Pharmacists' recognition, support strategies, and perceived challenges in caring for patients with limited medication literacy in Saudi Arabia: A quasi-experimental study

Introduction: Medication literacy is critical for safe and effective medication use; however, evidence indicates that many individuals in Saudi Arabia struggle to understand medication-related information. Pharmacists are well positioned to identify literacy needs and provide appropriate counselling, yet limited data exist on their current practices and the effect of targeted training. This study aimed to assess pharmacists' understanding of medication literacy, their approaches to supporting patients with limited literacy, and the impact of a brief educational intervention on self-reported practices. Methods: A pre-post quasi-experimental design was employed. Pharmacists across Saudi Arabia were recruited using convenience and snowball sampling. Participants completed a baseline questionnaire assessing their understanding of medication literacy, assessment methods, counselling strategies, and perceived barriers. A 10-min educational video was then delivered, followed by a post-intervention questionnaire one month later. Descriptive statistics and chi-square tests were used for analysis. Results: In total, 318 pharmacists completed the pre-intervention questionnaire, and 68 completed the follow-up. At baseline, 95.6% reported understanding medication literacy, but only 21.4% used standardized assessment tools. Common strategies included using simple language and prioritizing essential information (84.3%), teach-back methods (70.4%), and providing easy-to-read materials (58.8%). Post-intervention, 98.5% reported understanding medication literacy, and 82.4% reported assessing patients' literacy needs. Most participants indicated improved assessment (97.1%) and more tailored counselling practices (92.6%), and 92.6% found the module helpful. Major barriers included time constraints (82.1%), lack of incentives (24.8%), heavy workload (23%), and insufficient training. However, the substantial decline in participant numbers between the pre- and post-intervention samples may limit internal validity and the generalizability of post-intervention findings. Conclusion: Brief targeted training may support improvements in pharmacists' literacy-sensitive practices. Broader implementation of standardized assessment tools, enhanced professional education, and system-level support are needed to strengthen medication safety and patient understanding.