Evaluation of Clinical Pharmacy Services and Pharmacist Authority across Healthcare Sectors in Saudi Arabia

Background: Clinical pharmacists contribute to safer and more effective medication use, yet their roles and authority vary across healthcare settings. This study evaluates the clinical functions, scope of authority, and challenges faced by pharmacists in Saudi Arabia. Methods: A cross-sectional survey was conducted among pharmacy care departments in Ministry of Health (MOH) hospitals, military hospitals, private hospitals, medical cities, university hospitals, health clusters, and King Faisal Specialist Hospital and Research Centre. Institutions with 50 or more beds were targeted. The data were collected through structured questionnaires. Results: A total of 26 pharmacists responded. Most worked in MOH hospitals (26.9%), private hospitals (19.2%), or military hospitals (19.2%). Participation in morning rounds (61.5%), developing medication plans (65.4%), and monitoring drug concentrations (61.5%) were reported. Authority to change medication plans (50%) and request lab tests (53.8%) varied. Only 57.7% monitored side effects. Barriers included organizational (23.1%), legislative (11.5%), and cultural factors (11.5%). Nearly all participants (96.2%) agreed that overcoming these barriers improves care. Conclusion: While clinical pharmacists actively contribute to care, inconsistencies in their authority and institutional integration limit their impact. Expanding authority and standardizing roles are necessary to optimize pharmaceutical care.