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The University of Southampton
Medicine

Research project: Qualitative study on community pharmacists’ perspectives of recommending herbal medicine in acute infections

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Primary care accounts for approximately 80% of all human antibiotic prescriptions, and the majority are prescribed for self-limiting conditions such as uncomplicated respiratory tract infections (RTIs) and urinary tract infections (UTIs). A number of systematic reviews suggest that antibiotics provide no benefit in symptom improvement in colds, persisting acute purulent rhinitis, or acute laryngitis; and only slightly modify the course of acute otitis media and sore throat. In addition antibiotics provide minimal benefits for acute bronchitis and UTIs (Little et al., 2010). The marginal benefits are outweighed by increasing antibiotic resistance and common adverse reactions leading to unnecessary increases in healthcare costs.

Herbal medicines are potential alternatives with promising evidence on symptomatic relief in acute infections. Recent and ongoing studies at Southampton include trials investigating Pelargonium sidoides root extract for acute bronchitis, Andrographis paniculata for RTIs, NSAIDs and Arctostaphylos uva-ursi for UTIs, Chinese herbal medicine for recurrent UTIs, and qualitative studies exploring patients’ and practitioners’ experiences of using herbal medicine for these infections (HATRIC-Q study and GRAPHALO-Q, both ongoing). A literature search has revealed that there has never been a qualitative study of pharmacists’ views on this subject.

In order to facilitate rapid translation of research into clinical practice, there has been much interest in researching options currently available to the general public. Patients already seek pharmacists’ advice for symptom relief for acute infections, including the use of herbal medicines. However, there is an average 5-10% unlicensed or off-label medicines prescribed in the community. The number of medications available over-the-counter (OTC) without a prescription is rapidly increasing. Many clinical commissioning groups are promoting ‘Pharmacy First’ for various conditions as an alternative to consulting GPs (NHS, 2017). There is growing importance of community pharmacists in ensuring appropriate use of medicines, disseminating high-quality information and reducing unnecessary GP consultations.

This qualitative study aims to explore the experiences and views of community pharmacists in Southern England giving advice to patients on using herbal medicines in management of acute RTIs and UTIs. By performing this qualitative study, we will have a better understanding of community pharmacists’ views on barriers and facilitators to advising patients on using herbal medicines for acute RTIs and acute UTIs.

Local Investigators: Martin Logue, Dr Xiao Yang Hu

Study team: Martin Logue, Dr Xiaoyang Hu, Prof Mike Moore. Dr Merlin Wilcox, Dr Miriam Santer, Judy Chatwin

Funder: NIHR SPCR

Duration: 2019 -2020

Contact: martin.logue@soton.ac.uk; X.Hu@soton.ac.uk

Related research groups

Primary Care Research group
Primary Care & Population Sciences
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