ORIGINAL RESEARCH article

Front. Pharmacol.

Sec. Pharmacoepidemiology

Volume 16 - 2025 | doi: 10.3389/fphar.2025.1590794

This article is part of the Research TopicEmerging Trends in Real-World Pharmacoepidemiology and Drug Safety: 2025View all articles

Exploring Multidimensional Determinants of Medication Error Reporting in China: A Qualitative Study Using the Theoretical Domains Framework

Provisionally accepted
Hui  GuoHui Guo1Qian  GuoQian Guo2Xiuping  WangXiuping Wang1Yonghong  LiuYonghong Liu1Ze  WangZe Wang1*
  • 1Shanxi Cardiovascular Disease Hospital, Taiyuan, China
  • 2Second Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China

The final, formatted version of the article will be published soon.

Medication errors, defined as preventable events leading to inappropriate medication use or patient harm, remain a critical global healthcare challenge. Despite regulatory mandates in China, underreporting remains systemic. Existing research on healthcare professionals' reporting behaviors has been constrained by reliance on isolated theoretical frameworks, which inadequately address the interplay of individual, organizational, and cultural determinants. The aim of this study is to systematically explore barriers and facilitators affecting medication error reporting among Chinese healthcare professionals, using the Theoretical Domains Framework (TDF), a comprehensive behavioral model synthesizing 14 domains.We conducted semi-structured interviews with 27 nurses, pharmacists, and physicians in Chinese hospitals (July-October 2024). Interviews were guided by the TDF to explore barriers to medication error reporting. Data were analyzed through framework analysis using NVivo 14.0 until thematic saturation was reached.of semi-structured interviews explored 14 Theoretical Domains Framework (TDF) domains influencing medication error reporting among Chinese healthcare professionals, with 21 barriers and 15 facilitators delineated. Notably, eight domains emerged as predominant barriers: Knowledge, Skills, Beliefs about capabilities, Beliefs about consequences, Memory, attention and decision processes, Environmental context and resources, Social influences, and Emotion. Conclusion This study highlights the interplay of individual, cultural, and systemic factors shaping medication error reporting in China. The TDF effectively identified context-specific barriers, including knowledge fragmentation, fear of career repercussions, and inefficient reporting systems. To foster a safety culture, interventions must integrate targeted training, simplified reporting mechanisms, and leadership commitment to non-punitive environments. Cross-professional collaboration and policy enforcement are critical to transforming reporting from a fragmented obligation into a sustainable safety practice. These insights offer a roadmap for optimizing error reporting systems in hierarchical healthcare settings globally.

Keywords: Medication error, Error Reporting, Qualitative, Theoretical domains framework, China

Received: 10 Mar 2025; Accepted: 02 Jun 2025.

Copyright: © 2025 Guo, Guo, Wang, Liu and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Ze Wang, Shanxi Cardiovascular Disease Hospital, Taiyuan, China

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