Assessments of herbal medicine counseling practices, barriers, and information resource needs in community pharmacy settings

Abstract

The use of herbal medicines in Indonesia continues to rise; however, community pharmacists infrequently engage in patient counseling or documentation related to herbal medicine use. Strengthening pharmacists’ capacity through continuing professional education and improved access to reliable, evidence-based information may enhance the quality of pharmaceutical care involving herbal products. Objective: This study aimed to assess pharmacists’ practices regarding the discussion and documentation of herbal medicine use in community pharmacies, identify barriers to counseling, and evaluate information resource needs to support herbal medicine–related public health services. Methods: A cross-sectional survey was conducted using a validated structured questionnaire among pharmacists working in community pharmacies, recruited through convenience sampling. Data were analyzed using descriptive statistics, Chi-square tests, and Spearman’s correlation, with statistical significance set at p < 0.05. Results: A total of 451 pharmacists participated. Most reported occasionally discussing herbal medicine use with patients (51.0%), while 3.1% never did so. Documentation followed a similar pattern, with 33.5% recording occasionally and 14.6% never documenting. Discussions were more often patient-initiated (37.7%) than pharmacist-initiated (29.3%) and were commonly brief (25.9%). Although 94.0% of pharmacists expressed interest in discussing herbal medicines, practice remained limited. The most frequently reported barriers were time constraints (42%), insufficient knowledge (21%), limited scientific evidence (20%), and lack of reliable information sources (13%). Most pharmacists had access to herbal information at their workplace (87.6%) and herbal products were widely available (88.9%). However, evidence-based databases were rarely used, with websites and brochures being the most common information sources. Access to information and prior training were significantly associated with more frequent counseling and documentation, while herbal product sales and weekly working hours showed no significant associations. A moderate positive correlation was observed between discussing and documenting herbal medicine use (ρ = 0.563). Conclusion: Enhancing pharmacists’ counseling and documentation practices related to herbal medicines will require expanded continuing education opportunities, improved access to credible, evidence-based information resources, and the development of national guidelines and digital decision-support tools. Such measures are essential to support consistent, safe, and evidence-informed pharmaceutical services in community pharmacies across Indonesia.

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