title: Drug interaction between oral contraceptives and St. John's Wort: appropriateness of advice received from community pharmacists and health food store clerks.
abstract: OBJECTIVE
  To estimate the extent to which community pharmacists and health food store clerks provide appropriate advice regarding a drug interaction between oral contraceptives and St. John's wort (SJW).
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Three community pharmacy chains and three health food store chains in four highly populated counties in California.
  
  
  METHODS
  Community pharmacists (n=99) and health food store clerks (n=84).
  
  
  METHODS
  Investigators, posing as consumers, telephoned pharmacists and health food store clerks and asked the following question: "Is there a problem with taking SJW with birth control pills?"
  
  
  METHODS
  Respondents were classified based on their ability to correctly identify the drug interaction (yes or no) and on the overall appropriateness (i.e., the absence of incorrect advice) of their advice. Comparisons were made between men and women respondents and between pharmacists and health food store clerks.
  
  
  RESULTS
  Community pharmacists were more likely than health food store clerks to correctly identify the drug interaction (50.5% versus 10.9%; Xchi(1 df) = 54.32, P < 0.001). Overall, 31.8% of respondents provided inappropriate advice that implied the absence of a drug interaction (26.3% of 99 pharmacists and 34.8% of 184 health food store clerks; Xchi(1 df) = 2.15, P = 0.14). Appropriateness of advice varied significantly among the three pharmacy chains (P < 0.001) and the three health food store chains (P < 0.05). Responses did not differ by gender of respondents (P = 0.18).
  
  
  CONCLUSIONS
  Lack of awareness of the potentially serious drug interaction between SJW and oral contraceptives by those who sell these products places the public at risk. Training and education, more comprehensive product labeling, and policies to refer consumers to drug information centers are needed.
authors.affiliation: School of Pharmacy, University of California-San Francisco, CA 94143-0622, USA.
authors.forename: Lord V
authors.initials: LV
authors.lastname: Sarino
authors.forename: Kristy H
authors.initials: KH
authors.lastname: Dang
authors.forename: Nahal
authors.initials: N
authors.lastname: Dianat
authors.forename: Hera
authors.initials: H
authors.lastname: Djihanian
authors.forename: Neda
authors.initials: N
authors.lastname: Natanian
authors.forename: Karen Suchanek
authors.initials: KS
authors.lastname: Hudmon
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Ambrose
mesh_terms: D002140:California; D003276:Contraceptives, Oral / Q000009:adverse effects*; D019587:Dietary Supplements / Q000009:adverse effects*; D004347:Drug Interactions; D058870:Food, Organic; D006801:Humans; D020902:Hypericum / Q000009:adverse effects*; D010594:Pharmacies; D010595:Pharmacists
chemical_list: D003276:Contraceptives, Oral