Contributions and Expanding the Roles of Clinical Pharmacists in Space Pharmacy: A Scoping Review

Abstract

As human space exploration extends beyond low Earth orbit, the demand for comprehensive medical and pharmaceutical support is increasing. The extreme conditions of space significantly alter drug stability, pharmacokinetics, and pharmacodynamics. Although the role of clinical pharmacists in space missions has not been extensively studied, this review aims to analyze existing literature to identify their contributions and potential applications in space pharmacy. A scoping review was conducted following Arksey and O’Malley’s framework. Relevant literature published up to December 7, 2024, was retrieved from PubMed using predefined search terms related to clinical pharmacy, pharmaceutical care, space medicine, and microgravity. Articles discussing pharmaceutical challenges in space and the potential contributions of clinical pharmacists were included. Data was extracted and thematically analyzed. A total of 26 studies were reviewed. Clinical pharmacists play critical roles in three main domains: (1) medication management and supply, including drug stability and quality control, selection and inventory management of essential medicines, and on-site manufacturing; (2) clinical pharmacy services, such as pharmacotherapy optimization under altered physiological conditions, therapeutic drug monitoring, adverse event and drug interaction surveillance, and education and counseling for astronauts; and (3) research and development, encompassing the design of space-specific clinical trials and innovation in drug delivery systems. The complexity of space environments demands new professional competencies from clinical pharmacists. This review demonstrates that clinical pharmacists play essential roles in space missions. Future research should focus on refining space-specific pharmaceutical guidelines and enhancing training programs to ensure the safe and effective use of medications in extraterrestrial settings.