Reporting adverse drug reactions associated with herbal products: Consumer, health food store personnel and pharmacist perspectives.

摘要

Background. Natural health products (NHPs) are sold over-the-counter and are often perceived to be safe, despite potential risks. The current Canadian reporting system collects information on suspected adverse drug reactions (ADRs) and suffers from severe under-reporting. As retailers, pharmacists and health food store personnel may be in a position to facilitate collection of herbal ADR reports because of their accessibility to consumers.;Methods. In-depth interviews were conducted with retailers and consumers across Toronto until theoretical saturation was achieved (n=36). Participants were purposefully selected to ensure diverse backgrounds and experiences. Interviews were transcribed and coded for key emerging themes.;Results. Consumers tended to self-prescribe NHPs and were only likely to discuss their NHP use with people they trusted—usually health food store personnel, family and friends. Many consumers did not have good relationships with their conventional health providers, which inhibited discussions about NHP-related ADRs. When consumers did disclose suspected ADRs to retailers, the retailers generally did not report these NHP-related ADRs to Health Canada. Most pharmacists found workplace challenges insurmountable, although pharmacist approaches to herbal ADRs tended to vary depending on their professional disposition. Pharmacists who saw themselves as knowledge generators were more likely to report. Health food store personnel offered generous product return policies and actively returned NHPs suspected of causing an ADR to the manufacturer. However, they had no knowledge of the Canadian ADR reporting system and thus did not submit any reports.;Conclusion. Consumers tended to disclose suspected NHP-related ADRs only rarely and to retailers with whom they had developed previous good relationships. This highlights the importance of improving patient-practitioner (or retailer) communication. Pharmacists generally did not report ADRs due to workplace challenges, unless they had a very strong professional disposition. These results have important implications with respect to pharmacy education. Health food store return policies resulted in suspected ADR reports to the manufacturers. Manufacturers are mandated to report ADRs to Health Canada, so this finding may have important implications within industry for the future of ADR reporting systems involving herbal products and public health.;Objective. To investigate retailer and consumer responses to herbal ADRs.