Introduction

A dietary supplement, also known as food supplement or nutritional supplement is defined as a product that is intended to be used as an adjunct to a diet, contains one or more dietary ingredients such as vitamins, minerals, trace elements and substances such as enzymes. Dietary supplements can also be extracts or concentrates, and may be found in many forms such as tablets, capsules, softgels, gelcaps, liquids, or powders. Today many supplements contain herbs and amino acids as well. Herbal supplements come from plants or parts of plants, such as seeds or flowers. Currently, a wide variety of dietary or nutritional supplements are marketed to address the dietary needs of many individuals or specific health needs such as cardiovascular health (for elderly), prostate health (for men), protection against osteoporosis (primarily for women) or for general health. These products are often used by customer or patients with or without certain medical conditions. In addition, many customers/patients with busy schedules also utilize these products as a practical and healthier substitute to skipping meals and manage their diet in daily life.

Community pharmacys background

Sentral Pharmacy was established in 2004 by 2 pharmacists, who were course-mates in an abroad university in UK and both were registered pharmacist and member of Malaysian Pharmaceutical Society (MPS). This pharmacy premise takes the important step to instill the value of pharmacist in healthcare profession by providing 15 hours 6 days (9am-12 midnight) full time pharmacist service, providing free counseling service and blood pressure checking service. Both pharmacists have no nutritional education background but learned from booklet or sale representative that come every month to introduce new product to their pharmacy. Sentral pharmacy is selling prescription and non prescription medications, OTC products and other healthcare products including dietary supplements. All products are registered under MOH to ensure they are providing safe, high quality and effective healthcare products to meet customer needs.

The location of the premise and groups of customer

As the name implies, Sentral Pharmacy is located at Chow Kits business area near the cross junction. It is situated in front of popular 24 hour-based convenience store and was not far from KFC. Based on this position and as told by the pharmacist herself, the customer is comprised of people who are living, working or shopping within the surrounding areas and some come from outside area. There are three main groups of people who come to this community pharmacy. The first one is the employees of government sector, private sector and shop local/foreign workers who work at that area or even come from the other place like Setapak area because this premise is still opened till midnight. This group usually often asks for supplements for themselves and their family members. The second group is individuals and families who seek for health products. Sometimes this group of customer came to 7-eleven first to look for health products and they will go to this premise once they have been told by the cashier to go to retail pharmacy nearby. The last group is foreigner customer, during this attachment there was quite a lot of foreigner customer asking for pharmaceutical products. The foreigner group may not the permanent customer but the strategic location makes it easy to be found by this group of people who is travelling from one place to another. These three groups of customer are often come from nearby restaurants, shops and supermarkets. In addition, there was no other competitor located around that area.

The services that are provided by community pharmacy regarding the use of supplements Sentral Pharmacy provides counseling service to the customers in making the proper choice of supplements by assessing the patients' medical history and screening patients' drug profiles for potential drug interactions and contraindications. The pharmacist told us that pharmacists are in a key position to identify possible drug interactions with certain vitamins and minerals and to make clinical recommendations to physicians when needed. For example pharmacist should screen all patients for potential contraindications and/or drug-drug interactions, especially those on anticoagulant therapy, because some dietary or nutritional supplements contain vitamin K.

The pharmacist said that there are three supplement products (i.e. Blackmores, Kordels and Abott) that are always recommended to their customer. She said that those products that come from these three types of companies are easily absorbed by body. For Appeton and Vita Health products, pharmacist told that these products are already advertised to the public via newspaper or television so counseling service only will be given for those customers who need to be counseled by pharmacist. Mostly, she will recommend supplements and other products for those customers who come with prescription in order to enhance their treatment. For example she recommends the use of fish oil and Coenzyme 10 in hypertensive patient, SugarBal in diabetic patient and Celery 7000 for gout patient. The pharmacist said that patients who are using supplements should be advised to take only the recommended dosage and can take the supplement 1-2 hours after taking their medication. She informs her customer to only use the recommended amount of a supplement, because excessive amounts of some vitamins and minerals can product adverse effects or worsen some disease condition such as heart failure. In addition, she tells her customer the importance of incorporating a balanced nutrition plan into their daily routine and asks her customer to registered dietitians when necessary.

Products storage (Supplement/vitamin/food products)

There was no particular storage needed to store these products because they are not fastmoving products or important product like prescribed drugs. So the pharmacist usually calls the seller agent once there is only one or two products left on the shelves. The most expensive products such as sheep placenta with grape seed oil and birds nest white coffee are neatly arranged in a locked display cabinet and cannot be accessed by customers. All products are arranged systematically based on product brands such as Blackmores, Kordils, Appeton and VitaHealth are arranged at different shelve. However there were some products like proteinbased products, traditional medicines or supplement that consisted of different brands/companies are mixed together with the other.

Reflections From my point of view, this attachment is very important to me in selecting dietary or nutritional, vitamin, mineral and herbal supplements and to provide counseling on their proper use. As a pharmacist, we should able to address the needs of those customers or patients with certain medical conditions or those currently taking specific medications.