Hospital Pharmacists' Perspectives on Documenting and Classifying Pharmaceutical Interventions: A Nationwide...

Pharmacist interventions (PIs) are central to optimising pharmacotherapy, preventing drug-related problems, and improving patient outcomes. In Portugal, the absence of a validated tool to consistently document and classify PIs limits data comparability and service development. Given these gaps, this study aimed to describe hospital pharmacists' attitudes towards PI documentation and classification, following confirmatory factor analysis (CFA) of a survey instrument, and to provide a comprehensive overview of current practices and behaviours in hospital settings across Portugal. An online questionnaire, previously validated, was distributed online to all hospital pharmacists registered with the Portuguese Pharmaceutical Society (October-December 2024). Sociodemographic data and the cognitive and behavioural domains of pharmacists' attitudinal model were analysed descriptively, and CFA tested the three-factor structure (Process, Outcome, Satisfaction) of the attitudinal affective domain. Of 1848 pharmacists, 260 responded (14%). Respondents reported performing a mean of 49 PIs/month (SD = 196), although many never recorded (28.8%), classified (56.2%), or analysed (52.3%) interventions. Only 2.7% declared to use a validated classification framework. The CFA supported the structural coherence of the Process factor but revealed some overlapping between Process and Outcome and instability in the Satisfaction factor. The nationwide scope and application of CFA provided partial support for the hypothesised model and highlighted areas for refinement, including revision of Satisfaction items and reconsideration of Process and Outcome as overlapping constructs. Findings highlight strong professional commitment to PIs but persistent barriers, including less clear procedures and satisfaction, underscoring the need for a unified, standardised national system to support consistent recording, classification, and evaluation.