Learning, adopting, and sustaining the pharmacist-clinician role in clinical practice: a qualitative study among early adopters in the Netherlands

INTRODUCTION: Hospital pharmacists are increasingly involved in direct patient care; however, little is known about how to learn, adopt, and sustain this pharmacist-clinician role in practice. AIM: This study aimed to examine the implementation of the pharmacist-clinician role by exploring the key factors that shape its learning, adoption, and sustainment in clinical practice. METHOD: Early adopters of the pharmacist-clinician role in Dutch hospitals were recruited through purposive sampling via professional networks and national outreach. A semi-structured interview was conducted with the respondents. Data were analysed inductively using thematic analysis and were subsequently interpreted using the Normalisation Process Theory (NPT) to investigate key factors in learning, adopting, and sustaining the pharmacist-clinician role. RESULTS: A total of 21 Dutch pharmacists working in a hospital were included. Factors, grouped into four themes (Scope and role enactment of the pharmacist-clinician role, interprofessional collaboration as the driver for adoption, experiential workplace learning is more important than formal learning, and organisational conditions shape sustainment and scalability) described how the pharmacist-clinician role develops from local sense-making and interprofessional adoption to enactment through workplace learning. Although individual initiative enabled early uptake, the role remained highly context-dependent. An NPT-informed synthesis showed that long-term sustainment relied mainly on organisational support and structural embedding, and less on individual factors. CONCLUSION: Our findings imply that embedding the pharmacist-clinician role should be approached as an organisational effort rather than merely as an expansion of professional competencies. Its sustainable development requires deliberate implementation, clear role definition, and organisational support for embedding the role in everyday practice.