Australian pharmacists’ uncertainty about homeopathic products in community pharmacy

Abstract

Background Cochrane reviews conclude that there is no evidence for the efficacy of homeopathic preparations; however, these medicines are sold in community pharmacies globally, despite significant criticism from other healthcare practitioners. Consumer demand, profit and respect for choice are postulated reasons for this availability. Objectives To explore the factors that influence pharmacists’ preparedness to stock homeopathic products. Methods A mixed-methods approach was used; this included two focus groups [metropolitan and rural South Australia (n=13)], telephone interviews (n=18) and a cross-sectional survey (n=185) of Australian community pharmacists. Factor analysis and non-parametric tests were used to identify factors that contributed to pharmacists’ attitudes towards homeopathic products. Profitability was analysed using wholesale sales data, including contribution to profit in community pharmacy and views of owner versus employee pharmacists. Results Surveyed pharmacists indicated a commitment to being a source of information on medicines and health products. However, this study revealed that many pharmacists lacked knowledge on homeopathic products and were unable to differentiate them from other ‘natural medicines’. The impact of homeopathic products on profitability was regarded as limited. Overall, pharmacists were driven by concerns for consumer health and choice. Conclusions Pharmacists’ education should include skills to enable critical evaluation of health products and ability to explain why homeopathic products have no medicinal justification. The risk to professional credibility of selling these products is strong and most pharmacists do not endorse their value. Removal from pharmacies is unlikely to impact upon financial sustainability. There is a compelling argument for an urgent change to practice in this area.