Medication reconciliation and tracking are widely recognised strategies for improving safety and supporting continuity of information across healthcare encounters. However, their effectiveness depends on the availability and visibility of medication information. In Malaysia, these practices occur within a fragmented sociotechnical environment, shaped by a dual public-private healthcare system, limited digital interoperability, high patient mobility, and the ongoing combination of prescribing and dispensing in private clinics. These conditions frequently position community pharmacists outside the formal prescribing pathway and restrict their access to verified medication information.

This thesis examines how medication reconciliation and tracking are enacted in Malaysian community pharmacy settings and explores the sociotechnical conditions shaping these practices. The research adopts Soft Systems Methodology (SSM) as the overarching framework for sociotechnical inquiry. The research progresses through successive stages of exploration, interpretation, and system conceptualisation. Analytic autoethnography was first used to sensitise the subsequent studies to everyday medication-related encounters in community pharmacy practice. This was followed by two qualitative studies involving semi-structured interviews with community pharmacists and community pharmacy users, analysed using Reflexive Thematic Analysis. Collaborative reflection sessions were then conducted to refine and extend earlier interpretations through dialogic engagement with participants. Insights generated across these stages were synthesised using SSM tools, including root definitions and conceptual activity models, to identify sociotechnical conditions that could support medication information continuity.

The findings show that medication reconciliation and tracking are not purely technical processes but sociotechnical practices shaped by fragmented information flows, reliance on patient recall, multilingual communication, health literacy differences, mobility across healthcare providers, and trust dynamics during pharmacy encounters. Community pharmacists frequently reconstruct medication information using partial records, medication packaging, and patients’ verbal reports of their medicines, while community pharmacy users rely on informal strategies such as memory, support from family members, and ad hoc documentation to manage medications.

Synthesising these findings, the thesis identifies three interacting activity systems shaping medication information continuity: governance structures, pharmacist-facing reconciliation practices, and user-facing tracking practices. Misalignments across these systems contribute to the fragmentation of medication information within Malaysian community pharmacy settings.

Empirically, the thesis provides qualitative insight into medication information practices within the Malaysian community pharmacy, a context that remains under-examined in existing research. Practically, it identifies sociotechnical alignment conditions to support safer medication reconciliation and tracking, including clearer prescribing-dispensing role boundaries, patient-centred medication tracking tools, strengthened privacy governance, and expanded educational roles for community pharmacists. Conceptually, the thesis reframes medication reconciliation and tracking as sociotechnical system alignments rather than isolated behavioural or technical procedures, suggesting that medication safety depends on coordinated relationships between governance structures, professional roles, everyday medication practices, and digital infrastructures.