Objectives: To investigate response of the community pharmacists to acute back pain consultations by the patients, using doctor of pharmacy degree (Pharm D) final year students as simulated patients. Method:The study was a cross-sectional study, conducted over a three months period from April 2016 to July 2016 in community pharmacy setting. The study was done at the western area in Saudi Arabia, at three cities: (Jeddah-Mecca-Taif). Convenient sample of 300 pharmacies were chosen. The students appeared in the pharmacy as patients. A check list was filled immediately after the visit. Results: Results of the study showed that most of pharmacies studied were chain pharmacies (67.3%). The response of the pharmacists towards patients' counseling ranges from (6-55%). The majority of the pharmacists did not ask about spreading of the pain (93%), other disease (91%), medications taken (90%), intensity of pain (83.67%), and duration (83%). There was a low response of pharmacists towards self-care, except rarely, who gave advice for back exercise (6.667%). About 98% and above, did not give information about expected drug problems. Referral was given mainly for numbness symptoms (10.67%). Types of medications recommended were diclofenac sodium (44.67%), muscle relaxants (28.67%) and topical NSAIDS (25.33%). About 70%, of the pharmacists did not give advice spontaneously. Counseling time was less than one minute in 67.67% of the cases. Conclusions: The response of community pharmacists, to acute back pain consultations was inadequate, which necessitates educational and training programs in minor disease treatment, and availability of national guidelines.

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