Understanding pharmacists' engagement in sport and exercise medicine, including pharmacist-physiotherapist collaboration: A qualitative study and COM-B analysis.

Background: Sport and exercise medicine (SEM) is a multidisciplinary field that integrates expertise from various healthcare professionals to optimise athletic performance and promote physical activity for chronic disease prevention and management. Australian pharmacists are well-positioned to contribute to SEM, yet their roles remain undefined beyond niche areas like anti-doping. Interdisciplinary collaboration, particularly with physiotherapists, is also underexplored. This study investigates pharmacists' engagement in SEM and pharmacist-physiotherapist collaboration, using the Capability, Opportunity, Motivation-Behaviour (COM-B) model to explore behavioural components. Methods: A qualitative study was conducted using semi-structured interviews with 14 Australian pharmacists practicing across diverse settings. Data were thematically analysed and mapped to the COM-B framework. Results: Five key themes emerged: (1) Broad scope of pharmacy practice in SEM incorporating both pharmacological and non-pharmacological advice; (2) Opportunities and challenges in inter-professional collaboration, constrained by informal referral pathways and limited interdisciplinary communication (3) Gaps in SEM-related training and education, with pharmacists expressing interest in targeted professional development; (4) Perceived barriers to engagement, including time constraints, remuneration issues and lack of professional recognition; and (5) Future opportunities for pharmacists in SEM, such as integration into multidisciplinary SEM teams and supporting physiotherapist prescribing. Conclusions: Pharmacists are well-placed to play a broader role in SEM but face systemic and educational barriers. Enhancing training, establishing formal referral and interdisciplinary communication pathways and addressing structural challenges could improve engagement. This study lays the groundwork for future interventions to enhance pharmacists' contributions to SEM and strengthen pharmacist-physiotherapist collaboration, ultimately improving consumer care and health outcomes.