October 16, 2006 – Most Canadian pharmacists say they don’t know enough about natural health products to properly counsel their customers. Faced with the increase in demand, they are also calling for more training.
This is highlighted by Toronto researchers who scrutinized 19 American and Canadian studies examining the attitudes, knowledge and professional practices of pharmacists towards NHPs.1.
|
The customer has the choice |
One of these studies shows that 72% of Canadian pharmacists are asked at least once a day about natural health products (NHPs). In fact, nearly two out of three users of these products obtain them from pharmacies.
However, no less than 45% of pharmacists consider that they do not have the knowledge required to guide their clients. They express a need for better training, particularly in terms of potential interactions between drugs and NHPs, possible adverse effects, their therapeutic use and the required dosages.
Training to perfect
In this regard, 92% of Canadian pharmacists believe that studying NHPs should be an integral part of the training they receive at university, according to one of the studies analyzed by the researchers.
|
Need info? |
The crying need for training expressed in the studies analyzed is linked more to the lack of information than to a real need for training, estimates the secretary general of the Ordre des pharmaciens du Québec (OPQ).2, Manon Lambert.
According to her, the training devoted to NHPs in the two Quebec faculties of pharmacy would be acceptable, judging that few natural products have been the subject of conclusive studies as to their effectiveness. “A three-credit course, like the one offered at the University of Montreal, seems to me sufficient to make pharmacists aware of NHPs, if we consider that for 4,000 synthetic drugs, we receive 500 to 600 hours of lessons” , explains Manon Lambert.
For Heather Boon3, who co-authored the study, pharmacy schools should all offer a comprehensive introductory course on NHPs and, subsequently, incorporate notions about NHPs into the very content of other courses. A study is also underway to measure the training needs which it would be possible to realistically meet.
A specialist in NHPs, pharmacist Jean-Yves Dionne specifies: “It is a truth from La Palice that pharmacists lack training with regard to NHPs and that that offered in Canadian universities remains derisory. But the main obstacle to adding more class hours is funding, he said. “Since the pharmaceutical industry is not interested in NHPs, who will pay for these additional courses? He asks himself.
An advisory role to assume
For the Ordre des pharmaciens du Québec (OPQ), pharmacists must assume the same advisory role for NHPs as they offer for an over-the-counter product – such as syrups, for example. “If a client consults him, he must be able to advise him and, if not, he has a duty to consult a colleague. It seems to us to be an acceptable security element ”, underlines its general secretary.
If adopted as is, the next code of ethics of the OPQ will also make it compulsory for a pharmacist to turn to another pharmacist or another health professional, if he believes he is not. have the required information.
Pharmacists will no longer be able to refer a client to a naturopath or a homeopath, for example. “The Order considers unacceptable, in terms of public protection, that a patient is sent by a pharmacist to a person not recognized by a professional order,” insists Manon Lambert.
Aim for collaboration
|
And the attitude? |
Pharmacology professor Heather Boon says she understands the concern of the Ordre des pharmaciens du Québec about the importance of training people hired in pharmacies to advise clients on NHPs. But she believes that collaboration between pharmacists and competent advisers should be encouraged, in order to better serve consumers.
“We should measure the knowledge of counselors and give them certification when they have the required knowledge, because I do not believe that, realistically, we can expect pharmacists to become experts in NHP in the near future,” said Heather Boon.
A point of view shared by Jean-Yves Dionne. “Pharmacists already have their hands full with the overload in the health system,” he observes. But the current debate is between orthodox medicine and an openness that strikes the right balance for the well-being of the patient. “
According to him, pharmacists are more and more challenged by patient requests and the results they obtain with NHPs.
Manon Lambert nevertheless believes that the organization she represents has done its homework by publishing for its members, two years ago, a guide on the main NHPs sold in Quebec and their potential adverse effects. Nonetheless, she says it is up to pharmacists to learn more about NHPs. “He even has an obligation to keep his skills up to date and NHPs must be part of it,” she concludes.
Martin LaSalle – PasseportSanté.net
1. Kwan D, Hirschkorn K, Boon H, US and Canadian pharmacists’ attitudes, knowledge, and professional practice behaviors toward dietary supplements: a systematic review, BMC Complementary and Alternative Medicine, 2006 Sep 19; 6:31.
2. The website address of the Ordre des pharmaciens du Québec is www.opq.org [consulté le 16 octobre 2006].
3. Heather Boon is professor of pharmacology and researcher in alternative and complementary medicine (CAM) at the University of Toronto. She also works with the Canadian Society for Research on Natural Health Products (NHPRS): www.nhpresearch.bcit.ca [consulté le 16 octobre 2006].
