Barriers, Facilitators and Stakeholder Roles in Telepharmacy Implementation in Malaysia: A Consolidated Framework for Implementation Research (CFIR)-Informed Qualitative Study

Objective: Telepharmacy has emerged as a promising digital health approach to improve access to pharmaceutical care, particularly for underserved and remote populations. However, its implementation remains complex and context-dependent, requiring a clear understanding of stakeholder roles, system readiness, and implementation conditions. This study explored the stakeholder initiatives, barriers, and facilitators influencing telepharmacy implementation in Malaysia using the Consolidated Framework for Implementation Research (CFIR).Material and Methods: A qualitative study was conducted using semi-structured interviews with ten key stakeholders, including academic and industrial pharmacists in Malaysia. Interviews were carried out via Google Meet between April and June 2023. Data were transcribed verbatim and analysed thematically using NVivo software. Identified themes were mapped to CFIR domains to support structured interpretation.Results: Stakeholders highlighted key implementation initiatives, including telepharmacy education, research collaborations, and pilot service models. Major barriers included inadequate digital infrastructure, regulatory uncertainty, and limited organisational readiness. Facilitators and improvement strategies focused on strengthening technological support, enhancing workforce competencies, fostering interprofessional collaboration, and establishing enabling policies. These findings demonstrate the interaction of multilevel factors across CFIR domains, influencing telepharmacy adoption.Conclusion: Telepharmacy implementation in Malaysia is shaped by interconnected challenges at individual, organisational, and policy levels, particularly digital literacy gaps, regulatory uncertainty, and financial constraints. Regulatory clarity and sustainable reimbursement models were identified as critical for long-term adoption. Addressing these factors through coordinated policy development, workforce training, and infrastructure strengthening is essential to support the sustainable integration of telepharmacy into routine healthcare delivery and improve equitable access to pharmaceutical care.