OBJECTIVES: The purpose of this study was to explore associations between knowledge, attitudes and practices of U.S. pharmacy consumers towards OTC products and recommendation sources. METHODS: This study utilized a cross-sectional online survey administered using Qualtrics. A randomly selected Qualtrics panel was used to obtain participants who were stratified based on the U.S. population. Adults over 18 y/o, who reside in the U.S., and had used an OTC medication in the last six months were eligible to participate. The survey contained four main sections exploring demographics, attitudes, knowledge, and practices. This study focuses on recommendation sources of the last OTC product purchased. Data was entered and analysed using R. Logistic regression was used to determine the associations between the dependent and independent variables. RESULTS: A total of 2235 participants responded to the survey. Over 50% of participants (n=1294/2211) had consulted a non-healthcare provider (non-HCP) before purchasing their last OTC product. Significant differences in knowledge regarding OTC packaging was found between those who had sought recommendations from HCPs compared with non-HCPs (mean=6.36 vs. 6.90; p<0.001). In the logistic regression, participants who used their last OTC product correctly were 6 times more likely to have sought recommendations from a HCP compared to participants who had not used their last OTC product correctly . Using the OTC product correctly meaning; the participant have used it for the right indication and correct duration as specified by the consumer healthcare product association. The model also illustrates that participants who are knowledgeable about the information available on a OTC packaging, and who reads it before purchasing the medication are more likely to consult a HCP. CONCLUSIONS: Knowledgeable participants are more likely to seek recommendations from a HCP; which makes them more likely to use OTC medications correctly. Future studies will examine interventions to decrease the risk in using OTC medications.