KNOWLEDGE, ATTITUDES, AND COUNSELING PRACTICES REGARDING ECHINACEA PURPUREA AMONG PHARMACISTS IN TAFILAH, JORDAN: THE ROLE OF CONTINUING PROFESSIONAL DEVELOPMENT

Background: The increasing use of herbal medicines has strengthened the role of pharmacists in providing evidence-based counseling regarding their appropriate and safe use. Echinacea purpurea is widely used as a natural product, particularly for respiratory conditions, yet its use raises important considerations concerning evidence of efficacy, safety, contraindications, and potential herb-drug interactions. This study assessed the knowledge, attitudes, and practices (KAP) of pharmacists regarding Echinacea purpurea in Tafilah Governorate, Jordan, and examined the relationship between continuing professional development (CPD) and pharmacists' knowledge and professional practice.
Methods: A cross-sectional descriptive study was conducted among licensed pharmacists practicing in Tafilah Governorate, Jordan. Data were collected electronically using a structured and validated self-administered questionnaire assessing demographic and professional characteristics, knowledge, attitudes, counseling and dispensing practices, barriers, and CPD-related educational needs. A total of 134 pharmacists participated. Descriptive statistics, independent-samples t-test, one-way analysis of variance, chi-square test, Spearman's rank correlation, one-sample t-test, and multiple linear regression were used for data analysis.
Results: Pharmacists demonstrated moderate knowledge of E. purpurea (9.2 ± 2.1/16), with greater awareness of common uses than of safety-related issues. Knowledge was highest regarding use for the common cold 104 pharmacists (77.6%) and lower regarding autoimmune disease contraindications 74 pharmacists (55.2%) and adverse effects such as skin rash 80 pharmacists (59.7%). Attitudes were generally favorable (42.5 ± 5.4/60), whereas practice scores were moderate (18.3 ± 3.2/25). Only 51 pharmacists (38.1%) routinely asked about patients' medical history, while 58 pharmacists (43.3%) relied on the internet, leaflets, or other informal sources for information. CPD was positively correlated with knowledge (r = 0.43) and practice (r = 0.46), and knowledge, attitudes, and CPD significantly predicted practice behavior (R² = 0.48, adjusted R² = 0.45, p < 0.001).
Conclusion: Pharmacists demonstrated favorable attitudes toward their professional role but important gaps in safety-related knowledge and evidence-based counseling practice. Targeted CPD programs focusing on herb-drug interactions, special populations, safety, and evidence-based information resources may strengthen pharmacist competence and support safer use of E. purpurea in Jordan.