Herbal or conventional medicine? A cross-sectional study of Jordanian university students' preferences for cold and flu treatment.

BACKGROUND: 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. OBJECTIVE: 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. METHODS: 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. RESULTS: 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: 1.64-3.96; p < 0.001), whereas medical-field students had lower odds of same-day treatment initiation (aOR = 0.55, 95% CI: 0.42-0.72; p < 0.001). 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: 0.27-0.51; p < 0.001) or combining herbal and pharmaceutical treatments (aOR = 0.56, 95% CI: 0.45-0.70; p < 0.001). 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: 1.39-2.23; p < 0.001). CONCLUSIONS: 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.