ORIGINAL RESEARCH article
Front. Pharmacol.
Sec. Pharmacoepidemiology
Knowledge, Attitudes, and Practices of Pharmacists Toward Over-the-Counter Medication Use in Iraq: A Nationwide Cross-Sectional Study
Provisionally accepted
Mohamed AbdElrahman1,2*
Mohammed D. Al-Rekabi3
Ghadah Ali Al-Oudah4Aysam M. Fayed4Hasanain Kamil Owadh4- 1Al-Mustaqbal University College, Al-Hilla City, Iraq
- 2Helwan University, Helwan, Egypt
- 3University of Alkafeel, Najaf, Iraq
- 4Al-Mustaqbal University, Hillah, Iraq
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Introduction: Over-the-counter (OTC) medications play a vital role in global healthcare systems by offering accessible treatment options for minor ailments. However, the growing use of OTC drugs in Iraq raises concerns regarding pharmacists' knowledge, safety perceptions, and dispensing practices . Methods : A nationwide cross-sectional survey was conducted among 529 licensed pharmacists from January to March 2025 across all major Iraqi regions. The questionnaire assessed demographics, familiarity with OTC drugs, safety attitudes, and dispensing behaviours. Results: Most participants (95.4%) reported familiarity with OTC medications and frequent encounters with self-medicating patients, particularly in the Central and Southern regions. NSAIDs were the most commonly recommended OTC category (71.8%). Significant regional differences were observed in familiarity, frequency of self-medication, and safety perceptions (p = 0.0071, 0.00088, and 0.045, respectively). Pharmacists with less than five years of experience were more likely to report adverse drug reactions (p = 0.0332) and to enquire about patients' OTC use (p = 0.1035). Overall, younger pharmacists and those practising in the Kurdistan region demonstrated greater familiarity with OTC medicines, while neutral safety perceptions and practice in Southern Iraq were associated with lower familiarity. Conclusion: Iraqi pharmacists demonstrate generally strong awareness and proactive attitudes toward OTC medication use. Nonetheless, gaps remain in adverse reaction reporting and drug interaction recognition. Implementing standardised continuing education and structured OTC safety training could enhance practice consistency and promote safer self-medication behaviours nationwide.
Keywords: Over-the-counter medications, Self Medication, Pharmacy Practice, Pharmacovigilanc, Patient Safety
Received: 19 Jul 2025; Accepted: 03 Nov 2025.
Copyright: © 2025 AbdElrahman, D. Al-Rekabi, Ali Al-Oudah, M. Fayed and Kamil Owadh. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Mohamed AbdElrahman, mohamedmahmoud@uomus.edu.iq
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.