Community pharmacy resiliency during Covid-19 pandemic in Iran: A qualitative study

Background: The COVID-19 pandemic has profoundly impacted global healthcare systems. This qualitative study explores how community pharmacists in Iran demonstrated resilience during this disaster. Despite challenges like medication shortages, Personal Protective Equipment deficiencies, and staffing issues, pharmacists implemented innovative measures such as social distancing protocols, remote consultations, and home delivery services. Insights from this study inform strategies to enhance healthcare system preparedness for future public health preparedness. Objective: This study qualitatively explores experiences of Iranian pharmacists during the COVID-19 pandemic, focusing on resilience, emergency management strategies, challenges faced and future emergency preparedness. Methods: Semi-structured interviews were conducted with 25 pharmacists (14 men, 11 women; mean practice experience: 10-14 years) in Tehran and Alborz provinces. Data were analyzed thematically using MAXQDA and following Braun and Clarke's six-phase framework Results: Analysis of 1260 codes and 11 categories revealed that pharmacists faced operational challenges, including increased work load, psychological strain, financial constraints, and supply shortages. In response, they adapted creatively, employing strategies such as teleconsultations, public health education, inventory sharing, and strict safety protocols. However, participants consistently highlighted policy and systemic gaps, including insufficient governmental support and the limited integration of pharmacists into crisis management frameworks. Conclusion: Community pharmacies played a critical role during the COVID-19 pandemic by adapting rapidly and expanding public health services. Strengthening telepharmacy infrastructure, supply chain policies, and integrating pharmacists into national preparedness frameworks is essential to improve healthcare system resilience in future healthcare emergencies