Background and Importance Clinical pharmacist input in intensive care unit (ICU) patient care varies greatly among different countries and settings.

Aim and Objectives To identify areas of desired professional contribution and development, whilst exploring variability. This is envisaged to support leadership activities to enhance the clinical pharmacist workforce based on evolving ICU infrastructures.

Material and Methods Clinical pharmacists involved in the management of sepsis in the ICU setting were surveyed using semi-structured interview methods. Institutional ethical approval for the study was obtained, which included a data protection impact assessment. Recruitment via non-probability convenience and snowball sampling of registered pharmacists proficient in the English language occurred between 31 May 2013 and 13 July 2023. Data saturation determined the sample size. Remote interviews were conducted via Zoom. Interviews were transcribed, coded and thematically analysed in line with Braun and Clarke’s six-stage process. As this was an exploratory study, no theoretical assumptions were addressed.

Results Twenty participants from 14 countries participated. Reported aspirations varied between pharmacists working in dedicated ICU roles based at the bedside and non-dedicated ICU roles with little/no bedside component. Overcoming multifaceted professional barriers associated with physical, social, financial and training/education themes relative to local/national contexts were consistently reported. As were research aspirations. Physical and social themes were associated with scope of practice and ICU/patient record access. This included sepsis identification, initiating antimicrobials, individualising/altering antimicrobial dosing and ownership of therapeutic drug monitoring (TDM) activities. Improving multidisciplinary team integration, stakeholder perceptions, digital infrastructures and legislation were identified as key vehicles. Improved financial incentives were interlinked with stakeholder perceptions and metric capture associated with pharmacist contributions. Whereas education/training was desired for workforce standardisation, increasing scope of practice and improving research outputs. Including increased/improved TDM practices supplemented by pharmacokinetic/pharmacodynamic expertise, enhanced by point-of-care devices and metagenomics.

Conclusion and Relevance The content and variation in ICU clinical pharmacist aspirations worldwide reflects a broader disparity in ICU clinical pharmacist adoption/contribution worldwide, particularly in Europe. Leadership and research addressing study identified themes is required to enable pharmacists to maximise their impact on the care of septic patients. This must demonstrate the value of ICU clinical pharmacists to different stakeholders to promote adoption, capability enhancement and research outputs.

Conflict of Interest No conflict of interest.