Evaluating Clinical Pharmacy Services in Ministry of Health Hospitals in Al-Baha Region of Saudi Arabia, a Three-Year Retrospective Analysis

Abstract

Highlights What are the main findings? Active clinical pharmacist interventions accounted for 61.8% of all documented forms over the three-year period, concentrated in adult ICUs (74.1%) and records involving patients aged 65 years or older (61.1%); among the 1077 active interventions with a documented physician decision, 99.4% were accepted. Active interventions were also highly concentrated at one of the two study hospitals (99.6%). ICU placement independently predicted therapy optimization (OR 2.64, p < 0.001) but was protective against dosage-regimen errors (OR 0.30, p < 0.001), showing that intervention type is driven by clinical setting rather than patient demographics. What are the implications of the main findings? Peripheral Saudi health clusters can sustain high-density clinical pharmacy surveillance once electronic tracking and standardized documentation are in place, supporting decentralization of these services beyond tertiary centers. The strong physician acceptance rate and setting-dependent intervention patterns argue for expanding critical care pharmacist staffing and postgraduate residency placements in regional hospitals such as Al-Baha. Abstract Background: Clinical pharmacists play a crucial role in identifying and resolving drug-related problems (DRPs) in hospitals. However, there is limited empirical evidence concerning their effect on service organizations in smaller regional facilities in Saudi Arabia. Methods: A retrospective serial cross-sectional study was conducted using three years of administrative data (2023–2025) from two public hospitals in the Al-Baha region. A total of 1812 different database records were identified after full-scale data cleaning, validation, and deduplication. The statistical framework included chi-square test of independence, pairwise two-proportions Z-test, three multivariate binary logistic regression models, Cramer’s V association analysis, and Ward’s hierarchical cluster modeling. Results: Active intervention rates significantly increased from 48.9% in 2023 to 72.4% in 2024 (z = −8.58, p < 0.001), stabilizing at 69.6% throughout 2025 (p < 0.001 versus the 2023 baseline), because 2023 data came from a different source system than 2024 to 2025 data, this pattern is reported descriptively rather as a programmatic integration. The most frequent clinical actions addressed therapy optimization (28.4%), inappropriate dosage regimens (23.6%), and missing drug orders (18.8%). Most entries recorded were for adult intensive care units (ICUs) (74.1%), and most involved patients aged 65 years or older (61.1% of records). ICU setting was independently associated with the intervention being classified as therapy optimization (adjusted odds ratio [aOR] 2.64, p < 0.001), but it was an inverse predictor of dosage-error tracking (OR 0.30, p < 0.001). Conclusions: This is among the first serial cross-sectional studies to build an evidence-based framework describing clinical pharmacy practices in the Al-Baha region, showing pharmacists’ roles and prioritizing advanced clinical training programs, reinforcing the need for critical analysis of health cluster policies across peripheral Saudi networks.