Intersection of Traditional Medicine and Modern Pharmacy Practice in South East Nigeria: Toward an Integrative Framework for Safe Patient Care

The coexistence of traditional medicine and modern pharmaceutical practice in South East Nigeria presents both challenges and opportunities for patient safety, therapeutic efficacy, and health system integration. Despite widespread concurrent use of traditional remedies alongside prescribed medications, no theoretically grounded integrative framework has been developed to guide pharmacists in safely navigating this duality in the South East context. This study investigated the intersection of traditional medicine and modern pharmacy practice in South East Nigeria and developed an integrative patient care framework using a constructivist grounded theory design. Data were collected over 26 months across Anambra, Enugu, Imo, Abia, and Ebonyi States through 68 in-depth interviews with patients, traditional medicine practitioners, community pharmacists, hospital pharmacists, and physicians, alongside observational fieldwork in community pharmacy and traditional healing settings. Constructivist grounded theory analysis employing situational mapping and theoretical coding generated a substantive theory of negotiated therapeutic legitimacy, whereby patients navigate competing epistemological frameworks of healing through a process of pragmatic synthesis influenced by cost, cultural identity, treatment urgency, and interpersonal trust in practitioners. The integrative framework derived from this theory encompasses five pharmacist practice domains: cultural competence communication, herb-drug interaction screening, traditional practitioner collaboration protocols, safe disclosure facilitation, and institutional knowledge documentation. The framework provides a theoretically and empirically grounded foundation for developing culturally safe pharmaceutical care models in South East Nigeria and offers a model adaptable to other Nigerian zones with high traditional medicine use. Keywords: traditional medicine, integrative framework, South East Nigeria, pharmacist practice, herb-drug interactions