Natural health products

Pharmacists are among the most accessible health care professionals in Canadian society. But when Canadians approach them about natural health products (NHPs), do they have knowledge to share? I originally didn’t think so. As a frequent user of NHPs, it’s never occurred to me to approach a pharmacist about them. If I’ve needed to know where a certain product was located within a pharmacy, I would ask a pharmacist to assist me. But whenever I’ve sought specific guidance and wisdom about a particular NHP, it’s never crossed my mind to ask the pharmacist. I’ve assumed I would obtain better information by searching the Internet, contacting the producer of the product or even asking advice from an employee at a health food store. For the longest time, my perception was that the typical pharmacist has a very limited understanding of NHPs. But after I conducted my own research by browsing through back issues of CPJ, accessing online resources and talking to pharmacists as an intern here at the journal, I was surprised to discover this isn’t the case. I came to the realization that pharmacists do in fact have lots of information about complementary and alternative medicine at their fingertips. Of course, I recognize that some pharmacists are probably more informed about NHPs than others. Some may hold a special interest in natural health and seek out extra resources. But the fact that all pharmacists receive some basic training about NHPs in pharmacy school caught me off guard, as I had the perception that the majority of them were completely uneducated about NHPs. At first, I thought I was the “lone man out.” But after talking to some of my university-educated friends, I soon realized I wasn’t the only one who was oblivious to the fact that pharmacists are familiar with NHPs. Many people are unaware that they can talk to their pharmacist about NHPs, says Dr. Heather Boon, associate professor and associate dean in the Leslie Dan Faculty of Pharmacy at the University of Toronto. Along with this lack of awareness, her research has found that people believe pharmacists should be knowledgeable about NHPs, when in reality, these products are already a part of a pharmacist’s scope of practice. “If you ask the public, other pharmacists and other health care providers, everyone thinks pharmacists have a role,” she says. “But I think many people, like you, aren’t aware that pharmacists currently give information about NHPs.” In other words, there’s a blatant gap between what patients think pharmacists can do and what pharmacists actually can do. Patients have many opportunities to approach pharmacists and get advice about NHPs, says Dr. Boon, who is also the chair of Health Canada’s expert advisory committee for natural health products and one of the founding chairs and principal investigators of the Canadian Interdisciplinary Network for Complementary and Alternative Medicine Research (IN-CAM). “But they don’t use pharmacists as much as they could,” she says. And this is a definite problem, especially since 73% of Canadians regularly take NHPs.1 With such widespread use, communication lines need to be entirely open between patients and pharmacists regarding these products so that possible interactions with prescription medications can be identified. Patients should be aware that they can talk to their pharmacist about NHPs, and in order for this to happen, pharmacists should be putting more effort into promoting the fact that they’re familiar with, and sometimes very knowledgeable about, natural health products. Dr. Boon notes that some pharmacies have started being proactive by promoting NHPs and making it known that their pharmacists are well informed about them. But it’s also important that all other pharmacists step up to the plate, making it clear that they’re available to offer some guidance about NHPs, especially when patients are combining them with medications. I started this internship knowing very little about pharmacists. But now, I fully understand that they’re not simply drug dispensers who follow doctors’ orders. They are much more than that. Unfortunately, Canadians may still hold this belief, as many don’t have a clear understanding of the roles and responsibilities of pharmacists in general, let alone when it comes to NHPs. To combat this misperception, pharmacists need to recognize that it’s widespread, and work together to promote the realities of their occupation. With time, Canadians will further grasp that pharmacists have a lot to offer besides traditional medication. In the end, the importance of pharmacists, and the significant role they can and should play when it comes to the administration of NHPs, cannot be overstated. Awareness must be a priority. ■ (See the case report on p. 93 for an example of how important it is to discuss natural health products with pharmacists.)

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