Observation and Prevention of Caregiver-Related Medication Errors in Community Pharmacies: A Cross-Sectional Study Across Urban, Town, and Rural Settings.

Background: Medication errors committed by informal caregivers of older adults represent a significant risk to patient safety, particularly in the context of population aging and increasing therapeutic complexity. Community pharmacies could play a key role in detecting and preventing them; furthermore, pharmacy location (urban, town, or rural settings) role in medication errors remains underexplored. Objective: To analyze the types and frequency of caregiver-related medication errors observed by community pharmacists and to determine if differences exist according to pharmacy location. Methods: A cross-sectional study was conducted using an online self-reported questionnaire by pharmacists, technicians, and assistants working in the Region of Murcia, Spain. The questionnaire assessed types of medication errors observed, factors associated, preventive strategies, professional attitudes, and strategies at home. Descriptive statistics were calculated, and associations between pharmacy location and categorical variables were evaluated using Pearson's chi-square (χ2) test or Fisher-Freeman-Halton exact tests. Statistical significance was set at p < 0.05. Results: A total of 148 professionals participated, including 109 pharmacists (73.6%), 24 pharmacy technicians (16.2%) and 15 pharmacy assistants (10.1%). According to pharmacy location, 74 participants worked in urban pharmacies (50.0%), 63 in town pharmacies (42.6%) and 11 in rural pharmacies (7.4%). The most frequently reported medication errors were incorrect administration time (n = 91, 61.5%), omission errors (n = 87, 58.8%) and dosing errors. (n = 80, 54.1%). Treatment complexity and polypharmacy were identified as the main contributing factors. Most preventive strategies and professional practices showed no statistically significant differences detected for most preventive strategies and reported professional practices across settings. However, moderate associations were found regarding the perceived frequency of medication and prescribing errors in rural settings reporting lower frequencies. However, findings involving the rural subgroup should be interpreted cautiously due to a limited sample size. Conclusions: Community pharmacy professionals demonstrate a consistent and proactive role in detecting and preventing caregiver-related medication errors across urban, town, and rural settings. Although geographic location has limited influence on most professional practices, rural pharmacies may assume an expanded role in patient and caregiver support. Standardized prevention strategies could be implemented broadly, with additional adaptations for rural contexts.