'Prevalence, experience and awareness of substandard and falsified medicines among the public and healthcare professionals in Jordan'.

Introduction: This study aimed to assess the awareness, experiences and perspectives on substandard and falsified (SF) medicines among the general public and healthcare professionals in Jordan. SF medicines pose a global public health concern, yet data on their prevalence and associated risks in Jordan remain limited.

Methods: A cross-sectional study was conducted between January and June 2023 using a convergent mixed-methods approach. Quantitative data were collected through structured surveys administered to 209 members of the public and 136 healthcare professionals (pharmacists and clinicians) recruited via convenience sampling across Jordan's 12 governorates. Surveys were conducted in English and Arabic. Qualitative data from open-ended responses were analysed thematically.

Results: SF medicine awareness was low, with only 24% of the public and 35% of healthcare professionals reporting familiarity with the issue. Of those aware, only 8% (n=17) of the public and 25% (n=34) of healthcare professionals correctly identified SF medicines. Experiences with SF medicines were reported by 17% (n=36) of the public and 26% (n=35) of healthcare professionals, with some respondents describing adverse effects, including severe complications requiring medical intervention. Despite this, 81% of the public and all healthcare professionals who had encountered SF medicines did not report them, citing a lack of awareness of reporting mechanisms. Economic factors and misconceptions about generics were identified as contributing factors to the circulation and use of SF medicines.

Conclusion: Awareness of SF medicines in Jordan is critically low among both the public and healthcare professionals. The absence of formal reporting systems and economic constraints exacerbates the issue, increasing the risk of exposure to SF medicines. Urgent interventions, including nationwide education campaigns, the establishment of structured reporting mechanisms and policies addressing financial barriers, are essential to mitigating the impact of SF medicines on public health.