Pharmacy Practice & Complementary Medicine

Exploring the Interface Between Complementary Medicine and Community Pharmacy in Malaysia: A Survey of Pharmacists

Abstract and Background

The use of complementary medicine (CM) is on the rise worldwide, and Malaysia is no exception. In the Malaysian healthcare landscape, CM products are widely available as over-the-counter products in community pharmacies, and consumers increasingly expect pharmacists to be knowledgeable about these products. However, prior to this study, little was known about Malaysian community pharmacists’ attitudes towards CM, their knowledge of evidence-based CM, or the extent to which CM has been integrated into routine community pharmacy practice.

This cross-sectional study, conducted by researchers from Universiti Kebangsaan Malaysia and the Blackmores Institute in Australia, aimed to investigate the extent of CM integration into community pharmacy practice in Malaysia. Specifically, the researchers sought to characterise pharmacists’ attitudes towards CM, their role in recommending CM products, their knowledge of the evidence base for commonly used CM, their further education and training needs, and their awareness of reliable CM information sources.

Methodology

Ethics approval was obtained and a pilot study was conducted to validate the survey instrument. After amendments, community pharmacists across Malaysia were invited to complete a 41-item paper-based or web-based questionnaire. The survey was distributed through the Malaysian Pharmaceutical Society (MPS) and promoted through professional networks and social media platforms. Data collection took place through December 2015, with consent implied upon completion and return of the questionnaire. Descriptive analysis was performed using SPSS for Windows version 20.

The questionnaire addressed several domains including current CM practices, attitudes towards CM integration, knowledge of specific CM evidence, education and training needs, and information-seeking behaviours. The instrument drew on similar surveys conducted in Australia, the United Kingdom, and the United States, adapted for the Malaysian context.

Key Results

Current Practice Patterns

The study revealed that Malaysian registered pharmacists do not routinely ask customers about CM use as part of their standard patient interactions. Only a small proportion (3%, n=14) had formal qualifications in CM, such as certification as an Ayurvedic practitioner or similar credentials. Despite this, the majority of pharmacists reported encountering customer enquiries about CM products and supplements on a regular basis, indicating a gap between consumer expectations and pharmacist preparedness.

Attitudes and Interest

Community pharmacists in Malaysia demonstrated a positive attitude towards CM and expressed strong interest in learning more about evidence-based CM. A substantial majority of pharmacists viewed CM as having a legitimate role in healthcare, consistent with findings from similar surveys conducted among pharmacists in Singapore, the United States, and Australia. Pharmacists recognised their unique position at the interface between conventional medicine and CM, given their accessibility to the public and their training in pharmacology and drug interactions.

Knowledge and Education Needs

Almost all respondents (94%) acknowledged the need for additional CM education for pharmacists. When asked about factors influencing their recommendations, 65% of pharmacists indicated that the evidence base was a key consideration when recommending CM products to customers. Other factors they considered included customer preference, product quality and safety, and potential interactions with conventional medications.

The preferred format for CM training was continuing professional education sessions of one to two hours duration. The majority of pharmacists favoured education programmes that were practical, clinically oriented, and delivered through trusted professional organisations. The results were broadly comparable to findings from pharmacist surveys in the United Kingdom, United States, and Australia, though some differences in knowledge levels and practice patterns were noted.

Information Sources

The Malaysian Pharmaceutical Society was the most frequently cited source (52%) for CM information among respondents. Other information sources included academic databases, product manufacturer information, and international professional bodies. The findings highlighted an opportunity for Malaysian pharmacy professional bodies to play a more active role in curating and disseminating high-quality CM evidence.

Implications for Practice and Policy

The study’s findings have significant implications for pharmacy practice and health policy in Malaysia, particularly in light of the Malaysian Complementary Medicine Act 2016 and the growing integration of traditional and complementary medicine into the national healthcare system. Community pharmacists, as the most accessible healthcare professionals in many communities, are well-positioned to serve as a bridge between conventional and complementary medicine, provided they receive adequate training and support.

The recognition that pharmacists need structured CM education aligns with the broader Malaysian National Health Policy emphasis on integrating traditional and complementary medicine safely into the healthcare system. The development of standardised CM continuing professional education programmes, potentially modelled on successful programmes from Australia and the United Kingdom, could significantly enhance the quality and safety of CM-related advice provided through community pharmacies.

Limitations

The study relied on self-reported data, which may be subject to response bias. The response rate, while adequate for the analysis, may not fully capture the views of pharmacists who are less engaged with professional society activities or continuing education. The survey was limited to community pharmacists and did not include hospital pharmacists or pharmacists in other practice settings. Additionally, the study did not directly assess pharmacists’ actual CM knowledge through objective testing, relying instead on self-assessment of confidence and competence.

← Back to MJPHM Homepage