Joanne Barnes

Joanne Barnes
University of Auckland · School of Pharmacy

Professor

About

174
Publications
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6,592
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Publications

Publications (174)
Article
Full-text available
Background Starting in 2010, the epidermal growth factor receptor (EGFR) kinase inhibitors erlotinib and gefitinib were introduced into routine use in Aotearoa New Zealand (NZ) for treating advanced lung cancer, but their impact in this setting is unknown. Objective The study described in this protocol aims to understand the effectiveness and safe...
Article
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Withania somnifera (L.) Dunal, commonly known as ashwagandha, is promoted for its reputed effects in many conditions, including anxiety, stress, infertility and sleep disorders, and is said to be an ‘adaptogen’. The main bioactive constituents in ashwagandha root, the part of the plant usually used medicinally, include withanolides. Evidence from p...
Article
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Traditional, complementary and alternative medicine (TCAM) are popular healthcare choices among consumers globally. The latest national data on the use of TCAM practitioners in New Zealand (NZ) were collected over a decade ago. Robust data on the use of natural health products (NHPs) and TCAM practices alongside conventional medicines are not yet a...
Article
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Background Combining short-acting nicotine replacement therapy with varenicline increases smoking cessation rates compared with varenicline alone, but not all people tolerate these medications or find them helpful. We aim to investigate the therapeutic potential of an analogous combination, by evaluating the effectiveness, safety, and acceptability...
Preprint
BACKGROUND Starting in 2010, the epidermal growth factor receptor (EGFR) kinase inhibitors erlotinib and gefitinib were introduced into routine use in Aotearoa New Zealand (NZ) for treating advanced lung cancer, but their impact in this setting is unknown. OBJECTIVE The study described in this protocol aims to understand the effectiveness and safe...
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Chapter
Ethnobotanical and ethnopharmacological studies can contribute to advances in the development of new drugs, by providing data on efficacy and on harms. However, few studies use methods that are dedicated to the detailed record of aspects related to safety. This chapter presents some of the few studies that, although dedicated to these records, stil...
Article
Full-text available
Introduction: Traditional, complementary and alternative medicine (TCAM) refers to a broad range of health practices and products typically not part of the 'conventional medicine' system, and its use is substantial among the general population. TCAM products and therapies may be used in addition to, or instead of, conventional medicine approaches,...
Chapter
VigiBase is the World Health Organization global database of individual case safety reports (ICSRs), reports of suspected adverse drug reactions to medicines. VigiBase is maintained by the Uppsala Monitoring Centre, an independent centre for drug safety and scientific research. By June 2020, VigiBase contained over 21 million de-duplicated ICSRs, s...
Chapter
Many herbal and traditional medicines and other natural health products (HTMs/NHPs) are complex mixtures of chemical constituents and, like other substances used in medicine, these can cause adverse reactions. This, alongside the extensive use of HTMs/NHPs, and the ways in which these products/preparations are regulated, accessed, used, and perceiv...
Chapter
Herbal and traditional medicines are complex mixtures comprising up to several hundred or more potentially active constituents. The active constituent(s) responsible for pharmacological activity, however, is/are often unknown. Herbal and traditional medicines are available in a wide range of dose forms, from relatively crude preparations (e.g., tin...
Article
Aim: Traditional, complementary and alternative medicine (TCAM) is a popular healthcare choice worldwide. The extent of data available on TCAM, including prevalence and patterns of use in New Zealand, is unknown. This scoping review aims to map the existing research describing the use of TCAM (including prevalence, access, expenditure and concurre...
Article
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IntroductionMental illness is a leading cause of non-fatal disease burden worldwide. Natural health products (NHPs) are sought by patients with mental health conditions as a safer and more ‘natural’ option than conventional pharmacotherapy; however, the possible adverse events (AE) and interactions between NHPs and prescription medicines are not fu...
Article
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Aim To determine whether cytisine was at least as effective as varenicline in supporting smoking abstinence for ≥ 6 months in New Zealand indigenous Māori or whānau (extended‐family) of Māori, given the high smoking prevalence in this population. Design Pragmatic, open‐label, randomised, community‐based non‐inferiority trial. Setting Bay of Plent...
Article
Introduction: Detecting signals of safety concerns associated with complementary medicines (CMs) relies on spontaneous reports submitted by health professionals and patients/consumers. Community pharmacists are well placed to identify and report suspected adverse drug reactions (ADRs) associated with CMs, but pharmacists submit few CMs ADR reports...
Article
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Background Paediatric mental health patients frequently use natural health products (NHP) in addition to prescription medications, but very little is known about adverse events and possible NHP–drug interactions. Objective To determine: (1) the prevalence of paediatric mental health patients taking prescription medications only, NHP only, both NHP...
Article
Background Complementary medicines are a popular healthcare choice among patients/consumers, and most pharmacies sell these products. Pharmacists are well-placed to advise on complementary medicines, but their training and practices for these products are not optimal. Pharmacists’ professional practices for complementary medicines ought to be influ...
Article
IntroductionIntensive monitoring methods are used in pharmacovigilance for prescription medicines but have not yet been implemented for natural health products (NHPs).Objectives Our objective was to assess feasibility issues with a new ‘purchase event’ intensive monitoring method for pharmacovigilance of NHPs, including pharmacy and NHP purchaser r...
Article
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A case series of hepatotoxicity associated with an extract of Artemisia annua L. was identified through the New Zealand spontaneous adverse drug reaction reporting system. A. annua extract, produced using a supercritical carbon dioxide extraction method and formulated with grapeseed oil, has been marketed in New Zealand as a natural product for joi...
Article
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Introduction: Use of herbal medicines (HMs) is widespread across the world, with many people relying on HMs for their primary healthcare or using HMs in the context of a healthy life style. HMs originate from plant material and, as such, are often seen as “natural” and believed to be (relatively) safe by patients. Hepatobiliary disorders have been...
Article
Background: Hypnotherapy is widely promoted as a method for aiding smoking cessation. It is intended to act on underlying impulses to weaken the desire to smoke, or strengthen the will to stop. Objectives: To evaluate the effect and safety of hypnotherapy for smoking cessation. Search methods: For this update we searched the Cochrane Tobacco A...
Article
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Background and aims Cytisine, a nicotinic acetylcholine receptor partial agonist (like varenicline) found in some plants, is a low‐cost, effective smoking cessation medication that may appeal to Māori (the indigenous people of New Zealand [NZ]). The RAUORA trial aims to determine the effectiveness, safety, and cost‐effectiveness of cytisine (Tabex®...
Article
Objectives: To examine community pharmacists' perspectives on CMs regulation in New Zealand, where proposals for CMs regulations had recently been suspended and where, currently, CMs are only weakly regulated. Methods: Qualitative, in-depth, semi-structured interviews with New Zealand practising community pharmacists are identified through purpo...
Article
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Affordable;cost-effective;cytisine;regulatory approval;smoking cessation;treatment
Article
As in many developed countries, herbal medicines (HMs) are widely used in Australia and New Zealand (NZ). The popularity of HM continues to rise. Western, Asian and indigenous HMs are used, reflecting the cultural diversity of people in this region. HMs in Australia are regulated on a risk-based system with many HMs identified as being low risk. Th...
Article
Background: Dysmenorrhoea refers to painful menstrual cramps and is a common gynaecological complaint. Conventional treatments include non-steroidal anti-inflammatory drugs (NSAIDs) and oral contraceptive pills (OCPs), which both reduce myometrial activity (contractions of the uterus). A suggested alternative approach is dietary supplements. We us...
Article
Natural health products (NHPs), such as herbal medicines, probiotics, vitamins and minerals, are used regularly by 73% of Canadians.1 Many consumers believe that NHPs derived from plants (such as herbal medicines) are safe because they are “natural.”1 However, some plant-derived NHPs can interact with pharmaceutical medications, potentially resulti...
Article
Ethnopharmacological relevance Traditional Chinese Medicine (TCM) is a popular form of ethnomedicine in the UK, and is accessed by Western, Chinese and other ethnic groups. The current regulatory regime does not effectively protect the public against poor-quality and unsafe TCMs. Understanding ethnopharmacological information on how TCM is promoted...
Article
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Natural health products (NHPs), including melatonin, are widely used products. Despite the widespread assumption that all NHPs are safe, they contain pharmacologically active substances and can therefore have adverse effects and/or interact with pharmaceuticals. To investigate the mechanism underlying NHP interactions identified through the Pharmac...
Article
Placebo-controlled trials indicate that cytisine, a partial agonist that binds the nicotinic acetylcholine receptor and is used for smoking cessation, almost doubles the chances of quitting at 6 months. We investigated whether cytisine was at least as effective as nicotine-replacement therapy in helping smokers to quit. We conducted a pragmatic, op...
Article
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To investigate the rates and causality of adverse event(s) (AE) associated with natural health product (NHP) use, prescription drug use and concurrent NHP-drug use through active surveillance in community pharmacies. Cross-sectional study of screened patients. 10 community pharmacies across Alberta and British Columbia, Canada from 14 January to 30...
Article
To explore the views of New Zealand pharmacists on bowel cancer screening, particularly with regards to faecal occult blood testing (FOBT) kits, self-perceived knowledge on FOBT kits and barriers, motivators and experiences with selling and counselling consumers with respect to FOBT kits. Semi-structured interviews were conducted face to face or by...
Article
Natural health products (NHPs), a broad category that includes vitamins, minerals, herbs, homeopathic remedies, traditional medicines, probiotics, amino acids and fatty acids, are used to maintain and promote health, as well as to prevent or treat illness.1 Many consumers report using NHPs because they are perceived to be healthier or safer than co...
Article
Background: The last decade has seen the emergence of a new phenomenon in recreational substance use with the availability of herbal and synthetic, unregulated, psychoactive drugs in the market place; alongside this, international concern has developed in relation to their use and associated harms. New Zealand (NZ) was one of the first countries t...
Article
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Typically, ethnobotanical/ethnopharmacological (EB/EP) surveys are used to describe uses, doses/dosages, sources and methods of preparation of traditional herbal medicines; their application to date in examining the adverse effects, contraindications and other safety aspects of these preparations is limited. From a pharmacovigilance perspective, nu...
Article
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Background Many consumers use natural health products (NHPs) concurrently with prescription medications. As NHP-related harms are under-reported through passive surveillance, the safety of concurrent NHP-drug use remains unknown. To conduct active surveillance in participating community pharmacies to identify adverse events related to concurrent NH...
Data
Case summaries for all detailed patient interviews. (DOCX)
Data
Full-text available
MHPD Memo (February 23, 2012) supporting Health Canada passive surveillance cost data. (PDF)
Data
Cvijovic et al. 2011 Unpublished manuscript supporting Case 1. (DOC)
Article
Full-text available
Purpose To investigate the adverse event (AE) rates associated with natural health product (NHP) use, prescription drug use and concurrent NHPs-drug use through active surveillance in community pharmacies in Alberta and British Columbia, Canada. Methods Participating pharmacists and pharmacy technicians screened consecutive individuals picking up p...
Chapter
There is increasing awareness of the need to develop pharmacovigilance for complementary medicines, particularly herbal medicines. Applying standard pharmacovigilance techniques presents additional challenges, related to the ways in which complementary medicines are regulated, used, named, and perceived.Spontaneous reporting of suspected adverse dr...
Article
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To explore the current use of conventional and complementary medicines in Australians aged ≥ 50 years. Cross-sectional postal survey sent to a random sample of 4500 Australians aged ≥ 50 years between June 2009 and February 2010. Prevalence of medicines use, reasons for medicines use and sources of medicines. Response rate was 37.3%. Medicines use...
Article
Herbal medicines and other natural health products (NHPs) are sold in Canadian pharmacies as over-the-counter products, yet there is limited information on their safety and adverse effect profile. Signals of safety concerns associated with medicines can arise through analysis of reports of suspected adverse drug reactions (ADRs) submitted to nation...
Article
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Smokers need effective support to maximise the chances of successful quit attempts. Current smoking cessation medications, such as nicotine replacement therapy (NRT), bupropion, nortriptyline or varenicline, have been shown to be effective in clinical trials but are underused by smokers attempting to quit due to adverse effects, contraindications,...
Article
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The Dietary Supplements Information Expert Committee (DSI-EC) of the United States Pharmacopeial Convention (USP) reviews the safety of dietary supplements and dietary supplement ingredients for the purpose of determining whether they should be admitted as quality monographs into the United States Pharmacopeia and National Formulary (USP-NF). The U...
Article
Forty per cent of users of herbal medicinal products (HMPs) seek information, mainly concerning side-effects, how HMPs “work” and their uses, before purchase of HMPs Users of HMPs consult mainly non-pharmacy, non-professional sources for information on HMPs Almost 60 per cent of users of HMPs had used conventional medicines and HMPs concurrently in...
Article
Different types of hypnotherapy are used to try and help people quit smoking. Some methods try to weaken people's desire to smoke, strengthen their will to quit, or help them concentrate on a 'quit programme'. Trials have used different types and amounts of hypnotherapy and compared them with different control conditions, including no treatment, br...
Article
Future research of herbal products for menopausal women should include long-term safety assessments because women may use these products for prolonged periods of time. Growing numbers of women take prescription medications and concurrently use herbal products for alleviation of menopausal symptoms. Because of possible herb-drug interactions, both d...
Article
Objective As retailers of complementary medicines (CMs), pharmacists are well placed to advise consumers on the safe and effective use of these products; where CMs are available in pharmacies, pharmacists should be well informed about such products. This study explored the extent to which CMs are available in community pharmacies in England, and ex...
Article
Full-text available
Natural health products (NHPs), such as herbal medicines and vitamins, are widely available over-the-counter and are often purchased by consumers without advice from a healthcare provider. This study examined how consumers respond when they believe they have experienced NHP-related adverse drug reactions (ADRs) in order to determine how to improve...
Article
MESSAGE: Evidence for the efficacy of black cohosh extracts for treatment of menopausal symptoms is inconclusive. Black cohosh extracts have been associated with hepatotoxic reactions including changes in liver function test values, hepatitis, jaundice and hepatic failure. Health professionals should be aware of the possibility of (undisclosed) use...
Article
MESSAGE: Evidence for the efficacy of ginkgo extracts for cognitive impairment and dementia, intermittent claudication, acute ischaemic stroke, tinnitus and age-related macular degeneration is unconvincing. Ginkgo preparations have been associated with haemorrhagic reactions. Health professionals should be aware of the possibility of (undisclosed)...
Article
MESSAGE: There is no robust evidence that saw palmetto fruit extract is effective in the treatment of benign prostatic hyperplasia. Evidence indicates that it is a safe product (at current doses) but with questionable efficacy. As with all herbal medicines, saw palmetto products differ in their pharmaceutical quality, and the implications of this s...
Article
Black cohosh, Actaea racemosa L (syn. Cimicifuga racemosa [L] Nutt), has enjoyed a rapid rise in popular use for the amelioration or alleviation of menopausal symptoms. At the same time, the last decade has witnessed a significant expansion of research on the chemistry, pharmacology, and clinical efficacy and safety of this botanical species. As a...
Article
Full-text available
Herbal products are readily available over the counter in health food stores and are often perceived to be without risk. The current Canadian adverse event reporting system suffers from severe underreporting, resulting in a scarcity of safety data on herbal products. Twelve health food store personnel in the Greater Toronto Area were interviewed ab...
Article
MESSAGE: St John’s wort is about as effective as some conventional antidepressants (NNT=42) including certain SSRIs for treating mild to moderate depression and has a favourable adverse effect profile, at least with short-term use. However, it interacts with several other medicines, including digoxin, theophylline, warfarin and oral contraceptives....
Article
MESSAGE: There is evidence that Devil’s Claw can be an effective short-term treatment for acute exacerbations of low back pain and, to a lesser extent, in rheumatic and osteoarthritic conditions. Acute adverse effects reported in clinical trials were mild diarrhoea and flatulence. Long-term adverse effects have not been studied. As with all herbal...
Article
MESSAGE: Trials assessing echinacea for prevention and treatment of URTIs report conflicting results and at present there is insufficient evidence to recommend a particular preparation or dosage regimen. The limited data available indicate that echinacea preparations are generally well-tolerated, although allergic reactions may occur. As with other...
Article
The popularity of traditional Chinese herbal medicine (TCHM) in the UK raises questions about the safety of practice of TCHM retail outlets/shops. This pilot study involving twelve TCHM outlets included interviews with six employees to understand some aspects of TCHM practices in London and to assess the feasibility of undertaking this type of work...
Article
Our objective was to develop suggestions for reporting RCTs of herbal medicine interventions. We identified and invited potential participants with expertise in clinical trial methodology, clinical trial reporting, pharmacognosy, herbal medicinal products, medical statistics, and/or herbal product manufacturing, to participate in a consensus develo...

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