The Safety of Herbal Medicines (Phytovigilance) from Community Pharmacists' Perspective: A Cross-Sectional Study.

Objectives: The "safe if natural" perception of herbal products may have several undesirable side effects. It is important to raise awareness in public order to change this perception and ensure safer use of herbal products. The role of pharmacists is to supply herbal medicines safely and to provide accurate information to the patients about herbal products. The aim of this study was to analyze the perspective, knowledge, attitude, and behavior of community pharmacists about phytovigilance. Materials and Methods: A cross-sectional analysis was performed using community pharmacists (n= 879) using face-to-face surveys between April-June 2019 in Istanbul. For statistical analysis, student's t-test and one-way ANOVA were used to compare the mean values of the groups. Results: It was determined that 58.1% of the pharmacists heard phytovigilance for the first time and 93.5% of them had not reported any safety-related herbal medicine reported so far. Among the reasons for not reporting, well-known adverse reactions were found to be 24.2% and the difficulty of reporting was found to be 21.8%. 84.6% of pharmacists have never received training related to phytovigilance. It was found that pharmacists with a working experience of more than 20 years primarily selected herbal products provided in their pharmacy based on the manufacturing company primarily, whereas others selected based on the efficacy of the products. Conclusion: The results of this study have revealed the necessity to increase training on the safety of herbal medicines to cover all stakeholders and to give due importance to phytovigilance. The phytovigilance systems established in some countries for public health should be expanded to other countries. There is a need for a more user-friendly reporting system to increase adverse reaction reporting by pharmacists and other healthcare professionals. In the future, plan to perform studies to raise awareness in the public and promote reporting with digital technologies.