Challenges in understanding dosing instructions among polypharmacy patients with chronic illnesses in Iraq

Background: Patients with chronic conditions who are taking multiple medications often don't comprehend how to follow the dose schedule recommendations. Polypharmacy is becoming more common since there are more older people and more chronic conditions. Many patients depend on complicated pharmaceutical regimens that are recommended by more than one healthcare professional. 
Objectives: The study sought to evaluate the extent of the misunderstand regarding dose instructions among patients with chronic diseases undergoing a polypharmacy at the chronic outpatient pharmacy of the AL-Khadmyia teaching hospital in ‎Baghdad, Iraq.
Methods: From September 2024 to August 2025, an institutional based a cross sectional survey took place at AL-Khadmyia Teaching Hospital in Baghdad, Iraq. The subjects in this study were chosen used a rigorous random sampling technique. Medscape and drug.com also looked at drug-drug and drug-food interactions to see how important they were. The distributions of variables were described using frequency, percentage, and mean standard deviation (SD). The Chi-square test was used to see if there was a link between the variables and the main outcome, with a p-value of less than 0.05.
Results: Out of 620 participants, (60.3) % were women, and their average age was 46.17 years old (±17.09). The survey showed that almost half (80.6%) of the people who took part didn't understand at least one dose instruction, and around (18.9%) didn't understand how often to take the drug. About (92.4%) of patients were unaware of drug-drug interactions (DDIs). Sex (X2 = 16.605; P<0.0001), educational level (X2 = 21.565; P<0.001), Marital status (X2 =32.971; P<0.0001), and duration of medicine use (X2 =49.698; P<0.0001) were all strongly linked to not comprehending dose regimen instructions.
Conclusion: The study found that a considerable individual’s proportion were unable to comprehend their pharmaceutical dosage regimen directions. To deal with these serious drug-related problems, healthcare providers should use interventions including giving patients written instructions and more counseling.