cross-sectional evaluation of advanced pharmacy practice and specialisation among hospital pharmacists in a Nigerian tertiary health Institution: trends, barriers and recommendations

Introduction: Hospital pharmacy has evolved to include advanced roles such as medication therapy management, pharmacogenomics, and collaborative prescribing. Advanced pharmacy practice and specialisation (APPS) plays a crucial role in improving healthcare access, reducing costs, enhancing the quality of care, and achieving better patient outcomes. This study assessed the extent of APP and specialisation at the University of Abuja Teaching Hospital (UATH), identified key challenges, and proposed recommendations for improving APP in Nigeria Method: This cross-sectional, mixed-methods study collected quantitative data through a self-administered online questionnaire, while qualitative data was collected through five interviews. Data were analysed using SPSS (v23) and inductive thematic analysis. Census sampling was employed, and ethical approval was granted by the UATH Ethical Review Board (UATH/HREC/PR/2024/0/9192). Results: Of the 48 respondents, 79% expressed interest in specialisation, although only 37% had commenced residency training and 44% held advanced certifications. Engagement in advanced pharmacy practice was limited to 50%, and pharmacists lacked prescribing rights. Interest in specialisation was significantly influenced by qualification, with B.Pharm/M.Pharm holders showing greater interest (p=0.014). Younger pharmacists expressed less interest in pursuing specialization. Motivations for pursuing specialisation included career advancement (54%), personal interest (50%), and improved patient care (40%). Qualitative data revealed that limited financial support, insufficient institutional support, and professional barriers such as the absence of a structured specialisation pathway, limited recognition of APP, and limited interprofessional collaboration were major obstacles. Conclusion: Improving access to funding for specialisation training, implementing supportive policies such as the consultancy cadre, and increasing awareness and education on the value of APP are essential towards its wider adoption in Nigeria.