Community Pharmacist Perception and Practice of Herbal product in Eastern Nepal: A Cross-Sectional Study
Abstract
Objectives: Herbal Products (HP) are commonly utilized for both medicinal and preventative purposes, however, there is a rising concern about their efficacy and safety in contemporary medical practice. The study aims to determine the perception and practice regarding HP among community pharmacists in Eastern Nepal.
Methods: A cross-sectional, quantitative study was conducted in the Jhapa, Morang, and Sunsari districts of Eastern Nepal. Data were collected using a structured questionnaire to assess pharmacists' perceptions and practices regarding herbal remedies.
Results: Pharmacy personnel from 246 community pharmacies participated in the study, in which the majority were male (78.9%), and had more than 3 years of experience (57.7%). 47.2% of respondents had shown a positive perception towards HP, whereas only 25.6% of respondents demonstrated good practices regarding herbal items at their pharmacy. Cough preparations (45.9%) and general health tonics (26.4%) were the most sold HP. Most participants (69.5%) believed HP is safe and effective, with 76% recommending the need for proper regulation. A significant number (84.1%) reinforced incorporating HP subjects in the pharmacy curriculum. In terms of practice, over half (51.2%) of pharmacy personnel sometimes dispensed HP, with 87.4% advising consumers on their use. A pharmacist perception was associated with pharmacy practice experience (p=0.020), and practice was linked with age, with better practices seen in those with age ≤30 years (p<0.001).
Conclusion: The study concludes that most community pharmacy personnel had poor perception and infrequent practice of herbal products in their pharmacy. The study recommends strict quality control, education, and regulation of herbal products to safely and effectively integrate HP in community pharmacy settings.
Keywords: Herbal products, Ayurvedic product, Community Pharmacist, Complementary and alternative medicine, attitudes, Practice
Keywords:
Herbal medicine, Ayurvedic product, Community Pharmacist, Complementary and alternative medicine, attitudes, PracticeDOI
https://doi.org/10.22270/jddt.v14i12.6916References
1. Organization WH. Traditional, Complementary and Integrative Medicine Geneva, Switzerland: WHO; 2023. Available from: https://www.who.int/health-topics/traditional-complementary-and-integrative-medicine#tab=tab_1 .
2. Organization. WH. "Front Matter." A Global Brief on HYPERTENSION: Silent Killer, Global Public Health Crisis. World Health Organization, 2013.
3. Oyebode O, Kandala N-B, Chilton PJ, Lilford RJ. Use of traditional medicine in middle-income countries: a WHO-SAGE study. Health Policy and Planning. 2016;31(8):984-91. PMid:27033366 PMCid:PMC5013777 https://doi.org/10.1093/heapol/czw022
4. Alkharfy K. Community pharmacists' knowledge, attitudes and practices towards herbal remedies in Riyadh, Saudi Arabia. EMHJ-Eastern Mediterranean Health Journal, 2010;16(9):988-993. https://doi.org/10.26719/2010.16.9.988
5. Ernst E. Herbal medicines put into context. British Medical Journal Publishing Group; 2003. p. 881-2. PMid:14563719 PMCid:PMC218802 https://doi.org/10.1136/bmj.327.7420.881
6. 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 Medicine. 2011;9(1):94. https://doi.org/10.1186/1741-7015-9-94 PMid:21827684 PMCid:PMC3180693
7. Abdel-Aziz S, Aeron A, Kahil T. Health Benefits and Possible Risks of Herbal Medicine. 2016. https://doi.org/10.1007/978-3-319-25277-3_6
8. Firenzuoli F, Gori L. Herbal medicine today: clinical and research issues. Evid Based Complement Alternat Med. 2007;4(Suppl 1):37-40. https://doi.org/10.1093/ecam/nem096 PMid:18227931 PMCid:PMC2206236
9. Farah MH, Edwards R, Lindquist M, Leon C, Shaw D. International monitoring of adverse health effects associated with herbal medicines. Pharmacoepidemiology and Drug Safety. 2000;9(2):105-12. https://doi.org/10.1002/(SICI)1099-1557(200003/04)9:2<105::AID-PDS486>3.0.CO;2-2
10. Ming LC. Use of herbal products in Southeast Asian countries. Archives of Pharmacy Practice. 2016;7. https://doi.org/10.4103/2045-080X.183039
11. Kheir N, Gad HY, Abu-Yousef SE. Pharmacists' knowledge and attitudes about natural health products: a mixed-methods study. Drug Healthc Patient Saf. 2014;6:7-14. https://doi.org/10.2147/DHPS.S57756 PMid:24501547 PMCid:PMC3912048
12. Mahajan A, Kaur J, Kaur S. Herbal Medicines: Possible Risks and Benefits. American Journal of Phytomedicine and Clinical Therapeutics. 2013;1:226-39.
13. Olatunde S, Boon H, Hirschkorn K, Welsh S, Bajcar J. Roles and responsibilities of pharmacists with respect to natural health products: key informant interviews. Res Social Adm Pharm. 2010;6(1):63-9. https://doi.org/10.1016/j.sapharm.2009.02.004 PMid:20188329 PMCid:PMC2923149
14. Organization WH. National policy on traditional medicine and regulation of herbal medicines : report of a WHO global survey 2005. Available from: https://iris.who.int/bitstream/handle/10665/43229/9241593237.pdf?sequence=1 .
15. Oshikoya KA, Oreagba IA, Ogunleye OO, Oluwa R, Senbanjo IO, Olayemi SO. Herbal medicines supplied by community pharmacies in Lagos, Nigeria: pharmacists' knowledge. Pharmacy Practice. 2013;11(4):219. https://doi.org/10.4321/S1886-36552013000400007 PMid:24367462 PMCid:PMC3869638
16. Khdour M, Kurdi M, Hallak H, Jarab A, Dweib M, Al-Shahed Q. Pharmacists' Knowledge, Attitudes and Practices Towards Herbal Remedies In West Bank, Palestine. International Archives of Medicine. 2016;9. https://doi.org/10.3823/1974
17. Kouzi SA. Herbal remedies: the design of a new course in pharmacy. American Journal of Pharmaceutical Education. 1996;60(4):358-64. https://doi.org/10.1016/S0002-9459(24)04673-4
18. Noureldin M, Murawski MM, Mason HL, Plake KS. Student pharmacists' attitudes toward complementary and alternative medicine. J Am Pharm Assoc (2003). 2013;53(6):618-25. https://doi.org/10.1331/JAPhA.2013.12212 PMid:24141360
19. Khakurel B, Prasad R, Bhattarai D, Sheak A. In the name of herbal medicine. Journal of Institute of Medicine Nepal. 1998;20(1 & 2). https://doi.org/10.59779/jiomnepal.24
20. World Health Organization. Programme on Traditional M. Legal status of traditional medicine and complementary/alternative medicine : a worldwide review. Geneva: World Health Organization; 2001.
21. Administration DoD. Pharmacy List Biratnagar 2023. Available from: https://dams.dda.gov.np/manLogin/searchPharmacy .
22. Inc. R. Raosoft Sample Size Calculator 1996-2011 [cited 2023 22]. Available from: http://www.raosoft.com/ .
23. Alsayari A, Almghaslah D, Khaled A, Annadurai S, Alkhairy MA, Alqahtani HA, et al. Community Pharmacists' Knowledge, Attitudes, and Practice of Herbal Medicines in Asir Region, Kingdom of Saudi Arabia. Evidence-Based Complementary and Alternative Medicine. 2018;2018(1):1568139. PMid:30228824 PMCid:PMC6136488 https://doi.org/10.1155/2018/1568139
24. Gelayee D, Mekonnen G, Atnafie S, Birarra M, Asrie A. Herbal Medicines: Personal Use, Knowledge, Attitude, Dispensing Practice, and the Barriers among Community Pharmacists in Gondar, Northwest Ethiopia. Evidence-Based Complementary and Alternative Medicine. 2017;2017. PMid:28904558 PMCid:PMC5585575 https://doi.org/10.1155/2017/6480142
25. Mirkovi S, Janković S, Džudovi J, Gužvi V. Development and Validation of the Questionnaire for the Evaluation of Knowledge about Herbal Preparations (QEK-HP). 2017. https://doi.org/10.1515/afmnai-2017-0012
26. Ansari M. Evaluation of community pharmacies regarding dispensing practices of antibiotics in two districts of central Nepal. PLoS One. 2017;12(9):e0183907. PMid:28949990 PMCid:PMC5614431 https://doi.org/10.1371/journal.pone.0183907
27. Baral SR, Parajuli DR, Shrestha S, Acharya SR, Dahal P, Poudel P, et al. Undergraduate pharmacy students' attitudes and perceived barriers toward provision of pharmaceutical care: a multi-institutional study in Nepal. Integr Pharm Res Pract. 2019;8:47-59. https://doi.org/10.2147/IPRP.S203240 PMid:31240200 PMCid:PMC6556473
28. Asmelashe Gelayee D, Binega Mekonnen G, Asrade Atnafe S, Birarra MK, Asrie AB. Herbal Medicines: Personal Use, Knowledge, Attitude, Dispensing Practice, and the Barriers among Community Pharmacists in Gondar, Northwest Ethiopia. Evidence-Based Complementary and Alternative Medicine. 2017; 2017(1):6480142. https://doi.org/10.1155/2017/6480142 PMid:28904558 PMCid:PMC5585575
29. Administration DoD. Drug Registration Regulation 2038 Nepal: Government of Nepal; 1981 [cited 2024]. Available from: https://www.dda.gov.np/ .
30. Naidu S, Wilkinson JM, Simpson MD. Attitudes of Australian pharmacists toward complementary and alternative medicines. Ann Pharmacother. 2005;39(9):1456-61. PMid:15972324 https://doi.org/10.1345/aph.1G089
Published
Abstract Display: 310 
PDF Downloads: 286 PDF Downloads: 47 How to Cite
Issue
Section
Copyright (c) 2024 Prasanna Dahal, Rahi Bikram Thapa, Sushil Regmi , Nabin Thapa Magar
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
How to Cite
.