Professional practices and experiences with complementary medicines: a cross-sectional study involving community pharmacists in England


  • Joanne Barnes,

    associate professor in herbal medicines, Corresponding author
    1. School of Pharmacy, University of Auckland, New Zealand
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  • Neil C Abbot

    research fellow
    1. Vascular Diseases Research Unit, The Institute of Cardiovascular Research, Ninewells Hospital and Medical School, University of Dundee, Dundee, Scotland
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Associate Professor in Herbal Medicines, School of Pharmacy, Faculty of Medical and Health Sciences, Grafton Campus, Private Bag 92019, University of Auckland, Auckland, New Zealand. E-mail:


Objective As retailers of complementary medicines (CMs), pharmacists are well placed to advise consumers on the safe and effective use of these products; where CMs are available in pharmacies, pharmacists should be well informed about such products. This study explored the extent to which CMs are available in community pharmacies in England, and examined pharmacists' experiences, professional practices and training with regard to these products.

Method A cross-sectional study was conducted, involving a structured questionnaire posted to community pharmacists. Coded follow-up mailings were sent to non-responders after 2 and 4 months, and a reminder telephone call made after 3 months.

Setting All community pharmacists in six areas (Devon, Cornwall, Bradford, Leeds, Manchester, Stockport) of England (total n = 1337).

Key findings The response rate was 66.5%. Overall, 92% of respondents reported that CMs (excluding vitamins/minerals) are sold in the pharmacy in which they practise, 81% had received requests from patients/consumers for specific CMs in the previous year, and 58% had recommended CMs. Around 70% of respondents rarely/never asks about CMs use when counter-prescribing conventional medicines or when receiving reports of suspected adverse drug reactions (ADRs) associated with conventional medicines.

In total, 40% of respondents had undertaken training in complementary/alternative medicine (CAM). Pharmacists who had undertaken training were more likely to ask patients/consumers specifically about use of CMs when counter-prescribing conventional over-the-counter (OTC) medicines (37.0% versus 23.4%, respectively; χ2 = 17.4; P = 0.0003) and when receiving reports from patients/customers of suspected ADRs associated with conventional (prescribed or OTC) medicines (35.6% versus 23.8%, respectively; χ2 = 13.0; P = 0.0003).

Conclusion CMs are widely available in pharmacies in England, and pharmacists interact with users of these products. An opportunity exists for pharmacists to embrace a professional role as expert advisors on CMs. However, pharmacists' training, professional practices and competence with respect to CMs first need to improve.