Community pharmacists' knowledge, attitudes, and practices toward self-medication for common cold and influenza: A COM-B model–based cross-sectional study

Background: Community pharmacists play a crucial role in advising patients on self-medication for minor ailments such as the common cold and influenza. Howeve, behavioral factors influencing their consultation practices remain underexplored in Indonesia. Objective(s): To evaluate community pharmacists' knowledge, attitudes, and practices (KAP) regarding self-medication consultations for common cold and influenza, and to interpret these behaviors using the COM-B (Capability, Opportunity, Motivation–Behavior) framework. Methods: A cross-sectional survey was conducted among 221 community pharmacists in the Malang Region, East Java, Indonesia. A validated 67-item questionnaire assessed pharmacists' KAP. Data were analyzed using descriptive statistics, the item difficulty index (Pd), and the Relative Importance Index (RII), and multiple linear regression to identify behavioral predictors. Results: More than half of pharmacists demonstrated moderate knowledge levels (50.7%). Most knowledge items were moderately complex (Pd = 0.30–0.79). Pharmacists showed highly positive attitudes (RII > 0.90, range: 0.84–0.95) and generally good, though inconsistent, practice behaviors (median RII = 0.93, range: 0.50–0.95). Attitude was the strongest predictor of practice (β = 2.314, p < 0.001), whereas knowledge was not. Conclusion: Interpreted through the COM-B framework, Indonesian community pharmacists demonstrated moderate knowledge, positive attitudes, and generally good but inconsistent practices in self-medication consultations for the common cold and influenza. Attitude emerged as the primary behavioral determinant influencing practice. Interventions that enhance motivation, establish structured consultation guidelines, and integrate digital decision-support tools may strengthen responsible self-medication services in Indonesia.