Clinical pharmacists as translational partners in PK/PD-guided precision dosing in India: A structured narrative review with SWOT-TOWS analysis

Pharmacokinetic (PK) and pharmacodynamic (PD) information can support individualized dosing, but translation into routine clinical practice depends on pharmacist expertise, laboratory capacity, digital infrastructure, and multidisciplinary workflows. This structured narrative review synthesized literature on pharmacist-integrated PK/PD practice, including therapeutic drug monitoring (TDM), PK/PD-guided dosing, AUC-guided dosing, pharmacokinetic consultation, Bayesian dosing, and model-informed precision dosing (MIPD), with particular attention to implementation in India. The audited evidence set comprised 1,478 records, 890 unique records after deduplication, 47 primary or implementation publications, and 13 contextual publications; four of the contextual publications were India-specific. International evidence demonstrates pharmacist involvement across TDM, exposure-guided dosing, Bayesian approaches, and MIPD, while Indian literature remains more focused on TDM availability, infrastructure, and service development. Across the evidence, recurring implementation requirements included pharmacist competency, standardized sampling and interpretation, laboratory support, electronic systems, defined clinical responsibilities, and multidisciplinary collaboration. The findings support an evidence-informed, resource-stratified pathway in India that can progress from priority TDM and dose-optimization services toward AUC-guided, Bayesian, and MIPD approaches as institutional capability develops. This pathway is a proposed implementation framework rather than a validated Indian model, and downstream clinical benefits should be interpreted cautiously because outcome measures and study designs were heterogeneous.