Introduction & Objective: Pharmacists usually encounter requests for over the counter drugs. How a pharmacist performs in evaluating patients' signs and symptoms, treating them, and moreover his or her approach in prescribing over the counter (OTC) medications were the main goals of this study.    

Materials & Methods: In this cross- sectional study, the scenarios of cough, diarrhea and common cold were obtained from questionnaires. These scenarios were then designed by determining key questions. From the overall pharmacies in Hamadan, for each of the three scenarios, 46 pharmacies were randomly selected and analyzed. Performance of pharmacists, including their interventions on over the counter counseling, asking key questions, explaining drugs' side effects and interactions, and their approach of prescribing medications, were measured. Moreover, the influence of pharmacists' gender and type of the pharmacy were determined.

Results: In 41 out of 179 visits, pharmacists were not present in the pharmacy (22.9%), mostly in suburban pharmacies. The pharmacists' performances in explaining drug interactions were significantly better in urban pharmacies in comparison with suburban ones. Moreover, suburban pharmacies and male pharmacists, in comparison with urban pharmacies and female pharmacists, prescribed more drugs.

Conclusion: This study shows that despite the pharmacists asking the key questions ,the majority of pharmacists made weak recommendations. In order to improve pharmacists performances, modification of  educational system for pharmacy students in addition to the continuous and effective supervision of  authorities on pharmacists' performance in  OTC drugs is suggested.