There is currently no established framework for pharmacy practice related to herbal and dietary supplements (HDS) in hospitals. This study aimed to develop a framework outlining the key responsibilities of hospital pharmacists to ensure the safe and appropriate use of HDS in patients. A mixed-methods study was conducted in three phases: 1) an inductive approach involved focus groups of nine hospital pharmacists from King Chulalongkorn Memorial Hospital (KCMH) in Bangkok to draft the initial framework and develop a validated questionnaire for the second phase; 2) the second phase surveyed 100 KCMH pharmacists using the questionnaire and revised the draft based on their feedback; and 3) a focus group of three herbal medicine experts reviewed the revised draft and provided their opinions to reach a consensus on the framework’s content. Participants engaged in several HDS-related activities: answering patient questions (48% of activities), educating patients (22%), screening for HDS use during medication dispensing or reconciliation (12%), responding to healthcare professionals’ questions (10%), identifying the ingredients of HDS products (5%), and assessing adverse effects of HDS (3%). A proposed framework for hospital pharmacists includes the following components: 1) screen for HDS use; 2) identify HDS products; 3) assess potential interactions between herbs, drugs, and diseases; 4) monitor and manage adverse effects; 5) report adverse events to authorities; 6) educate and counsel patients on the rational HDS use; 7) provide reliable HDS information to health professionals; 8) document HDS use in a patient’s record. Participants requested a reliable source of HDS information for healthcare professionals, as well as education and training for post-registration pharmacists. The proposed framework serves as a guide for hospital pharmacists in the practice to support safe and appropriate HDS use in patients. The findings suggest that establishing a reliable information resource and educating pharmacists about HDS are crucial to supporting pharmacists’ roles in HDS. Further study is needed to explore the framework's feasibility and acceptability in other hospitals, as it was conducted in a single tertiary care hospital.
Paisansirikul et al. (Thu,) studied this question.