Influence of stress and knowledge on self-medication practices among pharmacy students: a cross-sectional study.

Background: Self-medication with over-the-counter (OTC) medicines is common among university students, particularly pharmacy students, despite the associated risks. Pharmacy students receive comprehensive education in pharmacology and medication safety. However, it remains unclear whether medication-related knowledge alone is sufficient to promote responsible self-medication practices or whether psychological factors, such as stress-related attitudes, also influence these behaviors. Addressing this gap is important, as pharmacy students are expected to promote the rational use of medicines in their future professional practice. Therefore, this study aimed to assess self-medication practices and associated factors among pharmacy students at Umm Al-Qura University in Makkah, Saudi Arabia. Methods: A cross-sectional study was conducted among full-time Doctor of Pharmacy (Pharm. D.) students at Umm Al-Qura University in Makkah, Saudi Arabia, between November and December 2025. Data were collected using a convenience sampling method through an electronic questionnaire developed by pharmacology faculty members. The questionnaire underwent review for face and content validity and was pilot-tested before administration. It assessed demographic characteristics, self-medication practices, medication-related knowledge, and stress-related attitudes. Descriptive statistics, chi-square tests or Fisher's exact tests, and Wilcoxon rank-sum tests were employed to analyze the study variables. Multivariable logistic regression was used to examine associations of demographic characteristics, medication-related knowledge, and stress-related attitudes with frequent self-medication. Statistical significance was defined as Results: A total of 244 pharmacy students participated, including 161 (66.0%) females and 83 (34.0%) males. 230 students (94.3%) reported practicing self-medication. Among them, the most frequently used categories were painkillers (189, 82.2%), topical preparations (154, 67.0%), and cough syrups (106, 46.1%). Male students were more likely than females to report self-medication for financial and time-saving reasons and were also more likely to use cough syrup. In contrast, female students reported greater use of sleeping aids. Higher medication-related knowledge (OR=1.21, 95% CI: 1.12-1.32; Conclusion: Medication-related knowledge and stress-related attitudes emerged as significant independent predictors of frequent self-medication among pharmacy students. These findings indicate the importance of integrating medication safety education with stress management strategies in pharmacy curricula to promote responsible self-medication practices among future pharmacists. Implementing such interventions may facilitate the rational use of OTC medicines, enhance patient safety, and improve public health outcomes.