Evaluation of community pharmacists' knowledge gaps and dispensing errors related to isotretinoin use in Erbil city: No
No
Copyright (c) 2026 Hawreen Azad Saber , Kameran Hassan Ismail (Author)

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
- Articles
- Submited: May 27, 2025
-
Published: April 23, 2026
Abstract
Background and objective: Isotretinoin, a potent treatment for severe acne, must be administered with caution due to the possibility of serious side effects. Community pharmacists play an important role in ensuring the safe dispensing of medications and providing patient counseling. However, dispensing errors may occur due to pharmacists' current knowledge gaps, particularly in Erbil City. Therefore, this study aims to evaluate the knowledge gaps and dispensing errors among community pharmacists in Erbil City regarding isotretinoin use, to improve safe dispensing practices and patient safety.
Methods: A cross-sectional study consisted of 350 community pharmacists in Erbil City who were selected using a convenience sampling method. Data were collected using a self-administered questionnaire divided into three sections: sociodemographic information, isotretinoin knowledge, and dispensing practices. The data was analyzed using statistical package for the social sciences (SPSS) version 25.
Results: The mean age of the participants was 28.32 ± 5.80 years, and the mean duration of working experience was 5.10 ± 4.60 years. A significant percentage of pharmacists demonstrated a lack of knowledge about isotretinoin treatment. Many people were unaware of its proper use, potential side effects, and the need for counseling. Approximately 67.1% of the participants were classified as having poor knowledge, and only 16.3% of the participants demonstrated good knowledge. This study indicated that the younger, female, and single pharmacists tended to have more knowledge. These findings indicate a significant knowledge gap among pharmacists, emphasizing the importance of more comprehensive educational initiatives to improve isotretinoin-related patient counseling and safe dispensing procedures.
Conclusion: A significant knowledge gap in isotretinoin therapy was identified among Erbil City's community pharmacists. Many pharmacists were not familiar with its proper use, side effects, and safety precautions, emphasizing the need for more comprehensive training and educational initiatives to increase pharmacists' level of knowledge in this area.
Metrics
References
- Alanazi TM, Alajroush W, Alharthi RM, Alshalhoub MZ, Alshehri MA. (20 Prevalence of acne vulgaris, its contributing factors, and treatment satisfaction among the Saudi population in Riyadh, Saudi Arabia: A cross-sectional study. J Dermatol Dermatol Surg. 2024; (1):33-7. https://doi.org/10.4103/jdds.jdds_71_19
- Heng AHS, Chew FT. Systematic review of the epidemiology of acne vulgaris. Sci Rep. 2020;10(1):5754. https://doi.org/10.1038/s41598-020-62715-3
- Tayel K, Attia M, Agamia N, Fadl N. Acne vulgaris: prevalence, severity, and impact on quality of life and self-esteem among Egyptian adolescents. J Egypt Public Health Assoc. 2020;95:1-7. https://doi.org/10.1186/s42506-020-00056-9
- Sutaria AH, Masood S, Saleh HM, Schlessinger J. Acne vulgaris. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 [updated 2023 Aug 17; cited 2025 May 26]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538235
- Habeshian KA, Cohen BA. Current issues in the treatment of acne vulgaris. Pediatrics. 20;145(Supplement_2):S225-S30. https://doi.org/10.1542/peds.2019-2056l
- Fallah H, Rademaker M. Isotretinoin for acne vulgaris–an update on adverse effects and laboratory monitoring. J Dermatolog Treat. 2022;33(5):2414-24. https://doi.org/10.1080/09546634.2021.1967269
- Ünlü Açıkel S, Sadettin Burak A. Bibliometric analysis of studies investigating the association between isotretinoin use and depression and suicide. Clin Exp Dermatol. 2025;50(4):779-87. https://doi.org/10.1093/ced/llae395
- Pile HD, Patel P, Sadiq NM. Isotretinoin [Internet]. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025 [cited 2025 Jul3]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482378/
- Passi SF, Butcher R, Orme DR, Warner JE, Stoddard GJ, Crum AV, et al. Increased incidence of pseudotumor cerebri syndrome among users of tetracycline antibiotics. J Neuroophthalmol. 2022;42(3):323-7. https://doi.org/10.1097/wno.0000000000001536
- Reifenrath J, Rupprecht C, Gmeiner V, Haslinger B. Intracranial hypertension after rosacea treatment with isotretinoin. Neurol Sci. 2023;44(12):4553-6. https://doi.org/10.1007/s10072-023-07039-6
- Karaosmanoğlu N, Mülkoğlu C. Analysis of musculoskeletal side effects of oral Isotretinoin treatment: a cross-sectional study. BMC Musculoskelet Disord. 2020;21:1-10. https://doi.org/10.1186/s12891-020-03656-w
- Maredia H, Tollefson M, Keehr A, Sartori-Valinotti JC. The Mayo Clinic experience: Once daily dosing of isotretinoin for acne. JAAD Int. 2024;17:82-3. https://doi.org/10.1016/j.jdin.2024.07.008
- Jarab AS, Al-Azzam S, Almutairi S, Mukattash TL. Patients’ knowledge and information needs about isotretinoin therapy use in Jordan. Int J Clin Pract. 2022;9443884. https://doi.org/10.1155/2022/9443884
- Jarab AS, Al-Azzam SI, Al-Mutairi S, Heshmeh SA, Mukattash TL, Walid A-Q, et al. Community pharmacists’ knowledge and awareness about isotretinoin therapy and its dispensing practice in Jordan. Heliyon. 2023;9(11). https://doi.org/10.1016/j.heliyon.2023.e22354
- Zhong B-L, Luo W, Li H-M, Zhang Q-Q, Liu X-G, Li W-T, et al. Knowledge, attitudes, and practices towards COVID-19 among Chinese residents during the rapid rise period of the COVID-19 outbreak: a quick online cross-sectional survey. Int J Biol Sci. 2020;16(10):1745. https://doi.org/10.7150/ijbs.45221
- Haron H, Kamal NF, Yahya HM, Shahar S. Knowledge, attitude and practice (KAP) of Malay elderly on salt intake and its relationship with blood pressure. Front Public Health. 2021;8:559071 .https://doi.org/10.3389/fpubh.2020.559071
- Rashid ZA, Al-Tabakha MM, Alomar MJ. Proper counseling and dispensing of isotretinoin capsule products by community pharmacists in UAE: A simulated patient study. Clin Cosmet Investig Dermatol. 2020;405-14. https://doi.org/10.2147/ccid.s256302
- Tuha A, Gurbie Y, Hailu HG. Evaluation of Knowledge and Practice of Pharmacy Professionals regarding the Risk of Medication Use during Pregnancy in Dessie Town, Northeast Ethiopia: A Cross-Sectional Study. J Pregnancy. 2019;2186841. https://doi.org/10.1155/2019/2186841
- Abukhalil AD, Yousef M, Ammar M, Jaghama W, Al-Shami Nm, Naseef HA, et al. Practices, efficacy, and reported side effects associated with isotretinoin treatment in Palestine. Patient Prefer Adherence. 2024;487-501. https://doi.org/10.2147/ppa.s442436
- Dabaghzadeh F, Hajjari R. Practice of community pharmacists related to multivitamin supplements: a simulated patient study in Iran. Int J Clin Pharm. 2018;40:190-5. https://doi.org/10.1007/s11096-017-0579-3
- Alghamdi WA, Alwesaibie HS, Albesher MA, Alghamdi FK, Albaqshi AA, Alwesaibie H. Knowledge, attitude, and practice regarding the use of isotretinoin in Saudi Arabia. Cureus. 2023;15(12). https://doi.org/10.7759/cureus.50516