Pharmacist Engagement in Fluid Stewardship in Kuwait: A Cross-Sectional Study

Background Intravenous (IV) fluids are among the most commonly administered therapies in hospitalized patients, and their appropriate use requires careful selection, dosing, monitoring, and de-escalation. Fluid stewardship provides a structured, multidisciplinary approach to optimizing these processes. Pharmacists are well positioned to contribute to fluid stewardship; however, their current involvement and the practice factors influencing their participation remain poorly characterized. This study aimed to characterize pharmacists’ engagement in IV fluid management and identify practice-level factors relevant to their participation in fluid stewardship in Kuwait hospitals. Methods A cross-sectional, web-based survey was conducted among registered pharmacists involved in direct patient care in Kuwait hospitals. The questionnaire assessed pharmacists’ perceived professional roles, current practices, training needs, barriers, and factors supporting participation in fluid stewardship. Responses were summarized descriptively, with exploratory comparisons according to professional experience and practice setting. Results Eighty-six pharmacists participated. Although most respondents supported pharmacist involvement across fluid assessment, selection and dosing, monitoring, and de-escalation, routine participation was less frequent: 37.2% reported reviewing IV fluid therapy always or often, and 41.9% reported direct involvement in fluid selection or dose adjustment. The absence of institutional guidelines or protocols was the most frequently reported barrier to participation (62.8%), while regular pharmacist training in IV fluid therapy and stewardship was the most frequently supported strategy (86.0%). Engagement did not differ significantly by professional experience or practice setting, although numerically higher engagement was observed among ICU/CCU pharmacists. Conclusions Pharmacists recognized a professional role across multiple components of IV fluid management, while their reported routine participation varied. Training, institutional guidance, and multidisciplinary collaboration were identified as factors that may support pharmacist participation in fluid stewardship. These findings provide baseline evidence on pharmacist engagement and practice factors relevant to the future development of multidisciplinary fluid stewardship initiatives in Kuwait and may inform similar efforts in other healthcare settings.