Background: Dietary supplements (DSs) are widely used to complement diets, particularly among individuals with specific nutritional needs. While DSs can promote health and prevent disease, improper use may lead to adverse effects or medication interactions, highlighting the need for safe, informed consumption. This study assesses knowledge, attitudes, and practices (KAP) related to DSs in Western Saudi Arabia, providing insights into national consumption patterns. Method: A cross-sectional online survey was conducted between December 2023 and February 2024. A 28-item questionnaire covering demographics, knowledge, attitudes, and practices regarding DSs was administered. Participants aged 18 years and older residing in the study regions were recruited through convenience sampling. Data were analyzed with SPSS version 22 using descriptive statistics and chi-square tests. Results: A total of 1006 participants completed the survey, with 70.5% (n = 709) reporting DS use. Most respondents were female (71.8%) and 34.3% were aged between 18 and 30 years. Although 82.5% were aware of DSs, only 41% knew the correct dosages, and 30.3% expressed uncertainty about DS safety. About 28.1% of DS users experienced side effects. Multivitamins were the most commonly used DS type (44.9%), followed by mono-vitamins (39.9%) and minerals (7.5%). The primary motivations for DS use were health improvement and ensuring adequate nutrition (66%), while 20% used DSs to address specific deficiencies. Most participants sourced DSs from pharmacies (85.5%), and 46.6% relied on the internet for information. Significant differences in DSs use were observed based on gender and age (p < 0.001). Conclusion: This study highlights the widespread use of DSs, with significant gaps in knowledge, attitudes, and practices concerning dosage and safety. Associations between DS use and demographic factors indicate that public health strategies should address these variables. Targeted education and clear guidance on safe DS use are essential for promoting informed consumption and reducing potential health risks.

Background/Objectives: Antibiotic resistance (ABR) is a global crisis leading to increased mortality and economic burden. Antimicrobial stewardship (AMS) promotes responsible antibiotic use and prescribing practices to combat ABR. This study assessed the knowledge, awareness, and perceptions of final-year medical and pharmacy students in Saudi Arabia regarding antibiotic use, ABR, and AMS. Methods: A national cross-sectional survey was conducted from January to April 2024 using a 49-item questionnaire. The survey assessed knowledge of antibiotic use, ABR, and AMS using predefined scoring, while perceptions were evaluated with a 5-point Likert scale. Data were analyzed using descriptive statistics and Chi-square tests to explore associations between independent variables and outcomes. A logistic regression analysis identified factors associated with good knowledge, and results were reported as adjusted odds ratios (aOR) with 95% confidence intervals (CI). Results: Among 197 participants from 26 Saudi universities, pharmacy students comprised 73.1% of the sample. Good knowledge was observed in 44.7% for antibiotic use, 47.7% for ABR, and 52.8% for AMS. However, 28.4% lacked awareness of AMS, and 5.6% were unaware of ABR. Pharmacy students demonstrated significantly higher knowledge and confidence in AMS and antibiotic handling compared to medical students (p < 0.001). Higher knowledge was also associated with the university’s region and prior education on resistance or AMS during college. Conclusions: This study highlights significant gaps in knowledge and awareness of antibiotic use, ABR, and AMS among final-year medical and pharmacy students in Saudi Arabia. The findings emphasize the need for targeted educational strategies, standardized curricula, and enhanced AMS training to better prepare future healthcare professionals to combat ABR effectively.

Aim: To develop a set of prescribing safety indicators related to mental health disorders and medications, and to estimate the risk of harm associated with each indicator. Method: A modified two‐stage electronic Delphi. The first stage consisted of two rounds in which 31 experts rated their agreement with a set of 101 potential mental health related prescribing safety indicators using a five‐point scale and given the opportunity to suggest other indicators. Indicators that achieved 80% agreement were accepted. The second stage comprised a single round in which 29 members estimated the risk of harm for each accepted indicator by assessing the occurrence likelihood and outcome severity using two five‐point scales. Indicators were considered high or extreme risk when at least 80% of participants rated each indicator as high or extreme. Results: Seventy‐five indicators were accepted in the first stage. Following the second stage, 42 (56%) were considered to be high or extreme risk for patient care. The 42 indicators comprised different types of hazardous prescribing, including drug‐disease interactions (n = 12), drug‐drug interactions (n = 9), inadequate monitoring (n = 5), inappropriate duration (n = 4), inappropriate dose (n = 4), omissions (n = 4), potentially inappropriate medications (n = 3) and polypharmacy (n = 1). These indicators also covered different mental health related medication classes, including antipsychotics (n = 14), mood stabilisers (n = 8), antidepressants (n = 6), sedative, hypnotics and anxiolytics (n = 6), anticholinergic (n = 6) and nonspecific psychotropics ( n = 2). Conclusion: This study has developed the first suite of prescribing safety indicators related to mental health disorders and medications, which could inform the development of future safety improvement initiatives and interventional studies.

Aims: To examine the prevalence of potentially hazardous prescribing in the prison setting using prescribing safety indicators (PSIs) and explore their implementation and use in practice.Methods: PSIs were identified and reviewed by the project team following a literature review and a nominal group discussion. Pharmacists at 2 prison sites deployed the PSIs using search protocols within their electronic health record. Prevalence rates and 95% confidence intervals (CIs) were generated for each indicator. Semi‐structured interviews with 20 prison healthcare staff across England and Wales were conducted to explore the feasibility of deploying and using PSIs in prison settings.Results: Thirteen PSIs were successfully deployed mostly comprising drug–drug interactions (n = 9). Five yielded elevated prevalence rates: use of anticholinergics if aged ≥65 years (Site B: 25.8% [95%CI: 10.4–41.2%]), lack of antipsychotic monitoring for >12 months (Site A: 39.1% [95%CI: 27.1–52.1%]; Site B: 28.6% [95%CI: 17.9–41.4%]), prolonged use of hypnotics (Site B: 46.3% [95%CI: 35.6–57.1%]), antiplatelets prescribed with nonsteroidal anti‐inflammatory drugs without gastrointestinal protection (Site A: 12.5% [95%CI: 0.0–35.4%]; Site B: 16.7% [95%CI: 0.4–64.1%]), and selective serotonin/norepinephrine reuptake inhibitors prescribed with nonsteroidal anti‐inflammatory drugs/antiplatelets without gastrointestinal protection (Site A: 39.6% [95%CI: 31.2–48.4%]; Site B: 33.3% [95%CI: 20.8–47.9%]). Prison healthcare staff supported the use of PSIs and identified key considerations to guide its successful implementation, including staff engagement and PSI 'champions'. To respond to PSI searches, stakeholders suggested contextualised patient support through intraprofessional collaboration.Conclusion: We successfully implemented a suite of PSIs into 2 prisons, identifying those with higher prevalence values as intervention targets. When appropriately resourced and integrated into staff workflow, PSI searches may support prescribing safety in prisons.

Prescribing errors and medication related harm may be common in patients with mental illness. However, there has been limited research focusing on the development and application of prescribing safety indicators (PSIs) for this population. Identify potential PSIs related to mental health (MH) medications and conditions. Seven electronic databases were searched (from 1990 to February 2019), including the bibliographies of included studies and of relevant review articles. Studies that developed, validated or updated a set of explicit medication-specific indicators or criteria that measured prescribing safety or quality were included, irrespective of whether they contained MH indicators or not. Studies were screened to extract all MH related indicators before two MH clinical pharmacists screened them to select potential PSIs based on established criteria. All indicators were categorised into prescribing problems and medication categories. 79 unique studies were included, 70 of which contained at least one MH related indicator. No studies were identified that focused on development of PSIs for patients with mental illness. A total of 1386 MH indicators were identified (average 20 (SD = 25.1) per study); 245 of these were considered potential PSIs. Among PSIs the most common prescribing problem was ‘Potentially inappropriate prescribing considering diagnoses or conditions’ (n = 91, 37.1%) and the lowest was ‘omission’ (n = 5, 2.0%). ‘Antidepressant’ was the most common PSI medication category (n = 85, 34.7%). This is the first systematic review to identify a comprehensive list of MH related potential PSIs. This list should undergo further validation and could be used as a foundation for the development of new suites of PSIs applicable to patients with mental illness.

Background: Antibiotic resistance (AMR) is a critical global and national health challenge, largely driven by the misuse and overuse of antibiotics. Understanding the public′s knowledge and practices regarding antibiotic use is essential for informing effective interventions. This study aimed to assess the levels of knowledge, attitude, and practice (KAP) related to antibiotic use among adults in Saudi Arabia’s Western Region and to identify the demographic and behavioral determinants of these outcomes. Methods: A regional cross-sectional survey was conducted from March to June 2025 using a 40-item self-administered online questionnaire. Adults aged ≥ 18 years residing in the Western Region of Saudi Arabia were recruited via social media using snowball sampling. Descriptive statistics and Chi-square tests were used to examine associations, while multivariate logistic regression was employed to identify determinants of high knowledge and good practices, presented as adjusted odds ratios (aOR) with 95% confidence intervals (CI). Results: A total of 891 participants were included; most were female (63.6%) and aged 18–30 years (56.2%). Moderate knowledge of antibiotic use was observed in 54.0% of participants, while 30.8% had high knowledge. In terms of attitude and practice, 55.6% demonstrated good performance and 42.8% average performance. High knowledge was significantly associated with the female gender (aOR = 1.90; 95% CI: 1.34–2.70), age of 41–50 years (aOR = 2.22; 95% CI: 1.42–3.48), and a postgraduate education (aOR = 15.37; 95% CI: 1.84–128.13). Good practices were associated with the female gender (aOR = 2.32; 95% CI: 1.66–3.24) and being married (aOR = 1.99; 95% CI: 1.43–2.77). A moderate positive correlation was found between knowledge and practice scores (r = 0.406, p < 0.001). Conclusions: Significant variability in public KAP regarding antibiotic use was identified. Female gender, older age, and higher education were key determinants of better KAP. These findings emphasize the need for targeted educational strategies focusing on high-risk groups to support rational antibiotic use and mitigate antimicrobial resistance.