The role of pharmacists and pharmacy team members in the prevention, preparedness, response and recovery of outbreaks - a global rapid systematic review.

BACKGROUND

Pharmacists and their teams can undertake pharmaceutical public health roles during outbreaks within the World Health Organization (WHO) emergency cycle of prevention, preparedness, response, and recovery. These may be at micro- (individual), meso- (regional or organisational) or macro- (national) levels. The primary outcome was to identify pharmacy team members' roles in outbreaks (excluding COVID-19) and classify by WHO emergency cycle phase and intervention level.

METHODS

We conducted a rapid systematic review (PROSPERO: CRD42024617152) in Embase, Medline, and SCOPUS databases including articles published from 2014 to Feb 2025. After duplicate removal, titles/abstracts and full texts were screened, extracted and assessed for bias by one reviewer, with 10% second-checked. Thematic synthesis was used and described narratively to reflect variability in the studies.

RESULTS

From 161 articles across all WHO regions, 145 distinct thematically derived role categories were identified. Most were in the response phase (46%), followed by prevention (29%), preparedness (15%), and recovery (10%). Roles were primarily at meso-level (37%) and micro-level (35%), with fewer at macro-level (28%). 34% of the articles reported contributions related to health inequalities. Reported barriers were clustered into five themes: knowledge/training gaps, regulatory restrictions, resource and infrastructure constraints, communication, and cultural factors.

CONCLUSION

Pharmacy team members have roles during non-COVID outbreaks across all stages of the WHO emergency cycle at all levels. However, their contributions are less well documented in recovery and at macro-level. Integrating pharmacy roles into emergency frameworks, supported by regulatory reform, funding, and training, may support health-system resilience, and reduce health inequalities.