Evaluating community pharmacists’ dispensing and counseling practices of semaglutide for weight loss in the United Arab Emirates: A simulated patient study

Background: The rising global prevalence of obesity has led to increased demand for medications such as Semaglutide (Ozempic®), which is approved for the treatment of type 2 diabetes. However, its off-label use for weight loss has raised international concerns regarding misuse, patient safety, and pharmacist accountability. Objectives: This study aimed to assess whether community pharmacists in the UAE dispense Ozempic® without a valid prescription and to evaluate the quality and comprehensiveness of pharmacists’ screening and counseling regarding Ozempic®. Methods: A cross-sectional study was conducted using the simulated patient (SP) methodology. A trained SP visited 153 randomly selected community pharmacies across Dubai and the Northern Emirates and requested Ozempic® without a prescription for weight loss. Data was collected using a structured checklist covering prescription requirements, screening practices, and counseling quality. Results: Of the 153 pharmacies visited, only a minority (26.8%) requested a prescription for Ozempic® before dispensing the medication. Chain pharmacies (35.4%) and female pharmacists (38.6%) were significantly more likely to request a prescription (p = 0.011 and p = 0.004). Additionally, when comparing the total percentage of pharmacists willing to dispense the medication without a prescription to a hypothetical benchmark of 50%, the difference was statistically significant (p<0.001). Screening practices were minimal, with only 3–30% of pharmacists inquiring about basic patient information. Counselling quality was generally low, with 27% of visits receiving no counselling. Male pharmacists had significantly higher counselling scores than female pharmacists (p = 0.024). Time spent in the pharmacy was significantly correlated with better counselling (p < 0.001). In 20.3% of visits, alternatives, such as Tirzepatide or herbal weight loss products, were suggested. Conclusion: The study revealed significant gaps in prescription compliance and patient counseling among UAE community pharmacists when dispensing Ozempic®. These findings reflect broader global concerns about off-label medication use and the critical role of pharmacists in ensuring safe access to high-demand therapies.