Empirical Analysis of Pharmacist-Physician Collaboration and Clinical Outcomes in Nigerian Teaching Hospitals

Pharmacist-physician collaboration has been associated with improved medication safety and clinical outcomes in international literature, but empirical evidence from Nigerian teaching hospitals is limited. This study empirically investigated the relationship between pharmacist-physician collaboration quality and selected clinical outcome measures across six teaching hospitals in the South West and North Central geopolitical zones. A cross-sectional mixed-methods design was employed. Collaboration quality was assessed using the adapted Collaboration and Satisfaction about Care Decisions (CSACD) instrument administered to 140 pharmacist-physician dyads from medical, surgical, and critical care teams. Clinical outcomes including adverse drug event incidence, medication error rates, and 30-day readmission rates were extracted from administrative data for the corresponding wards over a 12-month period. Spearman rank correlations and negative binomial regression were used in the analysis. Results demonstrated a significant negative association between collaboration quality scores and adverse drug event rates (rho = -0.61, p < 0.001), medication error rates (rho = -0.54, p < 0.001), and 30-day readmission rates (rho = -0.42, p < 0.01). Qualitative interviews with 24 participants identified communication barriers, role ambiguity, and hierarchical professional norms as primary collaboration impediments. Wards with formalised pharmacist rounds showed collaboration scores 32 percent higher than those without. The study fills a critical evidence gap on pharmacist-physician collaboration in Nigerian teaching hospitals, providing a quantified association between collaboration and clinical outcomes that strengthens the case for formalising collaborative practice models in Nigeria. Keywords: pharmacist-physician collaboration, clinical outcomes, teaching hospitals, Nigeria, pharmaceutical care