Medication errors and medication error reporting practices in Ghana: a systematic review

Abstract

Background: Medication errors (MEs) and their underreporting compromise patient safety in Ghana, but the landscape of error types, reporting systems, and barriers has not been comprehensively synthesized. Objective: This systematic review aims to map existing literature on MEs in Ghana and assess the functionality and utilization of reporting systems across healthcare settings. Design: Systematic review conducted in accordance with PRISMA 2020 guidelines. Data sources and methods: PubMed, PubMed Central, Scopus, ScienceDirect, and Google Scholar were searched for studies published between 1 January 2000 and 30 May 2025, with a final update search performed in August 2025 prior to data analysis. Eligible studies were conducted in Ghana and published in English, addressing MEs or medication-error reporting practices across any study design. Study selection, data extraction, and methodological quality appraisal were performed independently by two reviewers, and findings were synthesized narratively due to heterogeneity in study designs and outcome definitions. Results: Reported medication-error prevalence varied widely across included studies (47%–68.4%), reflecting differences in study designs, populations, clinical settings, and definitions of MEs. Omission errors were frequently identified as the most common type, accounting for up to 77.6% of documented errors in some studies. Contributing factors included inadequate training (91.6%), poor supervision (92.3%), and illegible prescriptions (63.7%), with severe underreporting highly evident. Reporting practices were often informal, with many errors conveyed verbally or not documented. Common barriers included fear of blame or disciplinary action, low confidence in reporting systems, insufficient anonymity, lack of standardized forms, limited training, and minimal mentorship. Conclusion: MEs remain a substantial patient-safety concern in Ghana, compounded by informal reporting systems and persistent organizational and cultural barriers. These findings underscore the urgent need to implement structured, non-punitive reporting systems, enhance staff training, and foster a culture of openness to support medication safety.