Machine learning for medication error detection: a scoping review

Objective Medication errors remain a substantial public health concern, and existing measures, such as workforce training, have achieved only partial success. Advances in data availability and computational methods have led to increasing use of machine learning (ML) to support medication safety. This scoping review synthesizes and categorizes ML-based approaches to medication error detection or prediction. Materials and Methods Following Preferred Reporting Items for Systematic Reviews and Meta- Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, PubMed, Embase, and Web of Science were searched for studies published between 2015 and April 2025. Two reviewers indepen- dently performed study selection using predefined eligibility criteria, and data extraction followed a structured extraction framework. Results Twenty-two studies met the inclusion criteria. Two dominant ML pipelines were identified. Most studies focused on prescription-related errors, relying on structured clinical data and tree-based models. A smaller group addressed medication-administration errors using unstructured multimodal data, such as images or video, analyzed with neural networks and multi-stage detection pipelines. Discussion ML shows substantial potential for medication error detection, particularly in prescription-focused workflows that align well with existing clinical processes. However, the evi- dence remains fragmented, with limited generalizability, inconsistent labeling, and scarce real-world evaluation. No studies addressed medication errors in clinical research settings, such as clinical trials, despite their distinct workflows and safety implications. Conclusion Advancing ML-based medication error detection will require high-quality multicenter datasets, rigorous and transparent validation, and deeper exploration of underused data modalities, including free text.