The quantitative phase included an English-language electronic survey (Qualtrics) distributed among pharmacists and the reports of S/F medications submitted to the IqPhvc. The target participants were pharmacists from across the country with experience in the private sector. The survey was distributed via two professional Facebook groups (members of the SIP and Al-Multaqa Al-Sadalany) between 23 April and 19 May 2020. These are well-known national professional Facebook groups that include around 20,000 members (any pharmacist with a Facebook account). The survey was reposted every other day.

The authors used the findings of the qualitative phase in addition to some items from previous studies that were customized to fit the Iraqi private sector [8, 12]. The authors also consulted current practising pharmacists before developing the survey to ensure the items were tailored to the domestic medicine market. Face validity of the new/modified survey items was checked by three experts in the field. Finally, a pilot study was conducted with ten community pharmacists to detect any unclear/inadequate questions, and the survey was revised accordingly.

The survey included five sections. Part 1 included six items about the responding pharmacist’s characteristics. Part 2 included eight items related to the pharmacist’s knowledge of and ability to detect S/F medications. Part 3 included seven items about the roles of the MOH, the IqPhvc, and the SIP in decreasing the distribution and use of S/F medications. Part 4 included eight items about the pharmacist’s perceptions of S/F medications (such as reasons and potential solutions for the problem of S/F medications). Part 5 included six items about the roles of current community pharmacists in decreasing the distribution and use of S/F medications. An additional question concerned the pharmacist’s awareness of ten IqPhvc alerts about S/F medications in 2019 and 2020.

Pharmacists without experience in the private sector were excluded from the questions identifying some S/F medications that were subject to alerts from the IqPhvc. Additionally, only community pharmacists could answer questions addressing the roles of community pharmacists in decreasing the distribution and use of S/F medications (using display logic question).

The Statistical Package for Social Sciences program (SPSS) version 24 (IBM SPSS Statistics, Armonk, NY, USA) was used for data analysis. Continuous characteristics were expressed as mean, range, and standard deviation. Categorical variables were expressed as frequencies and percentages. The answers to preparedness questions used the 5-score Likert scale: strongly disagree, disagree, neutral, agree, and strongly agree. The Kruskal–Wallis test was used to measure the differences in pharmacists’ knowledge of and ability to detect S/F medications according to years of experience in the private sector. P-values < 0.05 were considered statistically significant.

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