Background The Active Ingredient Prescribing (AIP) mandate was introduced Australia-wide on 1 February 2021. The AIP legislation makes the pharmacist a stakeholder who can provide valuable information to customers and patients.

Aim To explore the experiences of community pharmacists with AIP legislation with a focus on attitude, health literacy, and medication safety.

Method Semi-structured, in-depth interviews were conducted and guided by the Theoretical Domains Framework (TDF). Transcripts were analysed using a deductive approach to categorise data and inductive thematic analysis to identify concepts and themes. Ethical approval was granted by the Griffith University Human Research Ethics Committee (Reference no: 2021/878) and the study conforms to the Australian National Statement on Ethical Conduct in Human Research. Informed consent from all participants was obtained via a study information sheet distributed to all potential participants and completion of written consent forms prior to participation in the study. Participants received gift cards as compensation for their time.

Results Six pharmacists participated, and thematic analysis of collected data revealed three main themes. These included education, integration, and trust. Insights on patients' acceptance of their prescriptions and the expanded patient-facing opportunities were highlighted. Participants' opinions leaned towards enhancing the smooth integration into the AIP process of other stakeholders like prescribers and regulatory bodies. Establishing multilevel communication between stakeholders and customers was pivotal to improving health literacy and medication safety. Pharmacists' views on process integration provided unique insight into the practical challenges with the AIP mandate. In addition, ‘trust’ in the prescriber enhanced patient acceptance of generic medicines.

Conclusion The study provided baseline evidence to show that the AIP mandate enhances health literacy and empowers patients to know the active ingredients in their medicines, which in turn supports medication safety. Examining the implementation of the AIP legislation facilitated a nuanced understanding of the effect that these AIP changes have on patients.