Patients’ gender, age and ethnicity significantly influence the likelihood of having a medication-related error formally reported, according to a cross-sectional study by Barts Health NHS Trust in London, UK.
The findings of this first report assessing possible disparities in medicine-related incident reporting in England highlight that systematic support is required to reduce the variation of medicine error reporting among patients with key protected characteristics.
Gender, age and ethnicity disparities
Among 44,862 adult inpatients, 935 medication incidents were reported between January to July 2021 – around one medication error for every 48 admitted patients.
Male patients were 74% more likely to feature in a medication error report than females (risk ratio = 1.74; p < 0.001).
Adults aged 18–50 had fewer reported incidents than expected, with the 18-34 age group showing the greatest difference at 97 observed medicine error incident reports compared to the expected 250.
The 51-65 and 66-79 age groups received more reports than expected, with 281 observed versus 174 expected in the former group and 253 observed versus 161 expected in the latter group.
The observed report numbers for people in the 80+ age group were as expected.
Ethnic grouping significantly impacted the likelihood of medication error reporting (χ² = 27.8; p < 0.001). While people from white and black ethnic groups had more reports than statistically expected, patients from Asian and Chinese backgrounds had fewer reports than expected. This variation raised concern that cultural, linguistic or systemic barriers may be suppressing recognition and escalation of harm.
While only 1% of admitted patients had a recorded learning disability, reporting rates for this group matched expectations. However, the low number of reports makes it difficult to draw firm conclusions, highlighting a need for further targeted analysis in this population.
Towards equity in medication error reporting
Medication error underreporting may stem from a combination of patient-related factors, such as lower confidence in reporting, language barriers and cultural norms, as well as clinician-related challenges such as understaffing, the researchers observed.
These factors may compound existing healthcare inequalities and perpetuate distrust in medical systems among underrepresented groups, the researchers said and they advocated for healthcare systems to embed equity into patient safety infrastructure.
This study provides a methodological basis for future work to ensure ‘not only equity of care but also equity of recognition when care delivery goes wrong’, the researchers added.
Reference
Bassi S et al. Disparities in medication error reporting: a focus on patients with select protected characteristics. BMJ Open Qual 2025;14(2):e003175.
