Community pharmacists' knowledge, attitude and practices towards the use of complementary and alternative medicines in Durban, South Africa

Background: Atopic eczema (AE) is a common skin disease with an increasing worldwide prevalence, which has almost doubled over the last decade in South Africa. Many patients commonly explore complementary and alternative medicines (CAM) for AE and often initially seek advice from their local pharmacists. Aim: To explore the knowledge, attitude and practices amongst community pharmacists regarding CAM. Setting: The study was conducted amongst pharmacists working in community pharmacies in Durban, South Africa. Methods: During 2016, a cross-sectional study was conducted amongst 158 randomly selected pharmacists, of which 82 responded. Respondents were sent an email with a link to the questionnaire. Where logistically possible, questionnaires were hand-delivered. Results: The majority of respondents were male (n= 46; 56%), aged between 31 and 40 years. Despite most pharmacists not being familiar with various CAMs for AE, many (43%) recommend them, and 50% were amenable to referring patients to CAM practitioners. Despite 51% reporting that patients do ask about CAM for AE, 54% are not confident discussing or initiating discussions with patients. More than half of the pharmacists (55%) had no CAM training but believed it is essential for inclusion in the undergraduate pharmacy curriculum. Most were interested in broadening their knowledge on CAM and felt it would better prepare them in counselling their patients. Conclusions: The study demonstrated poor knowledge and communication about CAM for AE between pharmacists and patients, although pharmacists exhibited strong interests in learning more about CAM. There is a continuing need for education programmes and inclusion into undergraduate curricula that would assist pharmacists to advise patients on different types of CAMs

Impact of atopic dermatitis on the quality of life of Nigerian children: a hospital-based cross-sectional study

Background. Atopic dermatitis (AD) is the most common inflammatory skin disease in childhood. A skin disorder with a relapsing course,AD exerts a significant disease burden on affected children. However, there is a dearth of knowledge about the impact of AD on the quality of life (QOL) of affected children in Nigeria.Objectives. To examine the impact of AD on QOL in children of various age groups, and to identify the relationship between patient variables (age, gender, socioeconomic status), disease severity and QOL in AD.Method. This was a cross-sectional descriptive study of children with AD attending the dermatology clinic of Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria. AD cases were recruited from new paediatric patients ≤16 years who attended the clinic over a 6-month period. English and Yoruba versions of the Infants' Dermatitis Quality of Life Index (IDQOL) and the Children's Dermatology Life Quality Index (CDLQI) were used to determine the QOL of the subjects. AD severity was evaluated using the Objective SCORing ofAtopic Dermatitis (obj-SCORAD) index.Results. Forty-seven subjects with AD were identified. Their ages ranged from newborn to 16 years. The median(interquartile range (IQR))IDQOL score was 6.0 (3.0 - 15.5; n=25), and the median (IQR) CDLQI score was 9.5 (7.75 - 17.75; n=22). The mean (standard deviation)obj-SCORAD score was 34.4 (17.2). The question on itching was the highest-scoring question in both QOL questionnaires. There was no significant difference in QOL across age, gender and socioeconomic status groups. However, greater QOL scores were significantly correlated with higher AD severity scores.Conclusion. The study confirms that AD impairs the QOL of affected children in all age groups. QOL assessments are relevant tools which provide a patient's perspective, thus improving the understanding of the impact of AD on afflicted individuals