Medication Administration Errors by Caregivers of Children with Chronic Illness in Home Settings: A Systematic Review

BACKGROUND: Home-based medication administration is vital for managing paediatric chronic conditions but is prone to errors that affect patient safety and outcomes. Children suffering from​ chronic conditions such as cancer, diabetes, epilepsy, and sickle cell disease frequently require medication outside hospital settings, necessitating non-professional caregivers to administer and oversee these medications. This systematic review synthesised global evidence on medication administration errors (MAEs) by caregivers in home settings. METHODS: In accordance with the JBI methodology and PRISMA 2020 guidelines, a search was conducted in PubMed, Web of Science, ScienceDirect, and Scopus for English-language studies published between January 2015 and December 2025. The methodological quality of the studies was evaluated using the JBI critical appraisal checklists, and data were collected using standardized JBI forms and were synthesized narratively. RESULTS: Out of 25,508 records reviewed, 12 studies met the inclusion criteria. The prevalence of errors, as observed directly, ranged from 30% to 80%, with pharmacist-led assessments identifying a high rate of 89.89%. Dosing errors were the most frequently reported, appearing in six of the 12 studies, followed by errors related to timing and the method or route of administration. Clinical harm was reported in 8-12.8% of the error cases, resulting in preventable hospitalizations and treatment failures due to chronic underdosing. The most consistently noted risk factors were polypharmacy, insufficient health literacy among caregivers, and limited caregiver proficiency in English. CONCLUSIONS: Medication errors at home are frequent and have significant clinical implications for children with chronic illnesses. To address this, healthcare systems should incorporate structured education for caregivers into discharge plans and enhance access to dosing aids and digital tools, especially in resource-constrained areas such as sub-Saharan Africa.