Facilitators and Barriers to Prescription Medication Sharing: A Qualitative Study from the Public's Perspective in Saudi Arabia.

Background: Prescription medication sharing (PMS) poses significant health risks, including side effects, delayed care, and worsening of illness. Despite these risks, evidence explaining why people share or avoid sharing prescription medicines remains scarce. To address this gap, the present study explored the perceived facilitators and barriers to PMS among the public in the Kingdom of Saudi Arabia (KSA) using a qualitative approach. Methods: A qualitative study using face-to-face, semi-structured interviews was conducted in the Eastern Province with 60 participants, selected through a convenience sampling strategy. Eligibility criteria included the ability to communicate in Arabic or English, age ≥18 years, and taking a prescribed medication. Interviews continued until data saturation was achieved. Audio recordings were transcribed verbatim and analysed thematically using QSR NVivo 10 software. Results: The study included 60 participants. Most participants were female, younger adults, and university educated. Thematic analysis identified two main themes: facilitators and barriers of PMS. Facilitators included saving time and cost, limited access to medicines or healthcare services, availability of leftover medicines, socio-cultural factors, and prior experience or knowledge about an illness and its treatment. Barriers included unsafe or ineffective treatment, awareness of public health risks, risk of dependence, and risk of non-adherence among lenders. These themes reflected a complex interaction of individual, cultural, and system-level influences. While some drivers aligned with international findings, others were more specific to the Saudi context, such as over-prescribing by doctors, brand preferences, misuse of insurance, medicine accumulation, strong family ties, cultural expectations of generosity, stigma-related communication gaps, and personal illness experiences. Conclusion: This study provides the first qualitative insight into PMS in Saudi Arabia, highlighting how cultural norms, family dynamics, and healthcare system factors shape this behavior. The findings underscore the need for culturally informed policies and public health strategies to reduce risks and promote safe medication practices. Pharmacist-led counselling and community-based campaigns focused on safe medication use and proper disposal can further support safer medication practices and reduce the risks associated with PMS.