Persistent medicine shortages expose community pharmacies to recurrent changes in product availability, therapeutic choices, medication information and professional responsibilities. These disturbances create opportunities for medication errors when substitution decisions, clinical verification and patient communication occur under changing conditions. This article develops a shortage-responsive medication safety framework through a critical conceptual synthesis of literature on pharmaceutical supply disruption, community-pharmacy medication errors, therapeutic substitution, information exchange and organisational safety. The framework identifies the interdependence of supply information, patient-specific treatment decisions, knowledge updating, professional authorisation and incident learning. It distinguishes the operational achievement of maintaining medicine access from the clinical requirements for safe substitution and the separate evidentiary requirement to demonstrate reduced errors. Particular attention is given to information validity, coordination between pharmacists and prescribers, documentation of changed regimens, and responsibility for communicating revised instructions to patients. Adaptive safety governance is conceptualised as an iterative process in which emerging disturbances and reported problems inform subsequent verification and corrective action. The framework provides an analytical basis for developing context-sensitive pharmacy procedures and future empirical evaluation. Its contribution is a proposed systems explanation, not a validated intervention or an estimate of shortage-related medication-error reduction.
