Herbal and traditional medicine use in Jordan: Pharmacological interactions and safety concerns - A quantitative study among clinical pharmacists

The use of herbal and traditional medicine (HTM) is widespread among people in Jordan and is often perceived by users as a natural and harmless substitute for modern medicine. However, HTMs may have significant pharmacologic risks and, without professional assessment, may potentially lead to drug-herb interactions and endanger patients' health. Owing to their expertise in pharmacotherapy, clinical pharmacists are the professionals that are perfectly designed to identify, prevent or manage these interactions. The objective of this study was to assess the knowledge, attitudes and practices (KAP) of Jordanian clinical pharmacists regarding HTMs, especially those that relate to drug-herb interactions and safety aspects. A questionnaire-based, multi-centre cross-sectional study was conducted by distributing emails to 210 clinical pharmacists working in hospitals and health centres across Jordan.The descriptive statistical analysis was used in the evaluation of the answers. Response rate to the survey was 88.6 % (n = 186 pharmacists). Nearly 78 % encounter patients consuming herbals, but only one third (35 %) feel comfortable identifying herb-drug interactions. The most familiar interactions were St. John’s Wort, Ginkgo biloba and garlic with anticoagulant or antiplatelet medications. Notably, 60 % of pharmacists had no formal education in herbal pharmacology, but 71 % agreed to include this subject in continued education. Pharmacists frequently interact with patients using HTMs but often lack the knowledge or resources to provide safe clinical care. Such findings indicate that some educational curricula and national programs are required for clinical pharmacists to manage risk related to herbal medicine use.