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Published in: BMC Complementary Medicine and Therapies 1/2024

Open Access 01-12-2024 | Research

Beyond pillbox: a national cross-sectional study on the attitudes, practices, and knowledge of community pharmacists regarding complementary and alternative medicine

Authors: Farah Naja, Nada Abbas, Sharfa Khaleel, Falak Zeb, Tareq A. H. Osaili, Reyad Shaker Obaid, MoezAlIslam Faris, Hadia Radwan, Leila Cheikh Ismail, Haydar Hassan, Mona Hashim, Hamzah AlZubaidi

Published in: BMC Complementary Medicine and Therapies | Issue 1/2024

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Abstract

Background

While community pharmacists are uniquely positioned to promote the safe and effective use of complementary and alternative medicine, their potential role remains largely untapped. The objective of this study was to assess the knowledge, attitudes, and practices related to complementary and alternative medicine products among community pharmacists in the United Arab Emirates and explore the correlates of knowledge in the study sample.

Methods

Using a stratified random sampling frame, a national survey of community pharmacists was conducted in the United Arab Emirates. In a face-to-face interaction, participants completed a multi-component questionnaire consisting of four sections: sociodemographic and general characteristics; knowledge of complementary and alternative medicine products and usage; attitudes towards complementary and alternative medicine and practices related to complementary and alternative medicine. Based on participants’ answers, scores were calculated with higher scores indicating more positive knowledge, attitudes, and practices.

Results

373 community pharmacists participated in the study (response rate: 83%). For the knowledge questions, more than 50% of community pharmacists correctly answered the functions of complementary and alternative medicine, however lower percentages were noted for the side effects and drug interactions questions. Most community pharmacists had positive attitudes towards complementary and alternative medicine, except for particular aspects such as efficacy, where 40% agreed that complementary and alternative medicine is only effective in treating minor complaints. As for practices, while more than 70% of participants counseled patients on complementary and alternative medicine use, only 47% reported the toxic effects when encountered. Multiple linear regressions showed that community pharmacists working in independent pharmacies, those with fewer years of experience, and those who did not receive complementary and alternative medicine education during their academic degree had lower knowledge scores (p < 0.05).

Conclusions

The findings of this study showed that community pharmacists in the United Arab Emirates have good knowledge of complementary and alternative medicine functions and generally positive attitudes and practices, with few gaps identified in each. Together, these findings provide critical evidence for the development of targeted interventions to promote the role of community pharmacists towards safe and effective complementary and alternative medicine use in the country.
Literature
1.
go back to reference Organization WH. WHO global report on traditional and complementary medicine 2019. World Health Organization; 2019. Organization WH. WHO global report on traditional and complementary medicine 2019. World Health Organization; 2019.
2.
go back to reference Koithan M. Introducing complementary and alternative therapies. J Nurse Practitioners. 2009;5(1):18–20.CrossRef Koithan M. Introducing complementary and alternative therapies. J Nurse Practitioners. 2009;5(1):18–20.CrossRef
3.
go back to reference Aboushanab T, Khalil M, Al Ahmari Y. The present state of complementary medicine regulation in Saudi Arabia. J Integr Med. 2019;17(3):147–9.CrossRefPubMed Aboushanab T, Khalil M, Al Ahmari Y. The present state of complementary medicine regulation in Saudi Arabia. J Integr Med. 2019;17(3):147–9.CrossRefPubMed
4.
go back to reference Lee EL, Richards N, Harrison J, Barnes J. Prevalence of Use of Traditional, complementary and alternative medicine by the General Population: a systematic review of National studies published from 2010 to 2019. Drug Saf. 2022;45(7):713–35.CrossRefPubMedPubMedCentral Lee EL, Richards N, Harrison J, Barnes J. Prevalence of Use of Traditional, complementary and alternative medicine by the General Population: a systematic review of National studies published from 2010 to 2019. Drug Saf. 2022;45(7):713–35.CrossRefPubMedPubMedCentral
5.
go back to reference James PB, Wardle J, Steel A, Adams J. Traditional, complementary and alternative medicine use in Sub-saharan Africa: a systematic review. 2018;3(5):e000895. James PB, Wardle J, Steel A, Adams J. Traditional, complementary and alternative medicine use in Sub-saharan Africa: a systematic review. 2018;3(5):e000895.
6.
go back to reference Peltzer K, Pengpid S. Utilization and Practice of Traditional/Complementary/Alternative Medicine (T/CAM) in southeast Asian nations (ASEAN) Member States. Stud Ethno-Medicine. 2015;9(2):209–18.CrossRef Peltzer K, Pengpid S. Utilization and Practice of Traditional/Complementary/Alternative Medicine (T/CAM) in southeast Asian nations (ASEAN) Member States. Stud Ethno-Medicine. 2015;9(2):209–18.CrossRef
7.
go back to reference Jones E, Nissen L, McCarthy A, Steadman K. Windsor CJIct. Exploring the use of complementary and alternative medicine in cancer patients. 2019;18:1534735419846986. Jones E, Nissen L, McCarthy A, Steadman K. Windsor CJIct. Exploring the use of complementary and alternative medicine in cancer patients. 2019;18:1534735419846986.
8.
go back to reference White A, Boon H, Alraek T, Lewith G, Liu J-P, Norheim A-J, et al. Reducing the risk of complementary and alternative medicine (CAM): challenges and priorities. Eur J Integr Med. 2014;6(4):404–8.CrossRef White A, Boon H, Alraek T, Lewith G, Liu J-P, Norheim A-J, et al. Reducing the risk of complementary and alternative medicine (CAM): challenges and priorities. Eur J Integr Med. 2014;6(4):404–8.CrossRef
9.
go back to reference Shim J-M, Schneider J, Curlin, FAJMc. Patterns of user disclosure of complementary and alternative medicine (CAM) use. 2014:704-8. Shim J-M, Schneider J, Curlin, FAJMc. Patterns of user disclosure of complementary and alternative medicine (CAM) use. 2014:704-8.
10.
go back to reference Cockayne NL, Duguid M, Shenfield GMJB. Health Professionals Rarely Record History Complement Altern Med. 2005;59(2):254–8. Cockayne NL, Duguid M, Shenfield GMJB. Health Professionals Rarely Record History Complement Altern Med. 2005;59(2):254–8.
11.
go back to reference Blalock SJ, Roberts AW, Lauffenburger JC, Thompson T, O’Connor. SKJMcr, review. The Effect of community pharmacy–based interventions on patient health outcomes: a systematic review. 2013;70(3):235–66. Blalock SJ, Roberts AW, Lauffenburger JC, Thompson T, O’Connor. SKJMcr, review. The Effect of community pharmacy–based interventions on patient health outcomes: a systematic review. 2013;70(3):235–66.
12.
go back to reference Ung COL, Harnett J, Hu HJRS, Pharmacy A. Development of a strategic model for integrating complementary medicines into professional pharmacy practice. 2018;14(7):663–72. Ung COL, Harnett J, Hu HJRS, Pharmacy A. Development of a strategic model for integrating complementary medicines into professional pharmacy practice. 2018;14(7):663–72.
13.
go back to reference Association AMAJCAM. AMA position statement-Complementary medicine. 2002. Association AMAJCAM. AMA position statement-Complementary medicine. 2002.
14.
go back to reference Kroll DJ, Barnes R, Bickford CJ, Boothby L, Brennan C, Carr-Lopez S, et al. ASHP Statement use Diet Supplements. 2004;61(16):1707–11. Kroll DJ, Barnes R, Bickford CJ, Boothby L, Brennan C, Carr-Lopez S, et al. ASHP Statement use Diet Supplements. 2004;61(16):1707–11.
15.
go back to reference Miller LG, Hume A, Harris IM, Jackson EA, Kanmaz TJ, Cauffield JS, et al. White paper on herbal products. American College of Clinical Pharmacy. Pharmacotherapy. 2000;20(7):877–91.CrossRefPubMed Miller LG, Hume A, Harris IM, Jackson EA, Kanmaz TJ, Cauffield JS, et al. White paper on herbal products. American College of Clinical Pharmacy. Pharmacotherapy. 2000;20(7):877–91.CrossRefPubMed
16.
go back to reference NCCP. National Competency Framework for Pharmacists Working in Cancer Care. 2015. NCCP. National Competency Framework for Pharmacists Working in Cancer Care. 2015.
17.
go back to reference Bajis D, Chaar B, Penm J, Moles R. Competency-based pharmacy education in the Eastern Mediterranean Region—A scoping review. Currents Pharm Teach Learn. 2016;8(3):401–28.CrossRef Bajis D, Chaar B, Penm J, Moles R. Competency-based pharmacy education in the Eastern Mediterranean Region—A scoping review. Currents Pharm Teach Learn. 2016;8(3):401–28.CrossRef
18.
go back to reference Ung COL, Harnett J, Hu H. Community pharmacist’s responsibilities with regards to traditional medicine/complementary medicine products: a systematic literature review. Res Social Administrative Pharm. 2017;13(4):686–716.CrossRef Ung COL, Harnett J, Hu H. Community pharmacist’s responsibilities with regards to traditional medicine/complementary medicine products: a systematic literature review. Res Social Administrative Pharm. 2017;13(4):686–716.CrossRef
19.
go back to reference Ng JY, Tahir U, Dhaliwal S. Barriers, knowledge, and training related to pharmacists’ counselling on dietary and herbal supplements: a systematic review of qualitative studies. BMC Health Serv Res. 2021;21(1):499.CrossRefPubMedPubMedCentral Ng JY, Tahir U, Dhaliwal S. Barriers, knowledge, and training related to pharmacists’ counselling on dietary and herbal supplements: a systematic review of qualitative studies. BMC Health Serv Res. 2021;21(1):499.CrossRefPubMedPubMedCentral
21.
go back to reference Naja F, Alameddine M, Itani L, Shoaib H, Hariri D, Talhouk S. The Use of complementary and alternative medicine among Lebanese adults: results from a National Survey. Evidence-Based Complement Altern Med. 2015;2015:682397.CrossRef Naja F, Alameddine M, Itani L, Shoaib H, Hariri D, Talhouk S. The Use of complementary and alternative medicine among Lebanese adults: results from a National Survey. Evidence-Based Complement Altern Med. 2015;2015:682397.CrossRef
22.
go back to reference Shehadeh MB, Suaifan G, Abu-Odeh A, Darwish RJEMHJ. Complementary and alternative medicine use for weight management among females in Jordan: a community-based survey. 2020;26(4):443–52. Shehadeh MB, Suaifan G, Abu-Odeh A, Darwish RJEMHJ. Complementary and alternative medicine use for weight management among females in Jordan: a community-based survey. 2020;26(4):443–52.
23.
go back to reference Moeini R, Mozaffarpur SA, Mojahedi M, Nasrolahpour Shirvani SD, Gorji N, Saghebi R, et al. The prevalence of complementary and alternative medicine use in the general population of Babol, North of Iran, 2018. BMC Complement Med Ther. 2021;21(1):113.CrossRefPubMedPubMedCentral Moeini R, Mozaffarpur SA, Mojahedi M, Nasrolahpour Shirvani SD, Gorji N, Saghebi R, et al. The prevalence of complementary and alternative medicine use in the general population of Babol, North of Iran, 2018. BMC Complement Med Ther. 2021;21(1):113.CrossRefPubMedPubMedCentral
24.
go back to reference Radwan H, Hasan H, Hamadeh R, Hashim M, AbdulWahid Z, Hassanzadeh Gerashi M, et al. Complementary and alternative medicine use among patients with type 2 diabetes living in the United Arab Emirates. BMC Complement Med Ther. 2020;20(1):216.CrossRefPubMedPubMedCentral Radwan H, Hasan H, Hamadeh R, Hashim M, AbdulWahid Z, Hassanzadeh Gerashi M, et al. Complementary and alternative medicine use among patients with type 2 diabetes living in the United Arab Emirates. BMC Complement Med Ther. 2020;20(1):216.CrossRefPubMedPubMedCentral
25.
go back to reference AlBraik FA, Rutter PM, Brown D. A cross-sectional survey of herbal remedy taking by United Arab Emirate (UAE) citizens in Abu Dhabi. Pharmacoepidemiol Drug Saf. 2008;17(7):725–32.CrossRefPubMed AlBraik FA, Rutter PM, Brown D. A cross-sectional survey of herbal remedy taking by United Arab Emirate (UAE) citizens in Abu Dhabi. Pharmacoepidemiol Drug Saf. 2008;17(7):725–32.CrossRefPubMed
26.
go back to reference 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. 2010;8(2):109–15. 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. 2010;8(2):109–15.
29.
go back to reference Bhagavathula AS, Shah SM, Aburawi EH, Prevalence. Awareness, treatment, and Control of Hypertension in the United Arab Emirates: a systematic review and Meta-analysis. 2021;18(23):12693. Bhagavathula AS, Shah SM, Aburawi EH, Prevalence. Awareness, treatment, and Control of Hypertension in the United Arab Emirates: a systematic review and Meta-analysis. 2021;18(23):12693.
30.
go back to reference Alkherat AM, Alkhalidi DKJPP. Assessment of knowledge and counseling practice of warfarin among pharmacists in UAE: a cross-sectional study. 2022;20(4):1–7. Alkherat AM, Alkhalidi DKJPP. Assessment of knowledge and counseling practice of warfarin among pharmacists in UAE: a cross-sectional study. 2022;20(4):1–7.
31.
go back to reference Chang ZG, Kennedy DT, Holdford DA, Small RE. Pharmacists’ Knowledge and Attitudes toward Herbal Medicine. 2000;34(6):710–5. Chang ZG, Kennedy DT, Holdford DA, Small RE. Pharmacists’ Knowledge and Attitudes toward Herbal Medicine. 2000;34(6):710–5.
32.
go back to reference Hijazi MA, Shatila H, El-Lakany A, Ela MA, Kharroubi S, Alameddine M et al. Beliefs, practices and knowledge of community pharmacists regarding complementary and alternative medicine: national cross-sectional study in Lebanon. 2019;9(3):e025074. Hijazi MA, Shatila H, El-Lakany A, Ela MA, Kharroubi S, Alameddine M et al. Beliefs, practices and knowledge of community pharmacists regarding complementary and alternative medicine: national cross-sectional study in Lebanon. 2019;9(3):e025074.
33.
go back to reference Abahussain NA, Abahussain EA, Al-Oumi, FMJPp. Pharmacists’ Attitudes Aware towards use Saf Herbs Kuwait. 2007;5(3):125–9. Abahussain NA, Abahussain EA, Al-Oumi, FMJPp. Pharmacists’ Attitudes Aware towards use Saf Herbs Kuwait. 2007;5(3):125–9.
34.
go back to reference Naidu S, Wilkinson JM, Simpson MD. Attitudes of Australian pharmacists toward complementary and alternative Medicines. 2005;39(9):1456–61. Naidu S, Wilkinson JM, Simpson MD. Attitudes of Australian pharmacists toward complementary and alternative Medicines. 2005;39(9):1456–61.
35.
go back to reference Alkharfy KM. Community pharmacists’ knowledge, attitudes and practices towards herbal remedies in Riyadh, Saudi Arabia. 2010. Alkharfy KM. Community pharmacists’ knowledge, attitudes and practices towards herbal remedies in Riyadh, Saudi Arabia. 2010.
36.
go back to reference Shraim NY, Shawahna R, Sorady MA, Aiesh BM, Alashqar GS, Jitan RI, et al. Community pharmacists’ knowledge, practices and beliefs about complementary and alternative medicine in Palestine: a cross-sectional study. BMC Complement Altern Med. 2017;17(1):429.CrossRefPubMedPubMedCentral Shraim NY, Shawahna R, Sorady MA, Aiesh BM, Alashqar GS, Jitan RI, et al. Community pharmacists’ knowledge, practices and beliefs about complementary and alternative medicine in Palestine: a cross-sectional study. BMC Complement Altern Med. 2017;17(1):429.CrossRefPubMedPubMedCentral
37.
go back to reference Ung COL, Harnett JE, Hu H, Desselle SP. Barriers to pharmacists adopting professional responsibilities that support the appropriate and safe use of dietary supplements in the United States: perspectives of key stakeholders. Am J Health-System Pharm. 2019;76(13):980–90.CrossRef Ung COL, Harnett JE, Hu H, Desselle SP. Barriers to pharmacists adopting professional responsibilities that support the appropriate and safe use of dietary supplements in the United States: perspectives of key stakeholders. Am J Health-System Pharm. 2019;76(13):980–90.CrossRef
38.
go back to reference Mobark DM, Al-Tabakha MM, Hasan SJPP. Assessing hormonal contraceptive dispensing and counseling provided by community pharmacists in the United Arab Emirates: a simulated patient study. 2019;17(2). Mobark DM, Al-Tabakha MM, Hasan SJPP. Assessing hormonal contraceptive dispensing and counseling provided by community pharmacists in the United Arab Emirates: a simulated patient study. 2019;17(2).
39.
go back to reference Rashid ZA, Al-Tabakha MM, Alomar MJ. Proper Counseling and Dispensing of Isotretinoin Capsule Products by Community Pharmacists in UAE: A Simulated Patient Study. Clinical, Cosmetic and Investigational Dermatology. 2020;13:405 – 14. Rashid ZA, Al-Tabakha MM, Alomar MJ. Proper Counseling and Dispensing of Isotretinoin Capsule Products by Community Pharmacists in UAE: A Simulated Patient Study. Clinical, Cosmetic and Investigational Dermatology. 2020;13:405 – 14.
40.
go back to reference Moin T, Duru OK, Turk N, Chon JS, Frosch DL, Martin JM, et al. Effectiveness of Shared decision-making for Diabetes Prevention: 12-Month results from the prediabetes informed decision and education (PRIDE) trial. J Gen Intern Med. 2019;34(11):2652–9.CrossRefPubMedPubMedCentral Moin T, Duru OK, Turk N, Chon JS, Frosch DL, Martin JM, et al. Effectiveness of Shared decision-making for Diabetes Prevention: 12-Month results from the prediabetes informed decision and education (PRIDE) trial. J Gen Intern Med. 2019;34(11):2652–9.CrossRefPubMedPubMedCentral
42.
go back to reference Cramer H, Shaw A, Wye L, Weiss M. Over-the-counter advice seeking about complementary and alternative medicines (CAM) in community pharmacies and health shops: an ethnographic study. 2010;18(1):41–50. Cramer H, Shaw A, Wye L, Weiss M. Over-the-counter advice seeking about complementary and alternative medicines (CAM) in community pharmacies and health shops: an ethnographic study. 2010;18(1):41–50.
43.
go back to reference Simpson M, Cavanagh H, John G, Kerr P, Obied H, Robinson H, et al. Complementing a rural pharmacy course with CAM: reflections from a Decade. Experience. 2014;2(1):88–97. Simpson M, Cavanagh H, John G, Kerr P, Obied H, Robinson H, et al. Complementing a rural pharmacy course with CAM: reflections from a Decade. Experience. 2014;2(1):88–97.
44.
go back to reference Group TPCW. UAE PROFESSIONAL PHARMACY GRADUATES COMPETENCY FRAMEWORK 2021. Group TPCW. UAE PROFESSIONAL PHARMACY GRADUATES COMPETENCY FRAMEWORK 2021.
45.
go back to reference Boura F, Awaisu A, ElGeed H, Katoue M, Kheir N. Pharmaceutical care education at pharmacy colleges in the Middle East and North Africa region: a systematic review. 2022;47(8):1134–48. Boura F, Awaisu A, ElGeed H, Katoue M, Kheir N. Pharmaceutical care education at pharmacy colleges in the Middle East and North Africa region: a systematic review. 2022;47(8):1134–48.
47.
go back to reference Mertens JF, Koster ES, Deneer VHM, Bouvy ML, van Gelder T. Factors influencing pharmacists’ clinical decision making in pharmacy practice. Res Social Administrative Pharm. 2023. Mertens JF, Koster ES, Deneer VHM, Bouvy ML, van Gelder T. Factors influencing pharmacists’ clinical decision making in pharmacy practice. Res Social Administrative Pharm. 2023.
48.
go back to reference Smith T, McNeil K, Mitchell R, Boyle B, Ries N. A study of macro-, meso- and micro-barriers and enablers affecting extended scopes of practice: the case of rural nurse practitioners in Australia. BMC Nurs. 2019;18(1):14.CrossRefPubMedPubMedCentral Smith T, McNeil K, Mitchell R, Boyle B, Ries N. A study of macro-, meso- and micro-barriers and enablers affecting extended scopes of practice: the case of rural nurse practitioners in Australia. BMC Nurs. 2019;18(1):14.CrossRefPubMedPubMedCentral
49.
go back to reference Schafheutle EI, Seston EM, Hassell K. Factors influencing pharmacist performance: a review of the peer-reviewed literature. Health Policy. 2011;102(2):178–92.CrossRefPubMed Schafheutle EI, Seston EM, Hassell K. Factors influencing pharmacist performance: a review of the peer-reviewed literature. Health Policy. 2011;102(2):178–92.CrossRefPubMed
Metadata
Title
Beyond pillbox: a national cross-sectional study on the attitudes, practices, and knowledge of community pharmacists regarding complementary and alternative medicine
Authors
Farah Naja
Nada Abbas
Sharfa Khaleel
Falak Zeb
Tareq A. H. Osaili
Reyad Shaker Obaid
MoezAlIslam Faris
Hadia Radwan
Leila Cheikh Ismail
Haydar Hassan
Mona Hashim
Hamzah AlZubaidi
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Complementary Medicine and Therapies / Issue 1/2024
Electronic ISSN: 2662-7671
DOI
https://doi.org/10.1186/s12906-024-04391-8

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