Objective: To characterize pharmacists’ personal and professional beliefs and practices regarding herbal (H) and other natural products (ONPs).

Design: Cross-sectional mail survey of Indiana community pharmacies.

Methods: Of the 1252 registered Indiana community pharmacies, one-half were selected using a systematic random process. Questionnaires were mailed to the 626 selected pharmacies asking one staff pharmacist to complete a 31-item questionnaire.

Results: A total of 452 pharmacists responded to the questionnaire, providing a 72.2% response rate. Slightly more than a one-third of pharmacists were regular or sometime users of herbals (36.7%) and ONPs (34.3%). The primary reason respondents gave for using H/ONPs was to treat a disease/medical condition. The overwhelming majority (90.5%) of pharmacists indicated that they received questions weekly on H/ONPs from patients/customers. Like pharmacists, the primary reason patients/customers gave for using H/ONPs was to treat a disease/medical condition. Less than one-fourth (22.3%) of pharmacists generally recommend herbals and one-third (33.4%) recommend ONPs to their patients/customers. However, the majority of pharmacists felt that customers/patients expected them to recommend herbals (61.6%) and ONPs (60.8%) for certain uses. The overwhelming majority of pharmacists felt that herbals (74.5%) and ONPs (71.2%) were not efficacious and that herbals (73.7%) and ONPs (71.1%) were not safe and that herbals (84.1%) and ONPs (83.6%) were not worth the price paid. Still, less than one-fourth of pharmacists felt satisfied with their knowledge level of herbals (22.7%) and ONPs (19.4%). Eight-two pharmacists (18.1%) wrote, often powerfully, in the Comments section about the need for more product information and stiffer control over product quality and marketing.

Conclusions: Resurgence of consumer use of H/ONPs has resulted in an increased need for evidence-based information on these products. This study indicates that pharmacists are increasingly being used as information sources on H/ONPs. Still pharmacists strongly desired more information about these products. These results confirm the need to provide pharmacists with additional education on H/ONPs and allows for the development of appropriate health educational measures to train these healthcare professionals.