MD, PhD, MAE, FMedSci, FRSB, FRCP, FRCPEd.

A review conducted in 2015 reported community pharmacists are willing to adopt a professional role in counselling consumers about the appropriate and safe use of so-called alternative medicine (SCAM) but faced multiple barriers in doing so. This current review aimed to update and extend these findings, by identifying studies published since 2015 that reported on pharmacists across any setting.

Eligible studies published between January 01, 2016, and December 31, 2021, were identified across 6 databases (PubMed, Scopus, Web of Science, EMBASE, ScienceDirect and MEDLINE). A grounded theory approach was used to thematically synthesize the data extracted.

A total of 64studies representing pharmacists across 30 countries were included for review. The study designs varied and included:

  • cross-sectional surveys (n = 36),
  • qualitative studies (n = 14),
  • pseudo-patient studies (n = 3).

Eight studies reported on practice and/or bioethical responsibilities and 19 studies documented factors that would enable pharmacists to fulfill these responsibilities, while 37 studies reported on both.

The authors concluded that these findings indicate research about pharmacists’ responsibilities associated with SCAM is evolving from gap analysis towards research that is proactive in advocating for change in multiple areas. These findings can be used to inform a consensus discussion among pharmacists and key stakeholders regarding a set of professional responsibilities that would serve in the development of: a clearly defined role and associated practice standards, and competency requirements that inform educational learning objectives for inclusion in undergraduate, post-graduate and continuing professional pharmacy education.

I am puzzled why so many researchers in this specific area seem to avoid clearer language plainly stating the essential, simple, and undeniable facts. I am equally puzzled why so few pharmacists speak out.

It is obvious that community pharmacists are firstly healthcare professionals and only secondly shopkeepers. As such, they have important professional and ethical duties. Foremost, they are obliged to inform their customers responsibly – and responsible means telling them about the evidence for or against the SCAM product they are about to purchase. This duty also entails that pharmacists must inform themselves about the best current evidence. In turn, this means they must stop tolerating the current plethora of under- or post-graduate SCAM courses that are not evidence-based.

As we have discussed ad nauseam on this blog, none of this is actually happening (except in very few laudable cases)!

By and large, pharmacists continue to go along with the double standards of a) evidence for conventional drugs and b) fairy tales for SCAM. In the interest of progress, patient safety, and public health, it is time that pharmacists wake up and remind themselves that they are not commercially orientated shopkeepers but ethical healthcare professionals.

2 Responses to Community pharmacists must be reminded of their ethical duty when advising patients about SCAM

  • I wonder how often pharmacists are actually consulted about anything. Perhaps this happened more in the days of the small high street pharmacy but aren’t most now just employees of the larger chains and kept largely in the back room? There they fulfil the legal obligations while customer contact is handled by unqualified shop staff.

    I’ve certainly heard such staff discuss homeopathic remedies and suchlike but only in anecdotal terms or quoting what the manufacturers claim. Typically it seems that the pharmacist is only visible if coming out to ask some question relevant to a prescription.

    I’m talking about the UK – maybe it’s very different elsewhere.

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