Table 6 Quotes from participants regarding the feasibility of the framework

Practical local barriers need to be addressed

1

Oh. I think it’s a very nice framework in an ideal world, and if we are provided with tools and training and the resources to train the staff, I would be very happy to have that in the pharmacy. (D2P2-F)

2

I feel like it would be really helpful if there was a better database to look up interactions and all that type of thing because more often than not, I have to call either the company or look into it really far to make sure it doesn’t interact. So maybe extra training in that area like compulsory training, I guess. (D3P4-I)

3

So I think, honestly, I would just be keen to try it out in the shop and see how it actually works. But it’s sort of one of those questions. If you change the framework and require pharmacies to do something, some sort of fundamental change in how we provide advice, would that open up the space for a new database to actually provide some money so someone would actually make it? Would that then mean that companies looking to get their products into pharmacy would put more emphasis on evidence and therefore training? So pharmacists wouldn’t have to be doing these trainings. You’re going to get detailed by companies that are looking to get the best, most evidence-based product into your stores. (D5P9-F)

Additional training is needed and this is an opportunity

4

I’ve got 30 staff, and the idea that there could be more specialised training for people that have that interest [in evidence-based complementary medicines] and that could be another avenue for non-pharmacists into pharmacy careers. Immediately, that’s more attractive than going to work at Woolies [a large supermarket chain], where they just sell the stuff en mass for profit. How would that not be a good thing when we’ve copped a lot of bad press about some pharmacists? So yeah, definitely. I would be very interested to see if this framework allowed for more of that. (D5P9-F)

The potential role of practitioner-only lines

5

Well, I feel like there should be, I guess, a shift away from the front-shop selling. So just to distinguish pharmacy from the health food store, so other things that people just see on TV or things that people can buy without talking to a pharmacist or talking to someone that’s been trained in complementary medicines. So there’s the idea of what we’ve got, the pharmacy, with labelling it, even though it’s not necessarily a dangerous product, but just something that at least requires a consult from the first go. Not every time but just from the initial, first-selling to them so they know exactly why they’re taking it, rather than just they’ve been taking it for 10 years. And if we said, “Well, this is a better product, a better form of calcium or whatever it might be,” at least that way they can think of their complementary medicines along the same lines as their regular medications. So they still put some value on it, and they don’t just look for the cheapest option or the most convenient, necessarily, but something that they get more value out of. (D7P11-F)

Large-scale system change is needed

6

…[G]etting all the pharmacies on the same page. If you’ve got pharmacies that are run by corporations and banner groups that are more for-profit versus small community pharmacies that are trying to provide a service. You’ve got to have these frameworks that are enforceable, maybe through QCPP [Quality Care Pharmacy Program] or a PBS [Pharmaceutical Benefits Scheme] listing, and make sure that everyone does the same things and stocks the same products and doesn’t stock the same products based on evidence. (D7P12-F)

7

The next thing, I think, would be TGA [Therapeutic Goods Administration]. If they’re approving it, but then it’s not evidence based, then consumers will get confused because they would say, “Oh, but then it’s approved by TGA, so it must be all right or evidence based.” (D10P17-I)

8

Why should it be up to us as pharmacists? Why shouldn’t the TGA—when it goes to them in the first place to be approved, why is it even getting to us? Why are we required to make the decision? Why haven’t TGA done their job? (D5P7-F)