The Scientific Review of Alternative Medicine

An Investigation of Pharmacists' and Health Food Store
Employees' Knowledge about and Attitudes toward Kava

Authors:
Ian C. Webb, MA
Jennifer E. Chatterton, BA
Barry L. Beyerstein, PhD
Department of Psychology, Simon Fraser University

Background:
This study evaluated the information provided to potential clients by pharmacists and health food retailers regarding the herbal medication kava. Previous studies in which informants knew they were being evaluated by professionals suggest that pharmacists' and health food retailers' knowledge of the uses and risks of herbal remedies is often incomplete and/or erroneous. Suspecting that respondents might be even less cautious in the assertions they make to nonprofessionals when there was also a financial interest in making a sale, we thus undertook, by posing as inquisitive students and potential customers, to assess the accuracy of the information provided by retail staff. Questions concerned the applications, side effects, and associated risks of kava.

Methods:
Information was collected in a structured but conversational manner from personnel in 30 health food stores and 28 pharmacies in order to compare the quality of product information provided in these 2 types of outlet. Trained interviewers asked 5 open-ended questions concerning kava at each site visited, recording the answers from memory immediately upon leaving the premises.

Results:
Pharmacists and health food store employees suggested similar conditions that might be treated with kava (mostly sedative-related uses), but pharmacists made fewer claims for the benefits of kava and were more cautious with regard to assertions of safety. Pharmacists were more likely to claim that use of kava might result in undesirable side effects, whereas health food employees were particularly likely to deny even the possibility of adverse effects. While no pharmacist suggested that kava is better than relevant prescription medications, the majority of health food store employees asserted that kava is superior. Overall, the level of caution advised by both groups was inconsistent with available research data regarding safety and efficacy of kava.

Conclusion:
The level of misinformation provided by both pharmacists and health food store employees, but especially the latter, was high enough to raise the concern that the public may be subject to advice that could possibly result in both waste of money and adverse health consequences for would-be herbal product users.