{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T18:05:03Z","timestamp":1789495503566,"version":"build-2803163510"},"reference-count":32,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"\n Background<\/jats:title>\n University students frequently self-manage common cold and influenza symptoms using herbal remedies, pharmaceutical treatments, or both. However, evidence regarding treatment preferences among Jordanian university students remains limited.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To assess treatment preferences and factors associated with four outcomes: first-line treatment choice, timing of treatment initiation, response to perceived herbal treatment failure, and medication-obtaining behavior.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n An observational cross-sectional study was conducted in Jordan among 1,797 undergraduate students from 16 April to 16 September 2025 using a confidential, de-identified Arabic online questionnaire. Descriptive statistics and multinomial logistic regression were used to evaluate the four outcomes. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were reported.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Combined therapy was the most common first-line choice (44.5%), and 42.5% initiated treatment on the same day. Female participants had higher odds of preferring combined therapy than males (aOR = 2.55, 95% CI: 1.64\u20133.96; p\u2009<\u20090.001), whereas medical-field students had lower odds of same-day treatment initiation (aOR = 0.55, 95% CI: 0.42\u20130.72; p\u2009<\u20090.001). After perceived herbal treatment failure, 50.7% switched to pharmaceutical treatments; reliance on doctor-prescribed treatments was associated with lower odds of continuing herbal remedies (aOR = 0.38, 95% CI: 0.27\u20130.51; p\u2009<\u20090.001) or combining herbal and pharmaceutical treatments (aOR = 0.56, 95% CI: 0.45\u20130.70; p\u2009<\u20090.001). Regarding medication-obtaining behavior, 28.2% purchased pharmaceutical treatments without a prescription based on personal experience, and medical-field students had higher odds of this behavior (aOR = 1.76, 95% CI: 1.39\u20132.23; p\u2009<\u20090.001).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Treatment decisions reflected frequent combined self-care and were associated with sex, field of study, symptoms, prescription-related behavior, and treatment beliefs. Targeted health education may support more informed and rational self-care among university students.<\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pone.0358179","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T17:35:52Z","timestamp":1789493752000},"page":"e0358179","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Herbal or conventional medicine? A cross-sectional study of Jordanian university students\u2019 preferences for cold and flu treatment"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1608-2154","authenticated-orcid":true,"given":"Mohammad","family":"Al-magableh","sequence":"first","affiliation":[{"name":"Yarmouk University","place":["Irbid, Jordan"],"department":["Department of Pediatrics, Family Medicine, and Gynecology, Faculty of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9843-6864","authenticated-orcid":true,"given":"Abdulrhman H.M.","family":"Muhaisen","sequence":"additional","affiliation":[{"name":"Yarmouk University","place":["Irbid, Jordan"],"department":["Department of Basic Medical Sciences, Faculty of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rama M.","family":"Ateir","sequence":"additional","affiliation":[{"name":"Yarmouk University","place":["Irbid, Jordan"],"department":["Department of Basic Medical Sciences, Faculty of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shatha A.","family":"Abu_Eraq","sequence":"additional","affiliation":[{"name":"Yarmouk University","place":["Irbid, Jordan"],"department":["Department of Basic Medical Sciences, Faculty of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanan O.","family":"Hamed","sequence":"additional","affiliation":[{"name":"Yarmouk University","place":["Irbid, Jordan"],"department":["Department of Basic Medical Sciences, Faculty of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sama M.","family":"Al Atoum","sequence":"additional","affiliation":[{"name":"Yarmouk University","place":["Irbid, Jordan"],"department":["Department of Basic Medical Sciences, Faculty of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reem","family":"Bani Amer","sequence":"additional","affiliation":[{"name":"Yarmouk University","place":["Irbid, Jordan"],"department":["Department of Basic Medical Sciences, Faculty of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soha S.","family":"AlShirah","sequence":"additional","affiliation":[{"name":"Yarmouk University","place":["Irbid, Jordan"],"department":["Department of Basic Medical Sciences, Faculty of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"key":"pone.0358179.ref001","unstructured":"World Health Organization. Trends of acute respiratory infection, including human metapneumovirus, in the Northern Hemisphere. https:\/\/www.who.int\/emergencies\/disease-outbreak-news\/item\/2025-DON550. 2025."},{"key":"pone.0358179.ref002","unstructured":"World Health Organization. WHO updates influenza care guidelines: includes recommendations for viruses with pandemic potential. https:\/\/www.who.int\/news\/item\/13-09-2024-who-updates-influenza-care-guidelines--includes-recommendations-for-viruses-with-pandemic-potential. 2024."},{"key":"pone.0358179.ref003","unstructured":"World Health Organization. Influenza [Internet]. 2009. Available from: https:\/\/www.who.int\/europe\/news-room\/fact-sheets\/item\/influenza"},{"issue":"3","key":"pone.0358179.ref004","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1503\/cmaj.121442","article-title":"Prevention and treatment of the common cold: making sense of the evidence","volume":"186","author":"GM Allan","year":"2014","journal-title":"CMAJ"},{"issue":"1","key":"pone.0358179.ref005","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1038\/s41572-018-0002-y","article-title":"Influenza","volume":"4","author":"F Krammer","year":"2018","journal-title":"Nat Rev Dis Primers"},{"issue":"4","key":"pone.0358179.ref006","doi-asserted-by":"crossref","first-page":"2","DOI":"10.7249\/rhq-10-04-02","article-title":"The Societal and Indirect Economic Burden of Seasonal Influenza in the United Kingdom","volume":"10","author":"RJ Romanelli","year":"2023","journal-title":"Rand Health Q"},{"key":"pone.0358179.ref007","author":"V Bartkowiak","year":"2018"},{"key":"pone.0358179.ref008","unstructured":"World Health Organization. Traditional medicine. https:\/\/www.who.int\/news-room\/questions-and-answers\/item\/traditional-medicine. 2023. Accessed 2023."},{"key":"pone.0358179.ref009","doi-asserted-by":"crossref","first-page":"1160","DOI":"10.3389\/fphar.2020.01160","article-title":"Traditional Herbal Medicine in Mesoamerica: Toward Its Evidence Base for Improving Universal Health Coverage","volume":"11","author":"MS Geck","year":"2020","journal-title":"Front Pharmacol"},{"key":"pone.0358179.ref010","unstructured":"World Health Organization. WHO global report on traditional and complementary medicine 2019. Geneva: World Health Organization. 2019. https:\/\/iris.who.int\/handle\/10665\/312342"},{"issue":"2","key":"pone.0358179.ref011","doi-asserted-by":"crossref","first-page":"72","DOI":"10.61194\/jrkpk.v1i2.676","article-title":"Cultural and Socioeconomic Influences on Medicine Choice: A Comparative Review of Herbal and Pharmaceutical Drug Preferences and Their Implications for Health Policy","volume":"1","author":"A Kartiani","year":"2022","journal-title":"jrkpk"},{"issue":"1","key":"pone.0358179.ref012","doi-asserted-by":"crossref","first-page":"1918","DOI":"10.1186\/s12889-025-23113-4","article-title":"Status and influencing factors of OTC medicine use for self-medication in cold and cough: a cross-sectional survey in Japan","volume":"25","author":"Y-S Tian","year":"2025","journal-title":"BMC Public Health"},{"issue":"2","key":"pone.0358179.ref013","first-page":"112","article-title":"Self-medication practices among university students in Jordan","volume":"15","author":"MZ Malak","year":"2019","journal-title":"Malays J Med Health Sci"},{"issue":"10","key":"pone.0358179.ref014","first-page":"183","article-title":"Self-medication practices among health sciences students: the case of Mekelle University","volume":"1","author":"GB Gutema","year":"2011","journal-title":"J Appl Pharm Sci"},{"issue":"6","key":"pone.0358179.ref015","first-page":"436","article-title":"Self-medication: awareness and attitude among Malaysian urban population","volume":"5","author":"MIM Azhar","year":"2013","journal-title":"Int J Collab Res Intern Med Public Health"},{"key":"pone.0358179.ref016","doi-asserted-by":"crossref","first-page":"169","DOI":"10.2147\/RMHP.S170181","article-title":"Patterns of self-medication among medical and nonmedical University students in Jordan","volume":"11","author":"OY Alshogran","year":"2018","journal-title":"Risk Manag Healthc Policy"},{"issue":"4","key":"pone.0358179.ref017","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1093\/ecam\/neh133","article-title":"Tradition and perspectives of arab herbal medicine: a review","volume":"2","author":"B Saad","year":"2005","journal-title":"Evid Based Complement Alternat Med"},{"key":"pone.0358179.ref018","unstructured":"World Health Organization. Antimicrobial resistance. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/antimicrobial-resistance. 2023."},{"key":"pone.0358179.ref019","unstructured":"Centers for Disease Control and Prevention. Healthy habits: antibiotic do\u2019s and don\u2019ts. https:\/\/www.cdc.gov\/antibiotic-use\/about\/index.html. 2025."},{"issue":"10","key":"pone.0358179.ref020","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.0040296","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies","volume":"4","author":"E von Elm","year":"2007","journal-title":"PLoS Med"},{"issue":"11","key":"pone.0358179.ref021","doi-asserted-by":"crossref","first-page":"3926","DOI":"10.3390\/ijerph17113926","article-title":"Gender Differences in Medication Use: A Drug Utilization Study Based on Real World Data","volume":"17","author":"V Orlando","year":"2020","journal-title":"Int J Environ Res Public Health"},{"issue":"2","key":"pone.0358179.ref022","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1089\/jwh.2012.3972","article-title":"Influence of patient sex and gender on medication use, adherence, and prescribing alignment with guidelines","volume":"23","author":"M Manteuffel","year":"2014","journal-title":"J Womens Health (Larchmt)"},{"issue":"8","key":"pone.0358179.ref023","first-page":"561","article-title":"Health seeking behavior among medical students in the University of Sharjah","volume":"5","author":"K Sawalha","year":"2017","journal-title":"J Pharm Pharmacol"},{"key":"pone.0358179.ref024","doi-asserted-by":"crossref","first-page":"309","DOI":"10.4103\/jehp.jehp_378_20","article-title":"Comparison of self-medication practices with analgesics among undergraduate medical and paramedical students of a tertiary care teaching institute in Central India - A questionnaire-based study","volume":"9","author":"CA Chindhalore","year":"2020","journal-title":"J Educ Health Promot"},{"issue":"1","key":"pone.0358179.ref025","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1186\/s12906-022-03783-y","article-title":"Public knowledge, attitudes, and practices towards herbal medicines; a cross-sectional study in Western Saudi Arabia","volume":"22","author":"SF Zaidi","year":"2022","journal-title":"BMC Complement Med Ther"},{"issue":"4","key":"pone.0358179.ref026","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1093\/infdis\/jiu224","article-title":"Influenza-like illness, the time to seek healthcare, and influenza antiviral receipt during the 2010-2011 influenza season-United States","volume":"210","author":"M Biggerstaff","year":"2014","journal-title":"J Infect Dis"},{"key":"pone.0358179.ref027","doi-asserted-by":"crossref","first-page":"2001","DOI":"10.2147\/JMDH.S321765","article-title":"Current Awareness of Health Professionals on the Safety of Herbal Medicine and Associated Factors in the South West of Ethiopia","volume":"14","author":"G Hasen","year":"2021","journal-title":"J Multidiscip Healthc"},{"issue":"4","key":"pone.0358179.ref028","doi-asserted-by":"crossref","first-page":"262","DOI":"10.7326\/0003-4819-135-4-200108210-00011","article-title":"Long-term trends in the use of complementary and alternative medical therapies in the United States","volume":"135","author":"RC Kessler","year":"2001","journal-title":"Ann Intern Med"},{"issue":"9","key":"pone.0358179.ref029","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0257319","article-title":"Prevalence of complementary and alternative medicine despite limited perceived efficacy in patients with rheumatic diseases in Mexico: Cross-sectional study","volume":"16","author":"CI Caballero-Hern\u00e1ndez","year":"2021","journal-title":"PLoS One"},{"issue":"1","key":"pone.0358179.ref030","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1186\/s12906-025-05077-5","article-title":"Complementary and alternative medicine use among patients with type-2 diabetes mellitus attending a suburban tertiary healthcare centre in Sri Lanka","volume":"25","author":"M Thilakarathna","year":"2025","journal-title":"BMC Complement Med Ther"},{"issue":"2","key":"pone.0358179.ref031","doi-asserted-by":"crossref","first-page":"240","DOI":"10.4103\/mgmj.mgmj_92_25","article-title":"A comparative study on the knowledge, attitudes, and practices of self-medication in rural and urban regions of Tumkur, Karnataka, India","volume":"12","author":"CK Supriya","year":"2025","journal-title":"MGM J Med Sci"},{"issue":"1","key":"pone.0358179.ref032","doi-asserted-by":"crossref","first-page":"2123","DOI":"10.1186\/s12889-021-12137-1","article-title":"Factors associated with self-medication in children and the decomposition of rural-urban disparities in China","volume":"21","author":"J Ge","year":"2021","journal-title":"BMC Public Health"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0358179","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T17:36:00Z","timestamp":1789493760000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0358179"}},"subtitle":[],"editor":[{"given":"Jenny","family":"Wilkinson","sequence":"first","affiliation":[{"name":"Endeavour College of Natural Health","place":["AUSTRALIA"]}],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,9,15]]},"references-count":32,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9,15]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0358179","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,15]]}}}