Pharmacy inventory management practices and constraints in Asia-Pacific hospitals: a systematic review and qualitative synthesis

Background: Persistent medicine shortages across the Asia-Pacific region suggest variability in hospital inventory management capacity. Despite available guidelines, variations exist across hospitals in adopting recommended inventory management practices. Thus, this study aimed to identify existing inventory management methods, evaluate related challenges, and highlight recommendations for improvement. Methods: Searches were performed to identify relevant sources from 39 countries on CINAHL, Cochrane, Embase, PubMed, Scopus, Business Source Complete, and Emerald Insight. Non-indexed literature was retrieved through Google Scholar and general Google searches. Backward and forward citation searching was conducted. Data were extracted based on an initial framework comprising three components: planning and procurement, storage and stock management, and staff management. The framework was later expanded through inductive coding to include 12 subcomponents. Findings were narratively synthesised to describe inventory management methods and their impact on medicine supply. Methodological quality of the included empirical publications was assessed using the Mixed Methods Appraisal Tool (MMAT). Results: Seventy-two publications from 20 countries were included. Practices varied between hospitals even within the same country. Hospitals shared common inventory management challenges that weakened medicine supply systems. A conceptual framework was developed to outline three key themes: systemic constraints, infrastructural limitations, and staff skill gaps. Overcoming systemic constraints requires streamlining expenditure and enhancing central distribution systems. Implementing multi-supplier contracts may be effective at stabilising supply. Infrastructural improvements in storage space and inventory tracking systems may bolster medicine availability. Addressing staff skill gaps requires significant investment in training programmes to strengthen adherence to effective inventory management methods. Conclusion: This study mapped key determinants of medicine availability in hospitals, providing guidance on priority areas for intervention to policymakers, hospital leadership, and inventory personnel. Securing medicine supplies in hospitals requires practical inventory management guidelines that account for systemic constraints and infrastructural limitations while empowering staff to optimise pharmacy inventory management practices.