Poster Presentations
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ABSTRACTS
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Poster Presentations P.047 Retailers and Herbal Product-Related Adverse Drug Reactions: Whose Responsibility is It? R. Walji,1 H. Boon,1 J. Barnes,2 G.R. Baker,1 Z. Austin1 1 University of Toronto, Toronto, Ontario, Canada; 2 University of Auckland, Auckland, New Zealand Background: Herbal products are sold over-the-counter and are often perceived to be safe, despite increasing documentation of potential risks. The current Canadian reporting system collects information on suspected Adverse Drug Reactions (ADRs) and suffers from severe under-reporting, resulting in a paucity of safety data. As retailers, pharmacists and health food store personnel may be in a position to facilitate herbal ADR reports and advice about the safe use of herbs because of their accessibility to consumers. Research question: How do retailers (pharmacists and health food store personnel) perceive and respond to herbal product-related ADRs? Objective: To compare pharmacists and health food store personnel in their approach to safety issues related to herbal products. Methods: The theoretical perspective of this qualitative study is critical realism. In-depth interviews were conducted with community retailers across Toronto, Canada until reaching theoretical saturation in key emerging themes (n=22). Retailers were purposefully selected to ensure diverse work locations, consumer contact hours and years of experience. Retroduction was used in analysis of data, a technique to elicit the underlying structures behind how pharmacists respond to herbal-related ADRs. Results: Neither group of retailers reported ADRs to Health Canada, generally because of a lack of knowledge of the reporting system or workplace challenges, such as lack of time. A major theme in both groups was “responsibility” for advice about herbs. Pharmacist approaches to herbal ADR reporting tended to vary depending on the strength of their professional disposition. Those who saw themselves as responsible for contributing to pharmacy knowledge generation were more likely to take on the responsibility of adverse event reporting. These pharmacists were on the far end of the continuum. Most pharmacists found workplace challenges insurmountable and referred over to other health care professionals. Health food store personnel approaches tended to centre around an attempt to legitimise their work. They emphasised their years of experience and training and compared that to a perceived lack of training at other competitor health food stores. Health food store personnel perceived their responsibility in herbal product safety monitoring to be related to providing trustworthy products and services. Conclusion: Pharmacists were generally hesitant to assume responsibility for giving advice about herbs and for reporting ADRs unless they had a very strong professional disposition. Health food store personnel emphasised their practical knowledge or training and highlighted their relationships with their customers to show they were
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