, Nigeria
Abstract
Background: The use of herbal medicines is on the increase globally and they are usually supplied in pharmacies as non-prescription medicines. Pharmacists are, therefore, responsible for educating and informing the consumers about rational use of herbal medicines.
Objectives: To evaluate the knowledge of pharmacists in Lagos, Nigeria with regards to the herbal medicines they supplied by their pharmacies.
Methods: Pharmacists in charge of randomly selected 140 community pharmacies from 20 Local Government Areas in Lagos were required to fill out a self-administered questionnaire. We gathered information on their knowledge of the indications, adverse effects, potential drug-herb interactions and contraindications of the herbal medicines they supply in their pharmacies.
Results: Of the 140 questionnaires distributed, 103 (72.9%) participants completed the questionnaire appropriately. The majority (74; 71.8%) of the participants were males and 36-50 years (56; 54.4%). The pharmacies supplied mostly Yoyo cleanser bitters® (101; 98.5%), ginseng (97; 98.5%), Jobelyn® (91; 88.3%), Ciklavit® (68; 66.6%), gingko (66; 64.1%), herbal tea (66; 64.1%), and Aloe vera (57; 55.3%). The pharmacists self-rated their knowledge of herbal medicines mostly as fair (39%) and good (42%), but they exhibited poor knowledge with regards to the indications, contraindications and safety profiles. Seventy participants consulted reference materials such as leaflet insert in the herbal medicines (56%) and internet (20%) before supplying herbal medicines. The information most frequently sought was herb-drug interactions (85%), contraindications (75%) and adverse effects (70%).
Conclusions: Community pharmacists need to be informed about the indications and safety profiles of herbal medicines.
References
2. Oshikoya KA, Senbanjo IO, Njokanma OF, Soipe A. Use of complementary and alternative medicines for children with chronic health conditions in Lagos, Nigeria. BMC Complement Altern Med. 2008;8:66. doi: 10.1186/1472-6882-8-66
3. World Health Organization. General guidelines for methodologies on research and evaluation of traditional medicine. WHO/EDM/TRM/2000.1. Available from http://whqlibdoc.who.int/hq/2000/WHO_EDM_TRM_2000.1.pdf (Accessed 2013 April 24).
4. Fakeye TO, Tijani A, Adebisi O. A survey of the use of herbs among patients attending secondary-level health care facilities in South-western Nigeria. J Herb Pharmacother. 2007;7(3-4):213-227.
5. Mills E, Cooper C, Seely D, Kanfer I. African herbal medicines in the treatment of HIV: Hypoxis and Sutherlandia. An overview of evidence and pharmacology. Nutr J. 2005;4:19.
6. Bent S, Goldberg H, Padula A, Avins AL. Spontaneous bleeding associated with Ginkgo biloba: a case report and systematic review of the literature. J Gen Intern Med. 2005;20(7):657-661.
7. Skinner CM, Rangasami J. Preoperative use of herbal medicines: a patient survey. Br J Anaesth. 2002;89(5):792-795.
8. National Policy on Traditional Medicine and Regulation of Herbal Medicines - Report of a WHO Global Survey. Available from: http://apps.who.int/medicinedocs/pdf/s7916e/s7916e.pdf (Accessed 2013 March 20).
9. Adisa R, Fakeye T. Assessment of the knowledge of community Pharmacists regarding common phytopharmaceuticals Sold in South Western Nigeria. Trop J Pharmaceut Res. 2006;5(2):619-625.
10. Abahussain NA, Abahussain EA, Al-Oumi FM. Pharmacists’ attitudes and awareness towards the use and safety of herbs in Kuwait. Pharm Pract (Granada). 2007;5(3):125-129.
11. Fahmy SA, Abdu S, Abuelkhair M. Pharmacists’ attitude, perceptions and knowledge towards the use of herbal products in Abu Dhabi, United Arab Emirates. Pharm Pract (Granada). 2010;8(2):109-115.
12. Duraz AY, Khan SA. Knowledge, attitudes and awareness of community pharmacists towards the use of herbal medicines in muscat region. Oman Med J. 2011;26(6):451-453. doi: 10.5001/omj.2011.115
13. Bushett NJ, Dickson-Swift VA, Willis JA, Wood P. Rural Australian community pharmacists’ views on complementary and alternative medicine: a pilot study. BMC Complement Altern Med. 2011;11:103. doi: 10.1186/1472-6882-11-103
14. Semple S, Hotham E, Rao D, Martin K, Smith C, Bloustien G. Community pharmacists in Australia: barriers to information provision on complementary and alternative medicines. Pharm World Sci. 2006;28(6):366-373.
15. National Institute of Health. National Centre for Complementary and alternative Medicine (NCCAM). Complementary, Alternative, or Integrative Health: What’s in a name? Available from http://nccam.nih.gov/health/whatiscam (Accessed 30 July, 2013).
16. Hutchinson S, Mitchell K, Hansford D, Stewart D. Community pharmacists' views and experiences of counter-prescribing in pregnancy. Int J Pharm Pract. 2001;9(1):15-21.
17. Chang ZG, Kennedy DT, Holdford DA, Small RE. Pharmacists' knowledge and attitudes toward herbal medicine. Ann Pharmacother. 2000;34(6):710-715.
18. Dolder C, Lacro J, Dolder N, Gregory P. Pharmacists' use of and attitudes and beliefs about alternative medicines. Am J Health Syst Pharm. 2003;60(13):1352-1357.
19. Koh HL, Teo HH, Ng HL. Pharmacists’ patterns of use, knowledge and attitudes toward complementary and alternative medicine. J Altern Complement Med. 2003;9(1):51-63.
20. Brooks P. Undergraduate teaching of complementary medicine. Med J Aust. 2004;181(5):275.
21. Owen D, Lewith G. Teaching integrated care: CAM familiarisation courses. Med J Aust. 2004;181(5):276-278.
22. Tiralongo E, Wallis M. Attitudes and perceptions of Australian pharmacy students towards complementary and alternative medicine- a pilot study. BMC Complement Altern Med. 2008;8:2. doi: 10.1186/1472-6882-8-2
23. Chez R, Jonas W, Crawford C. A survey of medical students’ opinions about complementary and alternative medicine. Am J Obstet Gynecol. 2001;185(3):754-757.
24. Pokladnikova J, Lie D. Comparison of attitudes, beliefs and resource seeking behavior for CAM among first- and third-year Czech Pharmacy students. Am J Pharm Educ. 2008;72(2):24.
25. Naidu S, Wilkinson J, Simpson M. Attitudes of Australian pharmacists toward complementary and alternative medicines. Ann Pharmacother. 2005;39(9):1456-1461.
26. National Agency for Food Drug Administration and Control. Herbal Medicines and Related Products (Labelling) Regulations 2005. Available at http://www.wipo.int/wipolex/en/text.jsp?file_id=218178 (Accessed 10 November, 2013).
27. Raosoft® Sample Size Calculator. Available at: http://www.raosoft.com/samplesize.html (Accessed 17 July 2013).
28. Sarris J. St. John's wort for the treatment of psychiatric disorders. Psychiatr Clin North Am. 2013;36(1):65-72. doi: 10.1016/j.psc.2013.01.004
29. Jawad M, Schoop R, Suter A, Klein P, Eccles R. Safety and efficacy profile of Echinacea purpurea to prevent common cold episodes: a randomized, double-blind, placebo-controlled trial. Evid Based Complement Alternat Med. 2012;2012:841315.
30. Diamond BJ, Bailey MR. Ginkgo biloba: Indications, Mechanisms, and Safety. Psychiatr Clin North Am. 2013;36(1):73-83. doi: 10.1016/j.psc.2012.12.006
31. Choi J, Kim TH, Choi TY, Lee MS. Ginseng for health care: a systematic review of randomized controlled trials in Korean literature. PLoS One. 2013;8(4):e59978. doi: 10.1371/journal.pone.0059978
32. Eniojukan JF, Aina BA. Toxicological profiles of commercial herbal preparation, Jobelyn®. Int J Health Res. 2009;2(4):369-374.
33. Adeyemi OS, Fambegbe M, Daniyan OR, Nwajei I. Yoyo Bitters, a polyherbal formulation influenced some biochemical parameters in Wistar rats. J Basic Clin Physiol Pharmacol. 2012;23(4):135-138. doi: 10.1515/jbcpp-2012-0026
34. Alkharfy KM. Community pharmacists' knowledge, attitudes and practices towards herbal remedies in Riyadh, Saudi Arabia. East Mediterr Health J. 2010;16(9):988-993.
35. National Academy on an Aging Society. Chronic conditions: a challenge for the 21st century. Available from: http://www.agingsociety.org/agingsociety/pdf/chronic.pdf (Accessed 2013 April 24).
36. Wachtel-Galor S, Benzie IFF. Herbal Medicine: An Introduction to Its History, Usage, Regulation, Current Trends, and Research Needs. In: Benzie IFF, Wachtel-Galor S, eds. Herbal Medicine: Biomolecular and Clinical Aspects. 2nd edition. Boca Raton (FL): CRC Press; 2011. Chapter 1. Available from: http://www.ncbi.nlm.nih.gov/books/NBK92773/ (Accessed 25 April 2013).
37. Schoenberg NE, Stoller EP, Kart CS, Perzynski A, Chapleski EE. Complementary and alternative medicine use among a multiethnic sample of older adults with diabetes. J Altern Complement Med. 2004;10(6):1061-1066.
38. Poyares DR, Guilleminault C, Ohayon MM, Tufik S. Can valerian improve the sleep of insomniacs after benzodiazepine withdrawal? Prog Neuropsychopharmacol Biol Psychiatry. 2002;26(3):539-545.
39. Volmer D, Lilja J, Hamilton D, Bell JS, Veski P. Self-reported competence of Estonian community pharmacists in relation to herbal products: findings from a health-system in transition. Phytother Res. 2011;25(3):381-6. doi: 10.1002/ptr.3266
40. Raynor DK, Dickinson R, Knapp P, Long AF, Nicolson DJ. Buyer beware? Does the information provided with herbal products available over the counter enable safe use? BMC Med. 2011;9:94. doi: 10.1186/1741-7015-9-94
41. Nathan JP, Cicero LA, Koumis T, Rosenberg JM, Feifer S, Maltz F. Availability of and attitudes toward resources on alternative medicine products in the community pharmacy setting. J Am Pharm Assoc (2003). 2005;45(6):734-739.
42. Al-Arifi MN. Availability and needs of herbal medicinal information resources at community pharmacy, Riyadh region, Saudi Arabia. Saudi Pharm J. 2013;21(4):351-360. doi: 10.1016/j.jsps.2012.11.004
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