Evaluating Clinical Pharmacist Interventions in a Tertiary Care Hospital: A Retrospective Study from Saudi Arabia

<b>Background</b>: Clinical pharmacy services (CPSs) play a key role in ensuring medication safety, optimizing pharmacotherapy, and improving patient outcomes. While their benefits are well-documented globally, their specific impact within the Saudi healthcare system remains underexplored. <b>Objective</b>: This study aimed to evaluate the impact of pharmacist-led interventions in a tertiary medical center in Saudi Arabia. Methods: A retrospective chart review was conducted at a 1200-bed academic hospital in western Saudi Arabia. Pharmacist interventions documented between 1 January 2023 and 31 December 2023 were analyzed. Interventions were categorized into 13 types, including dosage errors, unavailable medications, and drug-drug interactions. Descriptive statistics were used to summarize the data. <b>Results</b>: A total of 38,143 pharmacist interventions were recorded. Dosage errors accounted for 77.2% (n = 29,584) of interventions, followed by issues with medication availability (6.57%, n = 2519) and incorrect medication orders (4.59%, n = 1761). The most frequently implicated medications were acetylsalicylic acid, enoxaparin, and paracetamol, collectively representing 43.55% of interventions. The highest intervention rates were in the Emergency Department (25.3%, n = 11,050), Oncology Clinics (9.81%, n = 4285), and Male Medical Units (9.43%, n = 4119). <b>Conclusions</b>: Clinical pharmacists play a significant role in reducing medication errors and improving patient safety across various specialties. Their targeted interventions optimize therapeutic outcomes, highlighting the need for integrating advanced tools and expanding CPSs to meet evolving healthcare demands in Saudi Arabia.