Adverse drug reaction reporting practices and reasons for underreporting among healthcare professionals in a tertiary care hospital: a questionnaire-based study
DOI:
https://doi.org/10.18203/2319-2003.ijbcp20261122Keywords:
Pharmacovigilance, Underreporting of ADRs, Adverse drug reaction reporting systems, Knowledge attitude practice, BarriersAbstract
Background: Adverse drug reactions (ADRs) are a major global public health issue. When severe it can lead to morbidity, mortality, hospital admissions, increased risk of readmission, longer hospital stays, and other negative outcomes. Unfortunately, underreporting is a major limitation of spontaneous notification systems, with only 6-10% of all ADRs reported, weakening pharmacovigilance and jeopardizes patient safety. This study was done to evaluate ADR-reporting practices and reasons for underreporting among healthcare professionals at a tertiary-care hospital.
Methods: A cross-sectional, questionnaire-based study was conducted using an online self-administered form circulated to all doctors and nurses at the study site. Data from 111 respondents were analysed. The questionnaire covered knowledge, attitudes and practices related to ADR reporting and perceived barriers to its reporting.
Results: Of 400 healthcare practitioners (HCPs) only 111 responded (27.75%). Among the 111 respondents; 77% knew the meaning of pharmacovigilance, 82% of respondents felt qualified to report ADRs, only 64.9% were aware of what to report, and even fewer (53.2%) knew how to report an ADR. Only 30 (27.0%) reported ever submitting an ADR report, while 81 (73.0%) had never reported. Among these non-reporters, the commonest barriers were lack of knowledge about the reporting procedure, uncertainty regarding causality, time constraints, and the perception that observed events were already known or not sufficiently serious to warrant reporting. Awareness of the institutional reporting mechanism and of national pharmacovigilance pathways was low.
Conclusions: Although awareness of pharmacovigilance was high, actual ADR reporting was low, hindered by unfamiliarity with processes, time constraints, and poor access to ADR reporting forms. Practical steps like hands-on training, simplified reporting, institutional support, and regular feedback are needed to convert positive attitudes into sustained reporting. Multicentre and longitudinal studies should evaluate these interventions.
Metrics
References
Aronson JK. Ferner RE. Clarification of terminology in drug safety. Drug Saf. 2005;28:851-70. DOI: https://doi.org/10.2165/00002018-200528100-00003
World Health Organization. Safety of medicines – adverse drug reactions. Available at: https://www. who.int/docs/default-source/medicines/safety-of-medicines--adverse-drug-reactions-jun18.pdf?sfvrsn= 4fcaf40_2. Accessed on 12 January 2026.
Nadew SS, Beyene KG, Michael, Beza SW. Adverse drug reaction reporting practice and associated factors among medical doctors in government hospitals in Addis Ababa, Ethiopia. PLoS One. 2020;15(1):e0227712.
Walter SR, Day RO, Gallego B, Westbrook JI. The impact of serious adverse drug reactions: a population- based study of a decade of hospital admissions in New South Wales, Australia. Br J Clin Pharmacol. 2017;83(2):416-26. DOI: https://doi.org/10.1111/bcp.13124
García-Abeijon P, Costa C, Taracido M, Herdeiro MT, Torre C, Figueiras A. Factors Associated with Underreporting of Adverse Drug Reactions by Health Care Professionals: A Systematic Review Update. Drug Saf. 2023;46(7):625-36.
World Health Organization. WHO Collaborating Centre for International Drug Monitoring. 2021. Available at: https://www.who.int/ medicines/areas/ quality_safety/safety_efficacy/collab-centre-uppsala/ en. Accessed on 12 January 2026.
Hardeep, Bajaj JK, Rakesh K. A survey on the knowledge, attitude and the practice of pharmacovigilance among the health care professionals in a teaching hospital in Northern India. J Clin Diagn Res. 2013;7:97-9. DOI: https://doi.org/10.7860/JCDR/2012/4883.2680
Palaian S, Ibrahim MI, Mishra P. Health professionals’ knowledge, attitude and practices towards pharmacovigilance in Nepal. Pharm Pract (Granada). 2011;9:228-35. DOI: https://doi.org/10.4321/S1886-36552011000400008
Nadew SS, Beyene KG, Beza SW. Adverse drug reaction reporting practice and associated factors among medical doctors in government hospitals in Addis Ababa, Ethiopia. PLoS One. 2020;15(1):e0227712. DOI: https://doi.org/10.1371/journal.pone.0227712
Datta S, Sengupta S. An evaluation of knowledge, attitude, and practice of adverse drug reaction reporting in a tertiary care teaching hospital of Sikkim. Perspect Clin Res. 2015;6(4):200-6. DOI: https://doi.org/10.4103/2229-3485.167096
Khan SA, Goyal C, Chandel N, Rafi M. Knowledge, attitudes, and practice of doctors to adverse drug reaction reporting in a teaching hospital in India: An observational study. J Nat Sci Biol Med. 2013;4(1):191-6. DOI: https://doi.org/10.4103/0976-9668.107289
García-Abeijon P, Costa C, Taracido M, Herdeiro MT, Torre C, Figueiras A. Factors Associated with Underreporting of Adverse Drug Reactions by Health Care Professionals: A Systematic Review Update. Drug Saf. 2023;46(7):625-36. DOI: https://doi.org/10.1007/s40264-023-01302-7
Katekhaye VM, Kadhe NG, John J, Pawar SR. Knowledge, attitude and practice of pharmacovigilance among medical professionals at a tertiary care hospital in Mumbai, Maharashtra, India. Int J Res Med Sci. 2016;5(1):156-61. DOI: https://doi.org/10.18203/2320-6012.ijrms20164540