title: Evaluating community pharmacists' perspectives and practices concerning generic medicines substitution in Saudi Arabia: A cross-sectional study.
abstract: OBJECTIVE
  To assess the community pharmacists' knowledge, attitude, perception and current practices towards generic medicines substitution in Saudi Arabia.
  
  
  METHODS
  A cross-sectional study was conducted between February and March 2016 in the Makkah region, Saudi Arabia. A 25-item, structured, validated, pilot-tested and self-completed questionnaire was used to achieve study objectives. A 4-step systematic sampling technique was used to recruit community pharmacists. Data were analysed using SPSS version 20.
  
  
  RESULTS
  Of 128 community pharmacists approached, 121 participated in the study (response rate=95%). Majority of the participants (n=108; 89.3%) had graduated from Egypt, were working as staff pharmacists (n=85; 70%) and had BPharm degree (97; 80.2%). Only 26 (22%) of the participants correctly answered all knowledge questions accurately. No statistically significant difference in total knowledge score was observed across different sociodemographic characteristics of participants (all P>0.05).Two-thirds of the respondents (83; 68.2%) supported the use of generic substitution. Medicines cost and patients' request were the most commonly cited reasons for performing generic substitution. Country of graduation (P=0.01) and number of years of practicing in Saudi Arabia (P=0.02) was associated with the pharmacists' support towards generic substitution.
  
  
  CONCLUSIONS
  The community pharmacists had clear knowledge deficits about generic medicines and their substitution which may partly explain low consumption of generic medicines in Saudi Arabia. Healthcare policy makers need to improve awareness about the safety and efficacy of generic medicines and promote their use in order to cut down cost of medicines and overall healthcare expenditure.
authors.affiliation: Department of Clinical Pharmacy, Umm-Al-Qura University, Makkah, Saudi Arabia.
authors.forename: Fahad S
authors.initials: FS
authors.lastname: Alkhuzaee
authors.affiliation: Department of Clinical Pharmacy, Umm-Al-Qura University, Makkah, Saudi Arabia.
authors.forename: Hamdan M
authors.initials: HM
authors.lastname: Almalki
authors.affiliation: Department of Clinical Pharmacy, Umm-Al-Qura University, Makkah, Saudi Arabia.
authors.forename: Ammar Y
authors.initials: AY
authors.lastname: Attar
authors.affiliation: Department of Clinical Pharmacy, Umm-Al-Qura University, Makkah, Saudi Arabia.
authors.forename: Shoeab I
authors.initials: SI
authors.lastname: Althubiani
authors.affiliation: Department of Clinical Pharmacy, Umm-Al-Qura University, Makkah, Saudi Arabia.
authors.forename: Wassam Ali
authors.initials: WA
authors.lastname: Almuallim
authors.affiliation: Department of Clinical Pharmacy, Umm-Al-Qura University, Makkah, Saudi Arabia.
authors.forename: Ejaz
authors.initials: E
authors.lastname: Cheema
authors.affiliation: Department of Clinical Pharmacy, Umm-Al-Qura University, Makkah, Saudi Arabia; School of Healthcare, University of Leeds, Leeds, United Kingdom. Electronic address: m.a.hadi@leeds.ac.uk.
authors.forename: Muhammad Abdul
authors.initials: MA
authors.lastname: Hadi
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D057915:Drug Substitution / Q000191:economics*; D016568:Drugs, Generic / Q000627:therapeutic use*; D007722:Health Knowledge, Attitudes, Practice; D006291:Health Policy; D006801:Humans; D010594:Pharmacies; D010595:Pharmacists / Q000523:psychology*; D012529:Saudi Arabia; D011795:Surveys and Questionnaires
chemical_list: D016568:Drugs, Generic
keywords: Community pharmacists; Cost saving; Generic medicines; Health policy; Saudi Arabia