Dietary Supplement Counseling Practices Among Pharmacists in Lahore, Pakistan: Identifying Knowledge and Training Gaps

Background: Dietary supplements (DS) are extensively used in Pakistan, frequently in conjunction with prescription medicines. Pharmacists are well positioned for patient counsesling due to their accessibility. However, their ability to provide evidence-based counseling remains uncertain due to their varying knowledge and training, especially in low- and middle-income countries (LMICs), including Pakistan. The study assessed pharmacists' knowledge, attitudes, and practices (KAP) regarding DS counseling and identified gaps requiring intervention. Methods: A cross-sectional study was conducted among 256 registered pharmacists in Lahore, Pakistan. Data were collected using a validated, self-administered questionnaire assessing knowledge, attitudes, and counseling practices concerning dietary supplements over a period of six months i.e., July to December 2025. Statistical analyses were performed using SPSS version 27. A p-value of < 0.05 was considered statistically significant. Results: Mean age was 31.0 {+/-} 6.2 years, with male predominance (56.3%), Doctor of Pharmacy degree (75.0%), community pharmacy practice (62.5%), and 1-5 years of experience (48.4%). Mean knowledge score was 6.18 {+/-} 1.71, with most (76.6%) exhibiting moderate knowledge. Mean attitude score was 7.01 {+/-} 1.94, with 91.4% demonstrating positive attitudes. Mean practice score was 7.91 {+/-} 2.93, with 68% exhibiting good counseling practices. Knowledge scores were significantly higher among female pharmacists (6.96 {+/-} 1.52 vs. 5.57 {+/-} 1.61, p=0.001), urban residents (6.39 {+/-} 1.61 vs. 4.37 {+/-} 1.30, p<0.001), and clinical pharmacists (7.10 {+/-} 1.68, p=0.001). Conclusion: Pharmacists practicing in Lahore, Pakistan demonstrated positive attitudes but moderate knowledge and inconsistent counseling practices. Key gaps were identified in drug-supplement interaction knowledge and counseling practices. These findings underscore the need for organized education, continued training, and regulatory supervision to improve counseling practices of dietary supplements.