The research team, headed by Wael Y. Khawagi and Abdullah A. Alshehri of Taif University’s Department of Clinical Pharmacy, surveyed 188 licensed pharmacists working in community pharmacies between January and April 2026. Using a structured online questionnaire, the researchers asked respondents about the availability and frequency of 26 distinct professional pharmacy services, grouped into three domains: core pharmacy services, clinical and public health services, and advanced and access services. Participants rated how often each service was provided, from not available at all to daily delivery, and the researchers converted these responses into summary scores for service breadth and overall utilization. The team then used Spearman correlation and multivariable logistic regression to identify which demographic, professional, and operational factors were associated with higher service provision.

The results paint a picture of a profession with one foot in the traditional dispensing model and the other hesitating at the threshold of expanded clinical practice. Prescription dispensing was reported as available by 97.9 percent of respondents, and medication counselling by 97.3 percent, with more than half of pharmacists reporting that they delivered these core services at high frequency. Management of minor ailments was available to 80.9 percent of respondents. But the picture changed dramatically for extended services. Vaccination was the least available clinical service of all, with 80.9 percent of pharmacists reporting that it was simply not offered in their pharmacy. Blood glucose and blood pressure screening were available to only 44.1 percent and 42.0 percent of respondents respectively, despite the kingdom’s high and growing burden of diabetes and cardiovascular disease.

The gradient was even steeper for advanced and access services, many of which depend on physical infrastructure or digital integration rather than clinical skill alone. Home delivery was the most prevalent service in this category, available to 72.9 percent of respondents, though only 17.6 percent provided it daily. Digital adherence monitoring was available to 53.2 percent, and pharmacovigilance and adverse drug reaction reporting to 51.6 percent, yet high-frequency adverse drug reaction reporting was uncommon at just 12.8 percent. The infrastructure-dependent services fared worst of all: 65.4 percent of respondents said their pharmacy could not prepare dosette or blister packs, 66.5 percent had no access to electronic health records, 72.3 percent offered no drive-thru dispensing, and 75.0 percent reported having no private consultation room. Only 4.8 percent of pharmacists used a consultation room daily, a figure that underscores how difficult confidential patient conversations can be in a retail pharmacy environment.

Perhaps the most statistically compelling finding concerned prescription volume. In the fully adjusted multivariable model, each category increase in daily prescription volume was associated with 3.52-fold higher odds of high service utilization, by far the strongest independent predictor in the analysis. Years of professional experience also mattered, with each category increase associated with 1.56-fold higher odds of higher utilization. Spearman correlations told a consistent story: prescription volume correlated moderately with both service availability and utilization, while experience showed smaller but significant positive associations. Intriguingly, the number of pharmacists per shift, daily opening hours, and urban versus rural workplace setting showed no significant association with either outcome, suggesting that raw patient throughput and individual professional engagement matter more than staffing levels or geography.

The qualification effect was one of the study’s more counterintuitive results. Pharmacists holding a PharmD degree, the more clinically oriented doctoral qualification, actually had 0.29 times the odds of high service utilization compared with BPharm holders after adjustment. Increasing age was also associated with lower odds of higher utilization, at 0.91 per year. The authors caution that these observational associations cannot establish causation and may reflect unmeasured factors such as workplace type, employer expectations, or the roles younger and older pharmacists occupy within organizations. The postgraduate subgroup was too small, with only eight respondents, to draw meaningful conclusions. A sensitivity analysis using the continuous utilization score rather than a median-based dichotomization produced broadly consistent results, lending some robustness to the primary findings.

When asked what stood in the way of providing more services, pharmacists pointed overwhelmingly to the system around them rather than to their own capabilities. Unclear regulations topped the list, cited by 55 percent of respondents, followed closely by high workload and time constraints at 53 percent, and administrative burden associated with the Wasfaty electronic prescribing system at 51 percent. More than a third also flagged limited training and continuing professional development, technical or software problems, and the absence of financial incentives. Notably, perceived barriers did not correlate significantly with the provision of core or clinical services, suggesting that pharmacists who already deliver expanded services do not necessarily perceive fewer obstacles, or that barriers operate uniformly across the profession.

Satisfaction with the current scope of practice was lukewarm at best. Only 42.0 percent of respondents reported being satisfied or very satisfied with the range of services they could offer, while 15.4 percent expressed dissatisfaction and the largest single group, 42.6 percent, sat squarely on the fence. That ambivalence may itself be informative: it suggests a workforce that recognizes the potential of expanded practice but sees the gap between what is expected of them and what the regulatory, financial, and physical environment actually permits. The Wasfaty system, which connects prescriptions electronically between prescribers and pharmacies and has been praised by patients for convenience, appears to have introduced its own administrative friction for the pharmacists operating it.

The study’s implications extend beyond Saudi borders, because the tension it documents is playing out in healthcare systems worldwide. International evidence from Europe, Australia, and other Middle Eastern countries has similarly found that introducing new pharmacy services does not guarantee their routine integration into practice, and that availability frequently outpaces actual utilization. In countries where community pharmacists have become established immunization providers, supportive legislation, reimbursement mechanisms, and clear role definitions preceded the expansion. The Saudi findings suggest that the kingdom’s reform agenda will need to address these structural enablers if community pharmacies are to relieve pressure on primary healthcare centers and hospitals as intended.

The authors are candid about the limitations of their work. The cross-sectional design cannot establish cause and effect, the convenience sampling strategy and the concentration of 75 percent of respondents in the Makkah region limit generalizability, and a response rate could not be calculated because the number of pharmacists who received the invitation was unknown. Self-reported service provision is vulnerable to recall and social desirability bias, the questionnaire was pilot-tested but not previously validated, and pharmacy-level clustering could not be accounted for because individual pharmacies were not identified. Future research, the team argues, should use nationally representative samples and objective service records, track changes longitudinally as Vision 2030 reforms unfold, and test interventions such as reimbursement models, workforce expansion, and digital integration. For now, the study offers a clear diagnosis: Saudi community pharmacists have mastered the dispensing core, but the clinical, preventive, and advanced services that could redefine their profession remain locked behind regulatory ambiguity, heavy workloads, and missing infrastructure.

Subject of Research: Availability and utilization of professional pharmacy services in Saudi Arabian community pharmacies

Article Title: Availability, utilization, and factors associated with professional pharmacy services in community pharmacies in Saudi Arabia: a cross-sectional study

Article References: Khawagi, W. Y., Al-Sharif, O. N., Al-Zahrani, T. A., Alghamdi, S. S. A., Alruqayb, W. S., & Alshehri, A. A. (2026). Availability, utilization, and factors associated with professional pharmacy services in community pharmacies in Saudi Arabia: a cross-sectional study. Journal of Pharmacy & Pharmaceutical Sciences, 29, Article 17413. https://doi.org/10.3389/jpps.2026.17413

Image Credits: AI Generated

DOI: 10.3389/jpps.2026.17413

Keywords: community pharmacy, Saudi Arabia, pharmaceutical care, pharmacist services, vaccination, health screening, Wasfaty, Vision 2030, cross-sectional study, pharmacovigilance, medication counselling, healthcare transformation