Pharmacists Perceptions of the Development of Herbal Medicines in Iran Asghari G. Faculty of Pharmacy and Pharmaceutica

2. Pharmacists Perceptions of the Development of Herbal Medicines in Iran Asghari G. Faculty of Pharmacy and Pharmaceutical Sciences Isfahan University of Medical Sciences, Isfahan, I.R.Iran

3. Introduction : • Objectives • Identify pharmacists overall assessments of the WHO-TRM Strategy components (2) influencing the development of herbal medicine market in Iran. • Herbal medicine market in Iran • More than 100 registered (locally produced) and several hundred non-registered, but regulated, herbal medicine are in the market. • 32 companies produce herbal medicine, mainly oral and topical dosage forms. • Although the sale of herbal medicine is growing, at present its share in the drug market is <5%.

4. Introduction : pharmacist role • Pharmacy has had a long association with herbal medicines. • Pharmacists are in a prime position to counsel patients wishing to self-medicate with herbal medicines. • Pharmacists have an opportunity to provide information to the health care team. • Pharmacists contribute to society as valuable members of the health-care team. • Herbal medicines market may be significantly influenced by several socially relevant determinants, one of which may be the attitude to herbal medicines among health care provider and the general public(1).

5. Methods:elements assessed • Access: affordibility, supply, distrubution, market expansion, health insurance coverage, price • Rational use: provider training, consumer information, public information, commercial advertizing • Safety, efficacy, quailty: pharmacovigilance, packeging and lebelling, quality assurance, clinical trial • Regulation: registration , .integration to NHS, legal consideration, licensing

6. Methods:Questionnaire used The 20 questions consisted of 5 items addressing safety, efficacy, and quality of herbal medicines, 5 items about the rational use, 5 items about the access to herbal medicines, and 5 items about regulation. • A five – point Likert rating scale was used for the final 17-item with choices strongly agree, agree, somewhat agree, disagree, and strongly disagree.

7. Methods:Subjects • 72 community retail pharmacists practicing in Isfahan city in private pharmacy were participate to complete the survey. Data were collected by self-administered questionnaire. • After their continuing education course, pharmacists were asked to complete a written survey evaluating elements that can influence the development of herbal medicine in Iran .

8. Methods:Analysis • Correlation and regression analyses were used to identify the relationships between herbal medicine development scales conducted using SPSS for windows, release 10. Analysis of variance was used to compare elements. • Reliability of measures was calculated with chronbach’s alpha.

9. Results: • The samples consisted of females (56.5 percent) and males (44.5 percent). • There were no significant differences among pharmacist’s opinions to 5 questions in rational use section. • In the safety, efficacy and quality section, there were significant differences between efficacy and others. The results showed that pharmacists believe poor efficacy in herbal product negatively influence their market. • There was a significant difference in access section between cost and availability. • The results demonstrated that the pharmacist perceptions of development of herbal medicines vary from access and regulation items to safety, efficacy, quality and rational use items.

10. Discussion : • In general, there was agreement with positive statements about the development of herbal medicine market. The results were in agreement with WHO-TRM Guidelines (3). • The findings of this study demonstrate that pharmacists rely more on evaluations of cost when assessing access. • Although the majority of pharmacists attitude toward all item were positive, they did not have the same positive attitudes to the influence of creating more manufacturer of herbal medicines.

11. Discussion : • Although many factors are contributing to herbal medicines market, but rational use and safety, efficacy, quality as important issues must be more addressed if herbal medicines market is to be developed successfully. • Since this data were collected to assess the perception of specific city pharmacist, they may not necessarily show the reality and may not nationally applicable or acceptable. It is reported that the attitude of GPs to CAM vary with geographic location.(4) • Iran health system needs to evaluate their herbal medicine market by various methods in order to promote their herbal medicine market to meet health care demands and assure that they are involving in economic development as well as productive employments.

12. References : • 1. De Smet, P.A.G.M., An introduction to herbal pharmacoepidemiology, Journal of Ethonopharmacology 38, 197-208, 1993 • 2. WHO Traditional Medicines Strategy: 2002–2005. Geneva, World Health Organization, 2002 • 3. General guidelines for methodologies on research and evaluation of traditional medicine. Geneva, World Health Organization, 2000 • 4. White A.R. Resch K.L., Ernst E. Complementary medicine: use and attitudes among GPs. Fam. Pract, 14:302-306, 1997