Managing Herbal Medicine Use at the Pharmacy
As a pharmacist, you may be well aware that many of your patients use herbal medicine in varying degrees. In a common scenario, patients approach their pharmacist with an herbal product purchased elsewhere, wondering whether they can take it concurrently with their prescribed medication(s). Other questions may deal with side effects, dosing or cost. Are you prepared to answer them?
If you were not encouraged to study herbal medicine in pharmacy school, and feel your knowledge in this area could improve, this may be a good time to learn more!
Who’s Using Herbal Therapy?
Consumers in the United States spent almost eight percent more on herbal dietary supplements in 2016 than in the previous year, according to a report by the American Botanical Council. Total US retail sales surpassed $7 billion for the first time in 2016, the 13th consecutive year of sales growth.
A 2017 study published in the Journal of Patient Experience found that older age and higher education were factors associated with a higher use of herbal supplements. The same study found people with chronic diseases were more likely to use herbal medicines than others. OTC drug users and patients with stroke were also more likely to use herbal medicines than others.
As the market for these products continues to become more and more profitable, the number of herbal supplements and medicines keeps growing, and thus, patients can have a difficult time recognizing and identifying high-quality items in the multitude.
Why Should Pharmacists Care?
While research suggests older adults use herbal medicine more than other groups, younger men and women may use vitamins or minerals to complement their diet or enhance the results of their workout regimes. So, even though the use of herbal therapy is generalized, health care providers do not receive the training needed to identify herb-drug interactions, herb-disease interactions, or other potential issues.
Because herbal supplements do not go through the same development process as pharmaceuticals, pharmacists may struggle to determine which products to make available to patients.
Tieraona Low Dog, MD, the director of the Fellowship in Integrative Medicine Program at the University of Arizona Health Sciences Center, sums up the core issue with herbal medicine:
“It is unreasonable to assume that average consumers will be able to easily identify a high-quality product that is evidence based for their specific condition, and know the dosage, duration of use, and possible interactions with other medications. Thus, it is imperative that patients have a trusted, nonbiased and authoritative voice that can help them make informed decisions regarding supplement use. In addition to the physician, it should include the pharmacist, a member of the health care team who is critically important in this regard, but definitely underutilized.”
So, What to Do?
First and foremost, get educated. You may be inclined to choose a prescription medication over an herbal/dietary supplement, but the trend suggests more and more patients are integrating pharmaceuticals and herbal therapy to keep their health. As a result, pharmacists will hear more questions and concerns regarding herbal products. If you aren’t familiar with herbal medicine, be sure to visit the Natural Medicine Database and the American Botanical Council, to start.
UW-Madison’s Division of Pharmacy Professional Development will hold its Annual Fall Milwaukee Conference this September. One of the topics is “Supplements and Herbal Therapies for Men and Women’s Health.” This talk is a unique opportunity to advance your professional skills and expand your education on the subject.
Organizations such as Kaiser Permanente Northwest, have adopted a comprehensive and systematic approach to managing and stocking herbal supplements—your pharmacy may be part of the KPN network or a similar organization that can facilitate access to their knowledge base and other resources.