Abstract
Background
Omega-3 polyunsaturated fatty acids are essential nutrients with interventional benefits for cardiovascular, dermatological, and immune systems. Unexpectedly, few studies have investigated the implications of pharmacy knowledge and practice on omega-3 dispensing in pharmacies in Jordan.
Objective
This study aimed to explore the knowledge, attitudes, and practices of pharmacy students and pharmacists in Jordan concerning the health benefits of omega-3 fatty acids, patient counseling, supplement use, and prescription of omega-3 in Jordanian pharmacies.
Methods
A cross-sectional study utilizing a structured questionnaire was conducted between March and May 2025. The research team developed the study questionnaire, and independent researchers evaluated its face and content validity. To evaluate the questionnaire’s internal consistency, a pilot test was carried out. Three sections covering different topics of interest made up the final questionnaire. The questionnaire assessed demographic information, knowledge of omega-3 sources and health benefits, awareness of recommended dosages, and professional practices in supplement recommendation. Data were analyzed using SPSS.
Results
Omega-3 supplements are used by 60.5% (n = 477) of the participants and 65.4% (n = 516) by the participants’ family members. The mean knowledge score of omega-3 among the participants was 2.95 (SD = 5.28), while the Self-Assessment of Omega-3 Knowledge for the participants (45.4%) (n = 358) was low. The majority of respondents (74.1%) reported that omega-3 cannot be synthesized endogenously. While only 12.0% identified fish and plants as sources of omega-3. Likewise, only 16.3% of the participants identified the recommended dose of omega-3 (1000 mg/day). Compared to students, pharmacists had higher percentages of correct responses for reducing the risk of preterm birth, incidence of depression, improving skin condition, and improving hair condition (p-value < 0.05). Additionally, there was a significant increase in correct identification of both the recommended daily dose of omega-3 (p-value = 0.038) and the enhancement of hair condition (p-value = 0.008) among intermediate and expert pharmacists. Meanwhile, in multiple linear regression, gender was identified as the sole statistically significant predictor of the omega-3 benefits knowledge score (p-value = 0.014).
Conclusion
Pharmacists and pharmacy students in Jordan demonstrate good awareness of omega-3 sources and general benefits but exhibit notable gaps in knowledge of dosage, non-cardiovascular effects, and evidence-based recommendations. Educational interventions and professional training, especially for pharmacy students during the practical courses for undergraduates, are recommended.
Keywords: Omega-3 fatty acids, Pharmacist knowledge, Pharmacy students, Dietary supplements, Jordan, Public health awareness
Introduction
During the last decade, there has been a growing trend in the consumption of dietary supplements to prevent disease and improve health, especially supplements not synthesized in the human body. Omega-3 Poly Unsaturated Fatty Acids (PUFAs) are nutritional fatty acids with the utmost impact on human health, and they are recommended to be implemented in the human diet or delivered as dietary supplements [1].
Three main types of omega-3 fatty acids are present: Alpha-Linolenic Acid (ALA), Eicosapentaenoic Acid (EPA), and Docosahexaenoic Acid (DHA). Natural PUFA sources are categorized into plant-based sources (such as flaxseeds, chia seeds, canola oil, and walnuts) and marine-derived sources (such as algal oil and several fatty fish, including salmon, sardines, and tuna). The marine-derived sources are uniquely rich in EPA and DHA. Foremost amongst these lipids are ALA and Linoleic Acid (LA), the “parents” of the other omegas—omega-3 and omega-6, respectively [2].
Clinical studies have demonstrated several benefits of omega-3 PUFAs on human health, exclusively in the fields of antioxidants, anti- inflammatory properties, antimicrobial effects, cognitive function, neurological and cardiovascular diseases (CVD), and inflammatory reactions; furthermore, they enhance the metabolic and physiological activities in the human body [3, 4]. On the contrary, the uncontrolled intake of omega-3 in high doses impairs the absorption of lipid-soluble hormones such as Vitamin D3 [5].
Additionally, omega-3 has a potent ameliorative effect on cardiovascular health in reversing the devastating consequences of dyslipidemia and hypertension. Several researchers declared that the intake of omega-3 supplementation in high doses of 3 g is associated with a significant mitigation in triglycerides, low-density lipoproteins (LDL), and cholesterol levels. Additionally, antiarrhythmic properties as an antihypertensive through vasodilation activity have been noticed [5–8].
The consumption of omega-3 fatty acids in the diet is crucial to enhance enzymatic pathways and support general health, as omega-3s have been associated with a lowering of side effects for chronic diseases, such as neuropathy and nephropathy in diabetic patients [6]. For instance, the American Heart Association promotes the consumption of two weekly servings of fish to decrease the risk of myocardial infarction and stroke. Moreover, clinical evidence suggests that a daily intake of at least one gram of EPA plus DHA is associated with reduced CVD mortality and enhances general cardiovascular health [6, 9–11].
Widely held improvement performance is directly connected to omega − 3 PUFAs, which have a pivotal role in ameliorating the immune system through the suppression of pro-inflammatory cytokine production like C-reactive protein and alpha tumor necrosis factor TNF-ꭤ, interleukin-1β (IL-1β), IL-6, and IL-17 A cytokines, which reduces the autoimmune disease susceptibility, enhances phagocytosis, efficient clearance of infections, maintains healthy tissue, enhances immune responses, aiding pattern recognition, and attacking pathogenic isolates [8, 12–14].
Several studies reveal that higher intakes of rich DHA lower the risk of metabolic Type II Diabetes Mellitus (T2DM) through an influence on oxidative stress. DHA-based research indicates that the EPA/DHA ratio in plasma has an important role in T2DM prognosis; despite these protective effects, maintaining regulatory insulin lipids (glucose) levels is essential. In addition, DHA-based interventions potentiate the action of glucose in plasma plus lipids regulation, acting as a control strategy that is utilized to prevent this condition [15, 16].
Omega-3 is crucial in neurogenesis, mental health, memory, cognitive functions, antidepressant effects, mood control, and brain development [17, 18]. Additionally, Omega-3 pertains to skin health and texture through augmenting anti-inflammatory activity and anti-aging by implementing stem cell regeneration and enhancing collagen formation [19–22]. The threat of preterm delivery associated with maternal, fetal, and environmental factors is significantly reduced by the administration of PUFAs such as EPA and DHA with regular dosages of 600 milligrams a day to ameliorate the harmful effects of preterm birth in low-risk pregnant women [23].
The current study sought to examine the implications of knowledge, attitude, and experience of pharmacy students and pharmacists on the dispensing of omega-3 supplements for outpatients in Jordanian society. The current study is the first to assess the impact of demographic factors, such as gender, age, level of education, and experience, on omega-3 dispensing among pharmacists in Jordan.
Materials & methods
Study design
A cross-sectional study was conducted using a developed electronic-based questionnaire to evaluate undergraduate pharmacy students’ and graduated pharmacists’ knowledge of omega-3 FAs. Pharmacists were categorized into three groups according to their experience (Beginner, Intermediate, and Expert). The study was conducted between March and May 2025.
Study population
Participants were eligible for the study if they were aged 18 years or older. There was no gender restriction or discrimination. Furthermore, to comply with the inclusion criteria, the participant should hold a degree in pharmacy, either a diploma, a bachelor’s, or a postgraduate degree, or be a student at the school of pharmacy. On the other hand, students who did not complete a training course in pharmacy, or pharmacists not employed at the time of the study, were excluded.
The incomplete responses, or answers with missing data, were excluded from analysis. All participants were requested to fill out an electronic consent form before filling out the questionnaire.
Questionnaire development
After conducting an extensive literature review, the research team developed the first draft of the questionnaire.
To ensure face and content validity, an expert panel of fifteen pharmacists was asked to review the questionnaire items. The panel members held a bachelor’s degree in pharmacy with a minimum of 10 years of pharmacy practice or a postgraduate degree with 5 years of practice. The expert panel assessed the clarity and comprehensiveness of the developed questionnaire and then provided suggestions and comments to enhance the clarity and comprehensiveness of the questionnaire.
The questionnaire was piloted with 10% of the anticipated sample to ensure its face and content validity. The objective of the pilot was to obtain feedback on the language used, comprehensibility, and clarity of the questionnaire to further align the aim of the study. The questionnaire was modified based on the feedback received. After the pilot study, the internal consistency of the questionnaire was tested via Cronbach’s alpha analysis, and the value of 0.75 was revealed, demonstrating a satisfactory degree of reliability.
Three major parts covering different topics of interest comprised the final version of the questionnaire. The first section contained items for collecting demographic data (gender, age, and level of education). Additionally, a self-assessment of the omega-3 knowledge item was added with three possible levels (low, middle, and high). The second section assessed participants’ knowledge of omega-3, using 20 multiple-choice questions. In this section, different topics were covered, including omega-3 sources, doses, benefits, and use among children. The third section assessed participants’ practices and attitudes toward omega-3 use.
Sample size
The minimum sample size was calculated using the Epi Info program software Version 7.2.7.0. The calculation was based on a 95% confidence level, a 50% expected frequency, an acceptable margin of error of 5%, and a design effect of 1.0. The minimum number of participants required was 385. The questionnaire was completed online using the Google Forms application sent by email. The instructions and consent forms were sent and completed anonymously to ensure confidentiality.
Statistical analysis
After data collection, coding of questionnaire responses and data entry were carried out in a database using the Statistical Package for the Social Sciences (SPSS), Version 27.0 (IBM Corp., Armonk, New York, USA). Continuous variables were presented as means (SD), whereas the qualitative characteristics were presented as percentages. The Chi-square test was used to assess the knowledge gap between students and pharmacists, as well as the variation in knowledge among pharmacists with different levels of professional experience.
The 20 items in the knowledge section (Sect. 2) had three responses: a correct answer, an incorrect answer, and an “I do not know” answer. The “I do not know” answer was scored with 0, a correct answer was scored with 1, and an incorrect answer was scored with − 1. Consequently, a total knowledge score ranging from − 20 to 20 was calculated, considering the cumulative scores of the 20 items. Furthermore, a knowledge score of omega-3 benefits was extracted from the knowledge section, consisting of 13 items (range: -13 to 13).
Multiple linear regression was performed to identify the independent variables affecting the total knowledge score. For this purpose, a simple linear regression was performed as an initial screening step to identify variables to be considered in the multiple linear regression. Any variable with a p-value < 0.250 was considered eligible. Subsequently, a variable with a p-value of > 0.05 was considered significant in the multiple regression. To confirm the absence of multicollinearity between the independent variables, a variance inflation factor (VIF) of less than 5 and a tolerance value of less than 0.2 were used. All independent variables were selected after evaluating their independence.
Ethical considerations
All participants provided written informed consent to the review committee in relevance to the Declaration of Helsinki Protocol. Ethical approval for the study was obtained from the Outcome Committee on Ethical Review before initiating any study procedures. The current study was approved by the IRB committee at Applied Science Private University, No. 25-PHA-33.
Results
Demographic characteristics of the participants
A total of 789 participants completed the questionnaire, with more than two-thirds being females (n = 532, 67.4%). The age distribution showed that the largest age category was 23–25 years, which included 35.0% of participants (n = 276). This was followed by 26–35 years (29.5%, n = 233) and 18–22 years (27.6%, n = 218). Regarding the educational level, students comprised 27.6% of the sample (n = 218). Additionally, more than half of the participants (57.0%, n = 450) held a bachelor’s degree (Table 1).
Table 1.
Demographic characteristics of the study’s participants (n = 789)
| Parameter | n (%) |
|---|---|
| Gender | |
| Male | 257 (32.6) |
| Female | 532 (67.4) |
| Age | |
| 18–22 | 218 (27.6) |
| 23–25 | 276 (35.0) |
| 26–35 | 233 (29.5) |
| 36–45 | 49 (6.2) |
| ≥ 45 | 13 (1.6) |
| Level of Education | |
| Student | 218 (27.6) |
| Diploma | 6 (0.8) |
| Bachelor’s degree | 450 (57.0) |
| Postgraduate degree (Master’s - PhD) | 115 (14.6) |
| Self-Assessment of Omega-3 Knowledge | |
| Low | 358 (45.4) |
| Intermediate | 389 (49.3) |
| High | 42 (5.3) |
Based on the self-assessment of omega-3 knowledge, 45.4% (n = 358) of the participants reported a low level, 49.3% (n = 389) reported an intermediate level, and 5.3% (n = 42) reported a high level (Table 1).
Participants’ knowledge of omega-3
The mean knowledge score regarding omega-3 among the participants was 2.95 (SD = 5.28), with scores ranging from − 12 to 18. The study participants demonstrated variable levels of awareness about omega-3 (Table 2). Nearly three-quarters of participants (74.1%) correctly identified that the human body does not produce omega-3 (item 1). In contrast, almost half (48.5%) reported that they are unaware of the recommended dose (item 3).
Table 2.
Knowledge about omega-3 among the study’s participants (n = 789)
| Statements | Correct Answer | I do not know | Incorrect Answer | Mean |
|---|---|---|---|---|
| n (%) | ||||
| 1. Does the human body produce omega-3? | ||||
| • No* | 585 (74.1) |
20 (2.5) |
184 (23.3) | 0.51 (0.847) |
| • Yes | ||||
| 2. What are the sources of omega-3? | ||||
| • Fish only | 95 (12.0) |
2 (0.3) |
692 (87.7) | -0.76 (0.652) |
| • Plants only | ||||
| • Fish and plants* | ||||
| • I do not know | ||||
| 3. What is the recommended daily dose of omega-3? (Please specify in mg/day)^ | 129 (16.3) | 383 (48.5) | 277 (35.1) | -0.19 (0.693) |
| 4. Does omega-3 boost immunity? | ||||
| • No | 768 (97.3) |
18 (2.3) |
3 (0.4) |
0.97 (0.193) |
| • Yes* | ||||
| • I do not know | ||||
| 5. Do omega-3 supplements improve mental performance in older adults? | ||||
| • No | 661 (83.8) |
18 (2.3) |
110 (13.9) | 0.70 (0.700) |
| • Yes* | ||||
| • I do not know | ||||
| 6. Do omega-3 supplements reduce the risk of preterm birth? | ||||
| • No | 612 (77.6) |
71 (9.0) |
106 (13.4) | 0.64 (0.707) |
| • Yes* | ||||
| • I do not know | ||||
| 7. Do omega-3 supplements reduce the incidence of depression? | ||||
| • No | 734 (93.0) |
34 (4.3) |
21 (2.7) |
0.90 (0.375) |
| • Yes* | ||||
| • I do not know | ||||
| 8. Omega-3 deficiency is associated with a higher risk of heart attack | ||||
| • True* | 358 (45.4) |
44 (5.6) |
387 (49.0) | -0.04 (0.972) |
| • False | ||||
| • I do not know | ||||
| 9. Omega-3 deficiency is associated with a higher risk of stroke | ||||
| • True* | 358 (45.4) |
44 (5.6) |
387 (49.0) | -0.04 (0.972) |
| • False | ||||
| • I do not know | ||||
| 10. Omega-3 deficiency is associated with a higher risk of exacerbation of diabetes | ||||
| • True* | 264 (33.5) |
46 (5.8) |
479 (60.7) | -0.27 (0.932) |
| • False | ||||
| • I do not know | ||||
| 11. Omega-3 deficiency is associated with a higher risk of heart disease | ||||
| • True* | 611 (77.4) |
25 (3.2) |
153 (19.4) | 0.58 (0.795) |
| • False | ||||
| • I do not know | ||||
| 12. Do omega-3 supplements improve skin condition? | ||||
| • No | 617 (78.2) |
26 (3.3) |
146 (18.5) | 0.60 (0.782) |
| • Yes* | ||||
| • I do not know | ||||
| 13. Do omega-3 supplements help treat dandruff? | ||||
| • No | 564 (71.5) |
29 (3.7) |
196 (24.8) | 0.47 (0.864) |
| • Yes* | ||||
| • I do not know | ||||
| 14. Do omega-3 supplements improve hair condition? | ||||
| • No | 287 (36.4) |
32 (4.1) |
470 (59.6) | -0.23 (0.952) |
| • Yes* | ||||
| • I do not know | ||||
| 15. Are omega-3 supplements used in cancer-related conditions? | ||||
| • No | 134 (17.0) |
13 (1.6) |
642 (81.4) | -0.64 (0.755) |
| • Yes* | ||||
| • I do not know | ||||
| 16. Are omega-3 supplements used in inflammatory conditions? | ||||
| • No | 90 (11.4) |
13 (1.6) |
686 (86.9) | -0.76 (0.643) |
| • Yes* | ||||
| • I do not know | ||||
| 17. Are omega-3 supplements important for children? | ||||
| • No | 605 (76.7) |
15 (1.9) |
169 (21.4) | 0.55 (0.822) |
| • Yes* | ||||
| • I do not know | ||||
| 18. Do omega-3 supplements improve children’s concentration? | ||||
| • No | 652 (82.6) |
18 (2.3) |
119 (15.1) | 0.68 (0.722) |
| • Yes* | ||||
| • I do not know | ||||
| 19. Do omega-3 supplements improve children’s mental abilities? | ||||
| • No | 370 (46.9) |
18 (2.3) |
401 (50.8) | -0.04 (0.988) |
| • Yes* | ||||
| • I do not know | ||||
| 20. Do omega-3 supplements improve children’s behavioral outcomes? | ||||
| • No | 114 (14.4) |
18 (2.3) |
657 (83.3) | -0.69 (0.710) |
| • Yes* | ||||
| • I do not know | ||||
* The Correct Answer
^ 1000 mg/day was considered a correct answer
Regarding the health benefits and clinical applications of omega-3 supplements (items 4–16), participants were generally aware of several statements (Table 2). Omega-3 boosts immunity was the statement with the highest correct response rate, with 97.3% answering it correctly (item 4). A high percentage of participants also knew that omega-3 reduces the incidence of depression (93.0%, item 7), helps older adults improve their mental performance (83.8%, item 5), helps improve skin condition (78.2%, item 12), reduces preterm birth (77.6%, item 6), treats dandruff (71.5%, item 13), and improves hair conditions (36.4%, item 14). However, there was much less awareness of some therapeutic uses, especially their use for inflammatory conditions (11.4%, item 16) and cancer-related conditions (17.0%, item 15).
The participants’ knowledge of health risks due to deficiency was mixed (Table 2). More than three-quarters of the participants correctly responded to the statement on heart disease (item 11). In contrast, lower proportions of correct responses were observed for heart attack and stroke (both 45.4%, items 8 and 9, respectively). Whereas one-third of participants (33.5%) correctly answered the item related to exacerbation of diabetes (item 10).
Regarding omega-3 use in children (items 17–20), more than three-quarters of the participants recognized the importance of omega-3 supplements in children (76.7%, item 17) and their role in improving concentration (82.6%, item 18). About 46.9% correctly stated that omega-3 can improve children’s mental abilities (item 19). In contrast, only 14.4% correctly recognized the impact of omega-3 supplements on enhancing behavior (item 20), marking it as the least accurately answered item among the child items (Table 2).
Comparison between students’ and pharmacists’ knowledge
The differences that were statistically significant between the pharmacists and students were limited to four items. Compared to students, pharmacists had higher percentages of correct responses for reducing the risk of preterm birth (79.9% vs. 71.6%, p-value = 0.034) and reducing the incidence of depression (94.4% vs. 89.4%, p-value = 0.028). Furthermore, pharmacists’ knowledge was slightly higher than students’ on improving skin condition (79.9% vs. 73.9%, p-value = 0.021) and hair condition (37.7% vs. 33.0%, p-value = 0.032). There were no statistically significant differences between other items in both groups (Table 3).
Table 3.
Assessment of pharmacists (n = 571) and students (n = 218) knowledge regarding omega-3
| Statements | Total n = 789 |
Students n = 218 |
Pharmacists n = 571 |
p-value# |
|---|---|---|---|---|
| Correct answer, n (%) | ||||
| 1. Does the human body produce omega-3? | ||||
| • No* | 585 (74.1) | 165 (75.7) | 420 (73.6) | 0.425 |
| • Yes | ||||
| 2. What are the sources of omega-3? | ||||
| • Fish only | 95 (12.0) | 30 (13.8) | 65 (11.4) | 0.454 |
| • Plants only | ||||
| • Fish and plants* | ||||
| • I do not know | ||||
| 3. What is the recommended daily dose of omega-3? (Please specify in mg/day)^ | 129 (16.3) | 33 (15.1) | 96 (16.8) | 0.146 |
| 4. Does omega-3 boost immunity? | ||||
| • No | 768 (97.3) | 209 (95.9) | 559 (97.9) | 0.264 |
| • Yes* | ||||
| • I do not know | ||||
| 5. Do omega-3 supplements improve mental performance in older adults? | ||||
| • No | 661 (83.8) | 174 (79.8) | 487 (85.3) | 0.140 |
| • Yes* | ||||
| • I do not know | ||||
| 6. Do omega-3 supplements reduce the risk of preterm birth? | ||||
| • No | 612 (77.6) | 156 (71.6) | 456 (79.9) | 0.034^ |
| • Yes* | ||||
| • I do not know | ||||
| 7. Do omega-3 supplements reduce the incidence of depression? | ||||
| • No | 734 (93.0) | 195 (89.4) | 539 (94.4) | 0.028^ |
| • Yes* | ||||
| • I do not know | ||||
| 8. Omega-3 deficiency is associated with a higher risk of heart attack | ||||
| • True* | 358 (45.4) | 86 (39.4) | 272 (47.6) | 0.116 |
| • False | ||||
| • I do not know | ||||
| 9. Omega-3 deficiency is associated with a higher risk of stroke | ||||
| • True* | 358 (45.4) | 86 (39.4) | 272 (47.6) | 0.116 |
| • False | ||||
| • I do not know | ||||
| 10. Omega-3 deficiency is associated with a higher risk of exacerbation of diabetes | ||||
| • True* | 264 (33.5) | 69 (31.7) | 195 (34.2) | 0.317 |
| • False | ||||
| • I do not know | ||||
| 11. Omega-3 deficiency is associated with a higher risk of heart disease | ||||
| • True* | 611 (77.4) | 160 (73.4) | 451 (79.0) | 0.243 |
| • False | ||||
| • I do not know | ||||
| 12. Do omega-3 supplements improve skin condition? | ||||
| • No | 617 (78.2) | 161 (73.9) | 456 (79.9) | 0.021^ |
| • Yes* | ||||
| • I do not know | ||||
| 13. Do omega-3 supplements help treat dandruff? | ||||
| • No | 564 (71.5) | 153 (70.2) | 411 (72.0) | 0.107 |
| • Yes* | ||||
| • I do not know | ||||
| 14. Do omega-3 supplements improve hair condition? | ||||
| • No | 287 (36.4) | 72 (33.0) | 215 (37.7) | 0.032^ |
| • Yes* | ||||
| • I do not know | ||||
| 15. Are omega-3 supplements used in cancer-related conditions? | ||||
| • No | 134 (17.0) | 38 (17.4) | 96 (16.8) | 0.944 |
| • Yes* | ||||
| • I do not know | ||||
| 16. Are omega-3 supplements used in inflammatory conditions? | ||||
| • No | 90 (11.4) | 34 (15.6) | 56 (9.8) | 0.068 |
| • Yes* | ||||
| • I do not know | ||||
| 17. Are omega-3 supplements important for children? | ||||
| • No | 605 (76.7) | 158 (72.5) | 447 (78.3) | 0.196 |
| • Yes* | ||||
| • I do not know | ||||
| 18. Do omega-3 supplements improve children’s concentration? | ||||
| • No | 652 (82.6) | 175 (80.3) | 477 (83.5) | 0.093 |
| • Yes* | ||||
| • I do not know | ||||
| 19. Do omega-3 supplements improve children’s mental abilities? | ||||
| • No | 370 (46.9) | 107 (49.1) | 263 (46.1) | 0.056 |
| • Yes* | ||||
| • I do not know | ||||
| 20. Do omega-3 supplements improve children’s behavioral outcomes? | ||||
| • No | 114 (14.4) | 35 (16.1) | 79 (13.8) | 0.065 |
| • Yes* | ||||
| • I do not know | ||||
* The Correct Answer
# Using the chi-square test
^Bold Significant at 0.05 significance level
Comparison of pharmacists’ knowledge across different levels of professional experience
There were two knowledge items where pharmacists’ knowledge was significantly associated with professional experience (Table 4). First, with experience, there was a significant increase in correct identification of the recommended daily dose of omega-3 (item 3, p-value = 0.038), from which it increased from 12.7% among beginners to 20.6% for intermediate and 21.0% for expert pharmacists. In addition, there was a significant association regarding omega-3 in enhancing hair condition (item 14, p-value = 0.008). Interestingly, an inverse correlation was revealed where beginners reported the highest correct responses (44.2%) compared to intermediates (31.3%) and experts (32.3%).
Table 4.
Pharmacists’ knowledge of omega-3 according to years of professional experience
| Statements | Pharmacists (Beginner) n = 276 |
Pharmacists (Intermediate) n = 233 |
Pharmacists (Expert) n = 62 |
p-value# |
|---|---|---|---|---|
| Correct answer, n (%) | ||||
| 1. Does the human body produce omega-3? | ||||
| • No* | 201 (72.8) | 171 (73.4) | 48 (77.4) | 0.758 |
| • Yes | ||||
| 2. What are the sources of omega-3? | ||||
| • Fish only | 26 (9.4) | 29 (12.4) | 10 (16.1) | 0.259 |
| • Plants only | ||||
| • Fish and plants* | ||||
| • I do not know | ||||
| 3. What is the recommended daily dose of omega-3? (Please specify in mg/day)^ | 35 (12.7) | 48 (20.6) | 13 (21.0) | 0.038^ |
| 4. Does omega-3 boost immunity? | ||||
| • No | 271 (98.2) | 227 (97.4) | 61 (98.4) | 0.803 |
| • Yes* | ||||
| • I do not know | ||||
| 5. Do omega-3 supplements improve mental performance in older adults? | ||||
| • No | 244 (88.4) | 194 (83.3) | 49 (79.0) | 0.089 |
| • Yes* | ||||
| • I do not know | ||||
| 6. Do omega-3 supplements reduce the risk of preterm birth? | ||||
| • No | 219 (79.3) | 186 (79.8) | 51 (82.3) | 0.875 |
| • Yes* | ||||
| • I do not know | ||||
| 7. Do omega-3 supplements reduce the incidence of depression? | ||||
| • No | 262 (94.9) | 220 (94.4) | 57 (91.9) | 0.651 |
| • Yes* | ||||
| • I do not know | ||||
| 8. Omega-3 deficiency is associated with a higher risk of heart attack | ||||
| • True* | 122 (44.2) | 115 (49.4) | 35 (56.5) | 0.173 |
| • False | ||||
| • I do not know | ||||
| 9. Omega-3 deficiency is associated with a higher risk of stroke | ||||
| • True* | 122 (44.2) | 115 (49.4) | 35 (56.5) | 0.173 |
| • False | ||||
| • I do not know | ||||
| 10. Omega-3 deficiency is associated with a higher risk of exacerbation of diabetes | ||||
| • True* | 100 (36.2) | 72 (30.9) | 23 (37.1) | 0.394 |
| • False | ||||
| • I do not know | ||||
| 11. Omega-3 deficiency is associated with a higher risk of heart disease | ||||
| • True* | 214 (77.5) | 182 (78.1) | 55 (88.7) | 0.136 |
| • False | ||||
| • I do not know | ||||
| 12. Do omega-3 supplements improve skin condition? | ||||
| • No | 228 (82.6) | 176 (75.5) | 52 (83.9) | 0.099 |
| • Yes* | ||||
| • I do not know | ||||
| 13. Do omega-3 supplements help treat dandruff? | ||||
| • No | 209 (75.7) | 163 (70.0) | 39 (62.9) | 0.085 |
| • Yes* | ||||
| • I do not know | ||||
| 14. Do omega-3 supplements improve hair condition? | ||||
| • No | 122 (44.2) | 73 (31.3) | 20 (32.3) | 0.008^ |
| • Yes* | ||||
| • I do not know | ||||
| 15. Are omega-3 supplements used in cancer-related conditions? | ||||
| • No | 42 (15.2) | 38 (16.3) | 16 (25.8) | 0.127 |
| • Yes* | ||||
| • I do not know | ||||
| 16. Are omega-3 supplements used in inflammatory conditions? | ||||
| • No | 30 (10.9) | 19 (8.2) | 7 (11.3) | 0.542 |
| • Yes* | ||||
| • I do not know | ||||
| 17. Are omega-3 supplements important for children? | ||||
| • No | 209 (75.7) | 183 (78.5) | 55 (88.7) | 0.081 |
| • Yes* | ||||
| • I do not know | ||||
| 18. Do omega-3 supplements improve children’s concentration? | ||||
| • No | 230 (83.3) | 193 (82.8) | 54 (87.1) | 0.718 |
| • Yes* | ||||
| • I do not know | ||||
| 19. Do omega-3 supplements improve children’s mental abilities? | ||||
| • No | 131 (47.5) | 102 (43.8) | 30 (48.4) | 0.656 |
| • Yes* | ||||
| • I do not know | ||||
| 20. Do omega-3 supplements improve children’s behavioral outcomes? | ||||
| • No | 43 (15.6) | 26 (11.2) | 10 (16.1) | 0.304 |
| • Yes* | ||||
| • I do not know | ||||
* The Correct Answer
# Using the chi-square test
^Bold Significant at 0.05 significance level
Participants’ practices and attitudes toward omega-3 usage
Omega-3 supplements were being used by 60.5% (n = 477) of participants and 65.4% (n = 516) by a family member. In addition, when asked whether they would recommend omega-3 supplements to others, it was found that 54.5% (n = 430) of the participants stated that it would depend on the case, while 40.4% (n = 319) stated that they would recommend it, and only 5.1% (n = 40) stated that they would not recommend it (Fig. 1).
Fig. 1.
Participants’ practices and attitudes toward omega-3 supplement use
More than three-quarters of the participants (78.5%, n = 619) disagreed with taking omega-3 on their own without the recommendation of a doctor or pharmacist, while 21.5% (n = 170) agreed (Fig. 1).
According to the multiple linear regression, gender was identified as the sole statistically significant predictor of the omega-3 benefits knowledge score (Table 5). Specifically, female participants had significantly higher benefits knowledge scores compared to male participants (p-value = 0.014). On the other hand, there were no statistically significant associations with knowledge score for age (p-value = 0.748), level of education (p-value = 0.465), self-assessment of omega-3 knowledge (p-value = 0.501), and personal use of omega-3 supplements (p-value = 0.073).
Table 5.
Assessment of factors associated with knowledge of omega-3 benefits among the study's participants (n=789)
| Parameter | Knowledge Score of Omega-3 Benefits | |||||
|---|---|---|---|---|---|---|
| Possible Range [-13 to 13] | ||||||
| Beta | P-value# | Beta | P-value$ | |||
| Gender | ||||||
| Male |
Reference 0.092 |
0.010^ | 0.089 | 0.014* | ||
| Female | ||||||
| Age | ||||||
| 18–22 |
Reference 0.064 |
0.071^ | 0.020 | 0.748 | ||
| 23–25 | ||||||
| 26–35 | ||||||
| 36–45 | ||||||
| ≥ 45 | ||||||
| Level of Education | ||||||
| Student |
Reference 0.087 |
0.015^ | 0.052 | 0.465 | ||
| Diploma | ||||||
| Bachelor’s degree | ||||||
| Postgraduate degree | ||||||
|
Self-Assessment of Omega-3 Knowledge | ||||||
| Low |
Reference 0.070 |
0.050^ | 0.030 | 0.501 | ||
| Intermediate | ||||||
| High | ||||||
| Do you use omega-3 supplements? | ||||||
| No |
Reference 0.075 |
0.034^ | 0.064 | 0.073 | ||
| Yes | ||||||
*Bold Significant at 0.05 significance level
Discussion
This research sheds light on the awareness, attitude, and practices of licensed pharmacists and pharmacy students towards knowledge and dispensing of omega-3. The findings point to a broad knowledge about the essential nature of omega-3 and the requirement for an ectopic source of PUFs to sustain biological function. Likewise, Backs et al. reported a high level of knowledge regarding the sources of omega-3 among pharmacists [24].
The study’s findings resonate with the broader context of omega-3 nutrition, where endogenous synthesis is insufficient, necessitating dietary intake primarily from marine sources [2, 11]. As demand rises globally and population increases, environmentally sustainable agricultural practices, such as microalgae cultivation, are essential to address the need for omega-3 [11].
Additionally, there was solid knowledge about the role of omega-3 in supporting mental health and managing skin conditions. On the other hand, a lower level of knowledge was found regarding the role of omega-3 in inflammatory and cancer therapy. Consistent with a study conducted by Kotchetkov et al., which demonstrated that pharmacists possess a good level of knowledge regarding omega-3 usage, where 64% of responders identified brain health as a benefit, while other health benefits were less widely recognized [25].
Moreover, there was foundational knowledge about the correlation between omega-3 deficiency and heart disease, but more than 55% of the respondents did not know the direct correlation between heart attacks and strokes. This finding is congruent with the extensive investigations showing the role of omega-3 PUFAs in lowering levels of triglycerides, LDL cholesterol, and blood pressure. In addition, omega-3 exhibits antiarrhythmic and vasodilator effects to reduce the risk of CVD complications such as stroke and myocardial infarction [6, 9, 10].
Regrettably, the current study’s participants were unaware of omega-3 benefits beyond cardiovascular functions, including their anti-inflammatory, antidiabetic, neuroprotective, dermatological, and immunomodulatory effects, since only 14.4% of pharmacists recognized the impact of omega-3 supplements on enhancing the behavior of children. Moreover, neurotransmitter functioning is modulated, causing depression risk reduction as well as helping cognitive function, such as memory, both of which are neuroprotective functions for EPA and DHA [17, 26]. For instance, omega-3 prevents skin breakdown by boosting collagen synthesis, preserving skin barrier integrity, and guarding against aging-related inflammation [20]. It also strengthens hair health through its anti-inflammatory and antioxidant activities [27]. These multifaceted benefits underscore the need for pharmacists to have comprehensive knowledge to effectively counsel patients.
These improvements are due to the neuroprotective action of DHA and EPA. These components preserve membrane fluidity, which fights neurodegenerative disease, regulates gene expression related to brain function, and decreases inflammation [28].
The pharmacy students lacked knowledge in several areas, including preterm birth, skin conditions, and the proper dose of omega-3, when compared with practicing pharmacists. This highlights the demand for a comprehensive course on the benefits of supplementary drugs in the Faculty of Pharmacy’s curriculum.
The experienced pharmacists demonstrated significantly higher accuracy in dispensing skills than the beginner ones in terms of dose and concentration. This could be attributed to the clinical experience gained during their practice and regular exposure to medical prescriptions.
It is worth highlighting that the current study reveals a lack of knowledge about recommended omega-3 dosages, with 84% of participants being uncertain about appropriate intake. Given that clinical studies recommend a minimum of 1 g/day of EPA and DHA for cardiovascular benefits [6, 9] and 600–1000 mg/day during pregnancy to reduce preterm birth risk [29, 30]. This knowledge gap could limit pharmacists’ ability to provide accurate dosing advice. Addressing this through targeted education is essential for optimizing therapeutic outcomes and minimizing risks. Overcoming this limitation through targeted education interventions is critical to ensuring optimal therapeutic outcomes and reducing risk factors. Kotchetkov et al. demonstrated that only 6% of pharmacists felt confident in counselling patients on omega-3 dosing [25].
Interestingly, beginner pharmacists possessed greater knowledge than the experts regarding improving hair condition; this could be attributed to the massive amount of information and exposure to these trends on social media. Benetoli et al. reported that a continuous education pattern through electronic learning for pharmacists is growing, especially among the younger age groups, and there is an enhanced pharmaceutical education [31].
A positive attitude toward omega-3 supplementation was observed, with more than 60% of the participants being regular consumers of omega-3, and they recommended its use on a case-by-case basis. Meanwhile, 55% of the participants recommended omega-3 supplements freely and independently, which may raise skepticism regarding possible side effects in the absence of professional guidance. Interestingly, 76% of participants did not support the prescription status of omega-3 supplements, preferring OTC availability. This viewpoint is congruent with the well-known safety profile of omega-3 supplements, but also underlines the key contributions of pharmacists in promoting informed and responsible use [6].
Gender was identified as the sole statistically significant predictor of the omega-3 benefits knowledge score, with female participants having significantly higher knowledge compared to male participants. These results could be oriented and account for the precise awareness of females in the details compared to males. Such findings indicate that the educational interventions need to be custom-adapted to target particular demographic segments, which may lead to broader competency gains. Moreover, the strong correlations between education level and knowledge of the dose and benefits of omega-3 are also emphasized by the importance of incorporating omega-3 content into pharmacy curricula and Continuing Professional Development for pharmacy teaching.
These findings underscore the demand for an interprofessional discussion with healthcare providers to improve pharmacists’ knowledge, which is vital to mitigate the side effects resulting from persistent knowledge gaps. Such targeted interventions ensure consistent information delivery, enabling users to make informed decisions, maximize resource accessibility, and improve the community’s quality of life.
Pharmacists, as accessible healthcare providers, can play a pivotal role in educating the public about diverse omega-3 sources and encouraging balanced dietary habits. This shows a reasonable awareness of omega-3 fatty acids among young pharmacists in Jordan, but as previously noted, there is still a significant knowledge gap and variability in practice, especially regarding the non-cardiovascular benefits and dosing. Therefore, pharmacy education and training on omega-3 fatty acids should be implemented to enable pharmacists to effectively promote the appropriate therapeutic use of omega-3. Consequently, this will improve the overall health consequences of cardiovascular, metabolic, neurological, dermatologic, and immune conditions in the community.
Acknowledgements
The current work was supported by Princess Nourah bint Abdulrahman University Researchers Supporting Project number (PNURSP2026R814), Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia. The authors would like to sincerely thank all pharmacists who participated in this study for their valuable time and honest responses. Special thanks are also made to the pharmacy (Faculty of Pharmacy - The Private Applied Science University, Amman, Jordan) for their support and encouragement during the data collection. The authors also mention colleagues, experts who reviewed the questionnaire and offered insightful comments to enhance the quality of this study.
Clinical trial number
Not applicable.
Limitations
The majority of the sample consisted of young individuals (62.6% aged between 19 and 25) and predominantly female participants (67.4%), which may not accurately represent the entire population of pharmacists in Jordan. The inclusion of students in the sample introduces potential confounding variables in the results. Self-reported knowledge could potentially differ from actual professional practices. Utilizing online convenience sampling raises concerns about selection bias. Additionally, the authors don’t have data regarding the response rate from the pharmacists.
Authors' contributions
Nesrin Seder, Razzan I Nassar and Reem Abutayeh: Conceptualization, study design, data collection, statistical analysis, and manuscript drafting. Walid Aburayyan and Sireen Shilbayeh: Supervision, validation of data, critical review, and editing of the final manuscript. O’la Ahmad AL-Fawares: Questionnaire development, literature review, and assistance in data interpretation. All authors read and approved the final version of the manuscript and agreed to its submission.
Funding
This project was funded by Princess Nourah bint Abdulrahman University Researchers Supporting Project number (PNURSP2026R814), Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia.
Data availability
The dataset used and analyzed during the current study are available on reasonable request.
Declarations
Ethics approval and consent to participate
All participants provided written informed consent to the Review Committee in relevance to Declaration of Helsinki Protocol. The Name was obtained from the Committee on Ethical Review received from the treatment procedures of the applicable before engaging in any portion of the study. The current study was approved by the IRB committee at the Applied Science Private University, No. 25-PHA-33. All participants were pharmacists who received written and oral information regarding the study objectives, procedures, and voluntary nature of their participation. Informed consent to participate was obtained from all participants in the study. No patient data were collected or used.
Consent for publication
Not applicable.
Competing interests
The authors declare no competing interests.
Footnotes
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
References
- 1.Patted PG, Masareddy RS, Patil AS, Kanabargi RR, Bhat CT. Omega-3 fatty acids: A comprehensive scientific review of their sources, functions and health benefits. Future J Pharm Sci. 2024;10(1):94. [Google Scholar]
- 2.Oliver L, Dietrich T, Marañón I, Villarán MC, Barrio RJ. Producing omega-3 polyunsaturated fatty acids: A review of sustainable sources and future trends for the EPA and DHA market. Resources. 2020;9(12):148. [Google Scholar]
- 3.Daboul SM, Abusamak M, Mohammad BA, Alsayed AR, Habash M, Mosleh I, Al-Shakhshir S, Issa R, Abu-Samak M. The effect of omega-3 supplements on the serum levels of ACE/ACE2 ratio as a potential key in cardiovascular disease: A randomized clinical trial in participants with vitamin D deficiency. Pharm Pract. 2022;21(1):2761. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 4.Sadah AHA, Issa R, Farah H, Oriquat G, Awwad SH, Mosleh I, Mohammad BA, Aljaberi A, Al-Najjar M, Abu-Samak MS. Effect of eicosapentaenoic acid, docosahexaenoic acid, and their combination on selected atherogenic biomarkers in a high-fat diet rat model. J Appl Pharm Sci. 2025;15(3):150–9. [Google Scholar]
- 5.Mohammad BA, Oriquat GA, Khader HA, Alsayed AR, Farah HS, Alhmoud JF, Al-Najjar MA, Hasoun L, Abdelhalim SM, Awwad SH. A comparison of the effect of omega-3 alone versus omega-3/Vitamin D3 co-supplementation therapy on 25-hydroxyvitamin D levels in adults with vitamin D deficiency. Pharm Pract. 2025;23(1):1–9. [Google Scholar]
- 6.Bernasconi AA, Wiest MM, Lavie CJ, Milani RV, Laukkanen JA. Effect of Omega-3 Dosage on Cardiovascular Outcomes: An Updated Meta-Analysis and Meta-Regression of Interventional Trials. Mayo Clin Proc. 2021;96(2):304–13. [DOI] [PubMed] [Google Scholar]
- 7.Al-Zoubi SM, Awwad SH, Issa RA, Daraosheh AQ, Al-Qaisi T, Farah H, Omari KW, Mohammad BA, Amer M, Khuzaie RF. Quantification of Bioactive Compounds in Coffea Arabica and Their Impact with Omega-3 Supplementation on Non-High-Density Lipoprotein Levels in Hyperlipidemia-Induced Rats. Baghdad Sci J. 2025;22(8):2587–601. [Google Scholar]
- 8.Al Najjar MAA, Abdulrazzaq SB, Al-Shaer S, Barakat M, Omar A, Zrieq R, Hasen E, Samak MA. The Antimicrobial Activity of Combination of Vitamin D3 and Omega-3 against Pathogenic Microorganisms. Comb Chem High Throughput Screen. 2025;28(8):1278–89. [DOI] [PubMed] [Google Scholar]
- 9.Elagizi A, Lavie CJ, O’Keefe E, Marshall K, O’Keefe JH, Milani RV. An Update on Omega-3 Polyunsaturated Fatty Acids and Cardiovascular Health. Nutrients. 2021;13(1):204. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 10.Gardner CD, Vadiveloo MK, Petersen KS, Anderson CAM, Springfield S, Van Horn L, Khera A, Lamendola C, Mayo SM, Joseph JJ, et al. Popular Dietary Patterns: Alignment With American Heart Association 2021 Dietary Guidance: A Scientific Statement From the American Heart Association. Circulation. 2023;147(22):1715–30. [DOI] [PubMed] [Google Scholar]
- 11.Qin J, Kurt E, T LB, Sa L, Xie D. Biotechnological production of omega-3 fatty acids: current status and future perspectives. Front Microbiol. 2023;14:1280296. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 12.El-Sayyad SM, Ali MA, Ragab GM, Ibrahim SSA. Metformin and omega-3 fish oil elicit anti-inflammatory effects via modulation of some dysregulated micro RNAs expression and signaling pathways in experimental induced arthritis. Int Immunopharmacol. 2021;92:107362. [DOI] [PubMed] [Google Scholar]
- 13.Khaled RA, Alhmoud JF, Issa R, Khader HA, Mohammad BA, Alsayed AR, Khadra KA, Habash M, Aljaberi A, Hasoun L. The variations of selected serum cytokines involved in cytokine Storm after Omega-3 daily supplements: A Randomized Clinical Trial in Jordanians with vitamin D deficiency. Pharm Pract. 2024;22(2):1–10. [Google Scholar]
- 14.Zhu L, Sha L, Li K, Wang Z, Wang T, Li Y, Liu P, Dong X, Dong Y, Zhang X, et al. Dietary flaxseed oil rich in omega-3 suppresses severity of type 2 diabetes mellitus via anti-inflammation and modulating gut microbiota in rats. Lipids Health Dis. 2020;19(1):20. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 15.Bayram SS, Kiziltan G. The Role of Omega- 3 Polyunsaturated Fatty Acids in Diabetes Mellitus Management: A Narrative Review. Curr Nutr Rep. 2024;13(3):527–51. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 16.Delpino FM, Figueiredo LM, da Silva BGC, da Silva TG, Mintem GC, Bielemann RM, Gigante DP. Omega-3 supplementation and diabetes: A systematic review and meta-analysis. Crit Rev Food Sci Nutr. 2022;62(16):4435–48. [DOI] [PubMed] [Google Scholar]
- 17.Sikka P, Behl T, Sharma S, Sehgal A, Bhatia S, Al-Harrasi A, Singh S, Sharma N, Aleya L. Exploring the therapeutic potential of omega-3 fatty acids in depression. Environ Sci Pollut Res Int. 2021;28(32):43021–34. [DOI] [PubMed] [Google Scholar]
- 18.Lin C, Lee SH, Huang CM, Wu YW, Chang YX, Liu HL, Ng SH, Cheng YC, Chiu CC, Wu SC. Cognitive protection and brain entropy changes from omega-3 polyunsaturated fatty acids supplement in late-life depression: A 52-week randomized controlled trial. J Affect Disord. 2024;351:15–23. [DOI] [PubMed] [Google Scholar]
- 19.Ismail S, Ahmed-Farid OA, Metwally GF, Mansour D, Khattab A. Anti-aging effect of mustard and flax seed oils based nanoemulsion gel on aged rat skin through antioxidant and anti-inflammatory activity. Sci Afr. 2024;26:e02369. [Google Scholar]
- 20.Koh YG, Seok J, Park JW, Kim KR, Yoo KH, Kim YJ, Kim BJ. Efficacy and safety of oral palmitoleic acid supplementation for skin barrier improvement: A 12-week, randomized, double-blinded, placebo-controlled study. Heliyon. 2023;9(6):e16711. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 21.Muraleedharan V, Kamath GS, Sasikumar G, Panicker SP. Advantages of Functional Foods in Supporting and Maintaining Hair and Skin Health. In: Pathak S, Banerjee A, Duttaroy AK, editors. Evidence-based Functional Foods for Prevention of Age-related Diseases. Singapore: Springer; 2023. 10.1007/978-981-99-0534-8_12. [DOI]
- 22.Pagac MP, Gempeler M, Campiche R. A New Generation of Postbiotics for Skin and Scalp: In Situ Production of Lipid Metabolites by Malassezia. Microorganisms. 2024;12(8):1711. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 23.Best KP, Gibson RA, Makrides M. ISSFAL statement number 7–Omega-3 fatty acids during pregnancy to reduce preterm birth. Prostaglandins Leukot Essent Fatty Acids. 2022;186:102495. [DOI] [PubMed] [Google Scholar]
- 24.Backes JM, Beavers CJ, Dixon DL, Gibson CA, Hilleman DE, Malesker MA, Saseen JJ, Dilsaver DB. Assessing pharmacists’ knowledge and practices involving dietary supplement omega-3 fatty acids. Journal of Clinical Lipidology. 2025;19(6):1738-44. 10.1016/j.jacl.2025.09.007. [DOI] [PubMed]
- 25.Kotchetkov A, Kamel M. Omega-3 Fatty Acids and Mental Health: Assessment of Pharmacists’ Knowledge and Educational Needs. Can J Educational Social Stud. 2025;5(4):102–31. [Google Scholar]
- 26.Mora I, Arola L, Caimari A, Escote X, Puiggros F. Structured Long-Chain Omega-3 Fatty Acids for Improvement of Cognitive Function during Aging. Int J Mol Sci. 2022;23(7):3472. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 27.Hossain MJ, Faruk O, Lira DN, Shill DK, Rouf ASS. Design and Evaluation of Hair Growth-Hair Fall Oil Formulation from Botanicals. Bangladesh Pharm J. 2024;27(1):9–18. [Google Scholar]
- 28.Kalkman HO, Hersberger M, Walitza S, Berger GE. Disentangling the Molecular Mechanisms of the Antidepressant Activity of Omega-3 Polyunsaturated Fatty Acid: A Comprehensive Review of the Literature. Int J Mol Sci. 2021;22(9):4393. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 29.Cetin I, Carlson SE, Burden C, da Fonseca EB, di Renzo GC, Hadjipanayis A, Harris WS, Kumar KR, Olsen SF, Mader S, et al. Omega-3 fatty acid supply in pregnancy for risk reduction of preterm and early preterm birth. Am J Obstet Gynecol MFM. 2024;6(2):101251. [DOI] [PubMed] [Google Scholar]
- 30.Serra R, Penailillo R, Monteiro LJ, Monckeberg M, Pena M, Moyano L, Brunner C, Vega G, Choolani M, Illanes SE. Supplementation of Omega 3 during Pregnancy and the Risk of Preterm Birth: A Systematic Review and Meta-Analysis. Nutrients. 2021;13(5):1704. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 31.Benetoli A, Chen TF, Aslani P. The use of social media in pharmacy practice and education. Res social administrative Pharm. 2015;11(1):1–46. [DOI] [PubMed] [Google Scholar]
Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Data Availability Statement
The dataset used and analyzed during the current study are available on reasonable request.