Study: Why pharmacists don't recommend your supplement

Key takeaways

‍• A study 102 pharmacists surfaced how pharmacists recommend  supplements.

• Experienced pharmacists are more likely to recommend supplements overall.

• Only 8.7% of senior pharmacists used systematic reviews vs 32.1% of juniors.

• 67.4% of senior pharmacists relied on educational programs.

A 2021 cross-sectional study of 102 pharmacists revealed a counterintuitive problem: pharmacists scored high on dietary supplement knowledge tests, but their recommendation decisions weren't driven by evidence. Instead, personal experience was the strongest predictor.

Senior pharmacists rarely used systematic reviews or clinical trials when choosing supplements to recommend. Less experienced pharmacists used better sources but still relied heavily on product labels. For supplement brands, this means rethinking education strategy entirely, moving beyond clinical data dumps toward experiential learning, peer influence, and making evidence accessible in the moment of decision.

The problem isn't knowledge — it's trust in experience over evidence

If you're a supplement brand investing heavily in clinical trials, peer-reviewed studies, and scientific marketing materials, here's an uncomfortable truth: most pharmacists won't use them when recommending your product to customers.

A study published in Pharmacy Practice examined how 102 community pharmacists in used, perceived, and made decisions about dietary supplements.

Researchers split pharmacists into two groups:

1. Those with less than 10 years of experience.
2. Those with 10 or more years.

Both groups scored high on general knowledge tests about supplements. The median score was 10-11 out of 14 possible points, with no significant difference between groups. But when researchers looked at what sources pharmacists actually consulted when choosing supplements to recommend, knowledge didn't predict behavior.

1. Personal use was the single strongest predictor of whether a pharmacist would recommend a supplement. Pharmacists who had used a supplement themselves were significantly more likely to recommend it to patients. The odds ratio was 0.216 with a 95% confidence interval, meaning the effect was statistically robust.
2. Work experience was the second strongest factor. More experienced pharmacists were more likely to recommend supplements overall, regardless of the evidence base. The odds ratio for work experience was 0.154.

This creates a strategic problem for brands. You can publish all the double-blind placebo-controlled trials you want. You can fund systematic reviews and meta-analyses. But if pharmacists haven't personally experienced your supplement working, or if they've had negative experiences with similar products, evidence alone won't move the needle.

Why senior pharmacists skip the research

Here's where things get more interesting. Less experienced pharmacists used higher-quality evidence sources significantly more often than their senior colleagues.

When choosing supplements, 32.1% of pharmacists with less than 10 years of experience consulted systematic reviews or meta-analyses. Among pharmacists with 10 or more years of experience, only 8.7% used these sources. That's nearly a four-fold difference.

Reports from randomized clinical trials showed a similar pattern:

• 32.1% of junior pharmacists versus 15.2% of senior pharmacists.
• Meanwhile, 67.4% of senior pharmacists relied on educational programs as information sources, compared to 46.4% of junior pharmacists.

The problem?

Educational programs aren't primary sources. They're not peer-reviewed, and they don't always include critical appraisal of evidence. They can be influenced by sponsorship, marketing, or the presenter's personal biases.

Senior pharmacists also used product labels far less frequently than junior pharmacists (21.7% versus 57.1%). But this isn't necessarily better — it likely reflects confidence built from years of experience rather than engagement with current evidence.

The researchers attributed these differences to pharmacy education.

Younger pharmacists graduated after evidence-based medicine became standard curriculum. They learned how to search databases like PubMed, evaluate study quality, and apply findings to practice. Senior pharmacists often missed this training entirely. Their degrees predated the evidence-based practice movement.

For supplement brands, this suggests two distinct audiences with different needs.

• Junior pharmacists want access to good evidence but may lack time or context to apply it.
• Senior pharmacists have decision-making confidence but may not know how to find or evaluate current research — or may not see the need.
  

The accessibility problem: Evidence is hard to use in the moment

Even when pharmacists want to use evidence, practical barriers get in the way.

Studies from Malaysia, Yemen, and Saudi Arabia (referenced in the research) identified common obstacles to evidence-based practice among pharmacists:

• Lack of time
• Limited access to high-quality sources
• Language barriers in non-English-speaking countries
• Insufficient skills in critical appraisal of literature

The pharmacist has maybe 2 to 5 minutes to respond

Community pharmacists work in fast-paced retail environments. A customer asks for a recommendation. The pharmacist has maybe two to five minutes to respond. They're not going to pull up PubMed, read through abstracts, evaluate methodology, and synthesize findings on the spot.

Instead, they rely on what's most accessible: memory, past experience, product labels, or advice they heard at a recent continuing education event.

The study found that 73.2% of junior pharmacists and 58.7% of senior pharmacists said they used databases like PubMed as information sources. But this likely reflects aspirational behavior — what they believe they should do — rather than what happens during actual customer interactions.

In a separate Australian study mentioned in the research, simulated patient visits to community pharmacies revealed significant shortcomings in complementary and alternative medicine recommendations. Pharmacists often recommended products with unproven efficacy and safety. The gap between stated practice and observed behavior was substantial.

This has major implications for how brands deliver education. Traditional approaches — white papers, clinical study summaries, detailed monographs — assume pharmacists have time and motivation to read and synthesize information. In reality, they need decision support that works in the moment, when a customer is standing in front of them.

What actually changes recommendations: The experience gap

The study revealed something brands often miss: pharmacists' decisions aren't purely rational or evidence-based. They're experiential and social.

• 81 out of 102 pharmacists (79.4%) had used dietary supplements at some point in their lives.
• 69 (67.6%) had used them in the past year.
• 38 (37.3%) had used them in the past month.
• Only 9 pharmacists (8.8%) reported experiencing adverse effects.

This high rate of personal use creates a perception problem. When pharmacists use supplements themselves without experiencing problems, they may perceive them as universally safe. They may discount risks for specific patient populations — people taking warfarin who shouldn't use ginkgo, for example, or elderly patients at higher risk for drug-herb interactions.

The researchers noted that pharmacists who used supplements were significantly more likely to recommend them. This makes intuitive sense. If something worked for you, you trust it. You have a story to tell. You can speak from experience rather than citing studies.

But personal experience is unreliable

It's subject to placebo effects, regression to the mean, confirmation bias, and small sample sizes (n=1). A supplement that worked for one pharmacist might be ineffective or even harmful for a patient with different genetics, medications, or health conditions.

For brands, this suggests a controversial strategy: experiential education may be more effective than evidence-based education. Instead of sending pharmacists study reprints, consider sampling programs, trial periods, or structured self-experimentation protocols that help them build positive personal experiences with your products.

This doesn't mean abandoning evidence. It means pairing evidence with experience. Give pharmacists both the clinical data and the opportunity to see results firsthand.

Rethinking supplement education for pharmacists

Based on the study findings, here's what doesn't work: Publishing more research, creating detailed product monographs, hosting webinars that lecture about study methodology, assuming knowledge translates to behavior change.

Here's what the evidence suggests might work better:

Make evidence accessible in the workflow

Pharmacists need just-in-time information, not comprehensive references. Create mobile-friendly decision tools that surface key points instantly: primary indication, typical dose, major interactions, contraindications, and a one-sentence summary of evidence quality.

Think about how pharmacists actually work. They're standing at a counter, a customer is asking questions, and they need an answer now. Your education needs to fit that reality.

Train through cases, not data

Instead of presenting clinical trial results, present patient scenarios. "A 55-year-old woman on a statin asks about XYZ. What do you recommend and why?" Let pharmacists work through decision-making processes with immediate feedback.

Case-based learning builds pattern recognition and confidence. It's also more memorable than abstract data. Pharmacists will recall the patient story when a similar customer appears.

Create peer learning networks

The study showed that pharmacists value educational programs and consultations with other healthcare professionals. Build platforms where pharmacists share experiences, ask questions, and learn from colleagues who've had success with your products.

Peer influence is powerful. If a respected pharmacist in someone's network recommends your supplement and reports good patient outcomes, that carries more weight than any white paper.

Bridge the generational divide

Junior pharmacists need different support than senior pharmacists. Younger pharmacists want evidence but struggle with time and application. Provide them with pre-appraised evidence summaries and clinical decision support tools.

Senior pharmacists may not seek out evidence, but they value experience and have established practice patterns. For this group, focus on continuing education that updates their knowledge without challenging their expertise. Frame new information as additions to their existing wisdom, not corrections.

Address the evidence-practice gap directly

The study's authors concluded that "further education about the practice of evidence-based pharmacy is necessary, with special emphasis on senior pharmacists who might have missed that aspect during their formal education."

But education alone won't close the gap. Pharmacists need systems, tools, and incentives that make evidence-based practice easier than experience-based practice. That might mean point-of-sale decision support, collaborative practice agreements with physicians, or quality metrics that reward evidence-based recommendations.

What this means for supplement brands

If you're marketing supplements to healthcare professionals, this study should fundamentally change your education strategy.

Stop assuming that publishing clinical trials and creating scientific marketing materials will drive recommendations. Evidence is necessary but not sufficient. Pharmacists need to trust your product, and trust comes from experience and peer validation more than data.

Start thinking about education as behavior change, not information transfer. Your goal isn't to make pharmacists more knowledgeable about supplements. Your goal is to make them confident recommending your specific products when appropriate.

That requires a multi-layered approach:

• Strong clinical evidence that gives pharmacists something to fall back on when questioned.
• Accessible, just-in-time information that fits their workflow.
• Opportunities for personal experience with your products.
• Peer networks where successful recommendations get shared.
• Case-based training that builds pattern recognition.
• Different strategies for different career stages.

The pharmacists in this study weren't ignorant or lazy. They scored high on knowledge tests. They understood supplement safety and efficacy issues. But when the moment came to make a recommendation, they relied on experience, intuition, and accessible information rather than searching for the best available evidence.

Your job is to make sure your supplement is the one they've experienced, remember, and trust when that moment arrives.

Frequently asked questions

1. Why don't pharmacists use clinical studies when recommending supplements?

Pharmacists face practical barriers including time constraints, limited access to journals, lack of critical appraisal skills (especially senior pharmacists), and language barriers in non-English speaking countries. In fast-paced retail settings, they rely on memory and experience rather than searching databases. The study found that while 73% of junior pharmacists claimed to use PubMed, actual behavior during customer interactions likely differs significantly from stated practices.

2. Do pharmacists who use supplements themselves recommend them more often?

Yes. Personal use was the strongest predictor of whether a pharmacist would recommend a supplement, with an odds ratio of 0.216. When pharmacists have positive personal experiences with a supplement, they trust it more and feel comfortable recommending it to patients. However, this creates a potential problem because personal experience is subject to placebo effects and confirmation bias, and what works for one person may not work for all patients.

3. Are younger or older pharmacists better at evidence-based supplement recommendations?

Younger pharmacists use higher-quality evidence sources more frequently. The study found 32.1% of pharmacists with less than 10 years experience consulted systematic reviews, compared to just 8.7% of those with 10+ years experience. This reflects changes in pharmacy education — newer graduates learned evidence-based practice and critical appraisal skills that older pharmacists may have missed. However, senior pharmacists were more likely to recommend supplements overall, suggesting greater confidence (though not necessarily better evidence use).

4. What information sources do pharmacists actually use for supplement decisions?

The most common sources varied by experience level. Junior pharmacists frequently used product labels (57.1%), PubMed databases (73.2%), and educational programs (46.4%). Senior pharmacists relied more heavily on educational programs (67.4%) and less on product labels (21.7%). Both groups used systematic reviews and randomized controlled trials infrequently. Notably, educational programs aren't primary evidence sources and may lack critical appraisal, yet they're heavily relied upon by experienced pharmacists.

5. How can supplement companies make their evidence more accessible to pharmacists?

Create mobile-friendly, point-of-care decision tools that provide instant access to key information: primary indication, typical dose, major interactions, contraindications, and evidence quality summary. Focus on just-in-time information rather than comprehensive references. Use case-based learning instead of data presentations. Build peer learning networks where pharmacists share experiences. Provide different educational formats for different career stages — evidence summaries with application guidance for junior pharmacists, and experience-based continuing education for senior pharmacists.

6. Does having more knowledge about supplements mean pharmacists make better recommendations?

Not necessarily. The study found all pharmacists scored highly on knowledge tests (median 10-11 out of 14 points), but knowledge didn't predict evidence-based behavior. Pharmacists knew about supplement safety and efficacy but didn't use that knowledge to search for and apply current evidence when making recommendations. The gap between knowledge and practice suggests that education strategies focused solely on information transfer won't change behavior — pharmacists also need systems, tools, and workflows that make evidence-based practice easier than experience-based practice.