Pharmacists' knowledge and attitudes about natural health products: a mixed-methods study

Objectives: To explore knowledge and attitude of pharmacists in Qatar towards natural health products (NHPs). Methods: The quantitative component of this study consisted of an anonymous, online, selfadministered questionnaire to assess knowledge about NHPs among pharmacists in Qatar. Descriptive statistics and inferential analysis were conducted using Statistical Package of Social Sciences (SPSS (R)). Means and standard deviation were used to analyze descriptive data, and statistical significance was expressed as P-value, where P <= 0.05 was considered statistically significant. Associations between variables were measured using Pearson correlation. The qualitative component utilized focus group (FG) meetings with a purposive sample of community pharmacists. Meetings were conducted until a point of saturation was reached. FG discussions were audio-taped and transcribed verbatim. Data were analyzed using a framework approach to sort the data according to emerging themes. Results: The majority of participants had average to poor knowledge about NHPs while only around 7% had good knowledge. In the FG meetings, participants considered the media, medical representatives, and old systems of natural health as major source of their knowledge. They criticized undergraduate pharmacy courses (for inadequately preparing pharmacists to deal with NHPs) and the pharmacy regulations (for being irrelevant). A perception of NHPs as being "safe" still exists among pharmacists. Conclusions: Pharmacists' ability to provide effective services associated with NHPs is limited by poor access to evidence-based information and poor knowledge. A perception of NHPs and CAM as 'safe' still exists among pharmacists, and regulations related to NHPs require addressing to follow best practice and ensure patient safety.