THE EVOLVING ROLE OF PHARMACISTS IN SPORTS MEDICINE

Abstract

Pharmacists remain an underutilized resource in sports medicine despite their unique expertise in medication safety, supplement counseling, and anti-doping compliance. We conducted a multi-method investigation comprising a systematic scoping review, qualitative interviews with fifteen to twenty pharmacists across three countries, a cross-sectional survey, and a longitudinal quasi-experimental cluster trial to examine how pharmacists navigate the tension between performance logic and clinical safety logic. Our systematic documentary analysis of WADA reports and national guidelines positioned pharmacists as ethical gatekeepers who classify products as legitimate care, risky enhancement, or inappropriate manipulation. Furthermore, the integration of a pharmacist into a sports medicine team altered collective sensemaking around medication-related adverse events through mediating mechanisms: psychological safety enabled open reporting, transactive memory systems strengthened as team members revised knowledge maps, and epistemic authority determined whether safety advice was fully integrated or remained advisory. However, a structured pharmacist-led pharmaceutical care intervention reduced supplement acceptance and flattened the trajectory toward doping-tolerant attitudes. Latent profile analysis identified distinct typologies of pharmacist readiness-rom high-competence high-legitimacy to low-readiness low-exposure-with macro-level predictors including anti-doping policy stringency and curriculum mandates. The review establishes sports pharmacy as an emerging specialty with demonstrated potential to improve athlete outcomes, yet its full integration remains constrained by inadequate educational preparation, inconsistent professional recognition, and structural barriers across national contexts.