First comprehensive contribution to medical ethnobotany of Western Pyrenees

<p>Abstract</p> <p>Background</p> <p>An ethnobotanical and medical study was carried out in the Navarre Pyrenees, an area known both for its high biological diversity and its cultural significance.</p> <p>As well as the compilation of an ethnopharmacological catalogue, a quantitative ethnobotanical comparison has been carried out in relation to the outcomes from other studies about the Pyrenees. A review of all drugs used in the area has also been carried out, through a study of the monographs published by the institutions and organizations responsible for the safety and efficacy of medicinal plants (WHO, ESCOP, and the E Commission of the German Department of Health) in order to ascertain the extent to which the Navarre Pyrenees ethnopharmacology has been officially evaluated.</p> <p>Methods</p> <p>Fieldwork was carried out over two years, from November 2004 to December 2006. During that time we interviewed 88 local people in 40 villages. Information was collected using semi-structured ethnobotanical interviews and the data was analyzed using quantitave indexes: Ethnobotonicity Index, Shannon-Wiener's Diversity, Equitability and The Informant Consensus Factor. The official review has been performed using the official monographs published by the WHO, ESCOP and the E Commission of the German Department of Health.</p> <p>Results</p> <p>The ethnobotanical and medical catalogue of the Navarre Pyrenees Area comprises 92 species, of which 39 have been mentioned by at least three interviewees. The quantitative ethnobotany results show lower values than those found in other studies about the Pyrenees; and 57.6% of the Pyrenees medical ethnobotany described does not figure in documents published by the above mentioned institutions.</p> <p>Conclusion</p> <p>The results show a reduction in the ethnobotanical and medical knowledge in the area of study, when compared to other studies carried out in the Pyrenees. Nevertheless, the use of several species that may be regarded as possible sources for pharmacological studies is reported here such as the bark of <it>Sambucus nigra</it>, the roots of <it>Fragaria vesca</it>, or the leaves of <it>Scrophularia nodosa</it>. These species are not currently approved by the WHO, ESCOP and the E Commission of the German Department of Health, institutions that, apart from encouraging the greater use of plants for medicinal purposes, may help in the design of development plans for these rural areas by validating their traditional medicine.</p

Psychosocial and behavioural determinants of the implementation of Pharmaceutical Care in Spain

Objective We aimed to gain greater understanding of the implementation of the Pharmaceutical Care (PhC) initiative in Spain. Our investigation was underpinned by Prochaska and Di Clemente’s stages of change model. We also used the A.S.E. (Attitude, Social influence and self-Efficacy) Model to identify the psychosocial determinants of this professional behaviour. Setting Spanish community pharmacists. Method A validated questionnaire was sent to all community pharmacists registered on a national database and 1,977 (10.3%) responded. The questionnaire assessed stage of change regarding the implementation of PhC and the psychosocial determinants of this professional behaviour. Data were analyzed using descriptive statistics. Kruskal–Wallis and Mann–Whitney U tests were used to compare psychosocial determinants according to stage of change. The profile of community pharmacists who had implemented PhC was identified through logistic regression analysis. Main outcome measures: attitude, social influence, self-efficacy, motivations, needs and stages of change to perform PhC. Results Some respondents (n = 228; 11.8%) had adopted PhC, and were, thus, in the action or maintenance stage. The mean A.S.E. determinants scores increased significantly by stage i.e. from “precontemplation” to “action”: attitude (0.28 vs. 0.99), social influence of people (2.61 vs. 3.07), and self-efficacy (2.74 vs. 3.61). Conversely, most needs were highlighted by precontemplators (3.66 vs. 347.). Variables significantly associated with the probability of implementing PhC were: having undertaken appropriate training (OR: 13.92; CI 95%: 5.37–36.08); self-efficacy (OR: 3.19; CI 95%: 2.38–4.28), having assistant pharmacists (OR: 1.70; CI 95%: 1.02–2.80) and positive attitude (OR: 1.03; CI 95%: 1.01–1.04). The A.S.E. determinants were the best predictors of PhC implementation according to the regression model. Conclusion The implementation of PhC among Spanish community pharmacists appears to be relatively low. Strategies to move pharmacists should be adapted to stage: focussed on emphasizing advantages at initial stages and facilitating training courses, guidelines and communication to professionals at intermediate and advanced stages