Pharmacists’ perspectives on recommending herbal medicines for acute infections: a qualitative study

Abstract

BackgroundCommunity pharmacists have an essential role in antimicrobial stewardship by providing self-care advice for self-limiting infections.AimTo explore community pharmacists’ perceptions and experiences of advising patients on management of acute respiratory tract infections (RTIs) and urinary tract infections (UTIs), and to explore issues regarding use of over-the-counter (OTC) medicines, including herbal medicines.Design & settingQualitative semi-structured interview through face-to-face or telephoneMethodQualitative interview study with community pharmacists carried out between November 2019 and March 2020. Data were collected through in-depth, semi-structured interviews, recorded and transcribed. A reflexive thematic analysis was undertaken.ResultsCommunity pharmacists’ responses from 18 interviews highlighted that they considered patients’ preferences when recommending self-management strategies. Some believed that conventional OTC medications had quicker and stronger effects, while others preferred herbal OTCs as a more natural approach, particularly for less severe symptoms. Factors influencing self-care advice from pharmacists included their perception of patient preferences, nature/severity of illness, research evidence, training, commercial pressures, and patient concerns about medication cost. Pharmacists sometimes experienced challenges with language barriers, and patients’ expectations of getting antibiotics. Pharmacists emphasised the importance of being trusted by their patients. There was widespread acceptance of their role in self-management advice for acute illness, and interest in the role of herbal medicines, but pharmacists did not feel confident in recommending these.ConclusionPharmacists are central to the management of self-limiting infections. There is a need to educate the public about appropriate use of antibiotics and provide training and support for pharmacists on self-management strategies including herbal medicine.