Knowledge, attitudes, and practices of community pharmacists regarding dietary supplements in Saudi Arabia: a multi-region cross-sectional study

Background Community pharmacists are a frontline resource for public counselling on dietary supplements in Saudi Arabia, where supplement use is high and largely self-directed. Multi-region evidence on pharmacist competency in this domain remains limited. Objectives To evaluate the knowledge, attitudes, and practices (KAP) of licensed community pharmacists in Saudi Arabia regarding dietary supplements and to identify the independent demographic and professional correlates of variation across each KAP domain using multivariable regression. Methods A cross-sectional study was conducted among community pharmacists practising at licensed retail outlets across five administrative regions of Saudi Arabia. A pre-tested, self-administered questionnaire covered three KAP domains—knowledge (8 items), attitudes (8 items), and practices (11 items)—plus four supplementary applied clinical-knowledge scenarios. Cronbach’s α coefficients were 0.81 (knowledge), 0.69 (attitude), and 0.86 (practice). Independent-samples t-tests, one-way ANOVA (with Tukey HSD post-hoc tests), Pearson’s r, and multivariable linear regression were used to examine associations of gender, education, university of graduation, experience, and pharmacy position with each KAP domain. Results Of 1,104 questionnaires distributed, 843 (76.4%) were completed and analysed. All three KAP domain scores were positively inter-correlated (Attitude–Practice r = 0.545; Knowledge–Attitude r = 0.359; Knowledge–Practice r = 0.357; all p < 0.001). In the multivariable model for knowledge (R² = 0.230, F(7,835) = 35.71, p < 0.001), Pharm.D. qualification (β = 0.314), 2–7 years of experience (β = 0.292), and male gender (β = 0.176) were the strongest independent correlates. Female gender was independently associated with more favourable attitudes (β = −0.194 for male gender) and better self-reported practices (β = −0.361 for male gender). Conclusions Saudi community pharmacists in this sample showed generally positive attitudes toward supplement counselling, with meaningful variation in knowledge and self-reported practice. Pharm.D. qualification and 2–7 years of experience were associated with stronger KAP profiles, although the cross-sectional design precludes causal inference. The findings primarily support competency-based workforce development: pharmacists who undertake dietary-supplement counselling should have appropriate preparation, continuing professional development, and access to reliable point-of-care information. The study does not provide a numerical staffing model because supplement-related workload and consultation demand were not measured.