Professional self-perception of hospital clinical pharmacists and its influencing factors: a systematic review

The global demand for clinical pharmacy services has intensified due to aging populations, increasing polypharmacy, and healthcare workforce shortages. The professional self-perception of clinical pharmacists (CPs) critically impacts service quality, retention, and patient relationships, necessitating strategic career planning.

To systematically evaluate hospital CPs' professional self-perception in different countries and regions and analyze its influencing factors, providing a reference for policy optimization in low- and middle-income countries.

From two English databases and four Chinese databases, we searched for original studies on the perception of CPs regarding their profession until January 2025. Two researchers independently screened the literature and extracted the data, and the included studies were assessed for quality according to the Let Evidence Guide Every New Decision (LEGEND) evidence evaluation tools.

A total of 18 studies (17 cross-sectional studies and one prospective study) spanning 1977-2023, covering the USA, China, Sweden, and Vietnam were included. In the USA, higher levels of satisfaction are reported among pharmacists who are engaged more in direct patient care; however, challenges such as insufficient recognition and limited career advancement still remain. In China, CPs generally exhibit positive professional self-perception, although gaps in competency, income dissatisfaction, and workload challenges persist. Swedish CPs demonstrated high professional acceptance, effective interdisciplinary collaboration, and confidence in expanding their prescribing responsibilities within healthcare teams. Vietnam highlighted stress from patient care responsibilities and income disparities. The key influencing factors that affect CP job satisfaction include intrinsic factors (e.g., clinical activity involvement, autonomy), extrinsic factors (e.g., training) and other factors (e.g., level of hospital, level of skills).

CPs' professional self-perception exhibited notable regional differences. Given the qualitative nature of data and heterogeneity of study designs, the results still suggest that clinical activity involvement and autonomy consistently correlate with higher job satisfaction among CPs, whereas inadequate recognition, excessive workload, limited advancement opportunities and financial constraints hinder professional fulfillment.

Registered protocol at PROSPERO: CRD42024470413.