Adverse Drug Reporting and Determinants of Under-reporting among Doctors of a Tertiary Care Hospital: A Survey on Knowledge, Attitude and Practice

Background: Adverse drug reaction reporting is a core pharmacovigilance activity, yet spontaneous reporting systems remain limited by under-reporting among healthcare professionals. Understanding doctors' knowledge, attitude, practice, and perceived barriers is essential for strengthening institutional drug-safety systems. The objective is to assess knowledge, attitude, and practice regarding adverse drug reaction reporting among doctors of a tertiary care hospital and to identify determinants of under-reporting. Material and Methods: This hospital-based analytical cross-sectional survey was conducted among 150 doctors at Gayatri Vidya Parishad Institute of Healthcare and Medical Technology, Visakhapatnam, from March 01, 2026 to March 31, 2026. Data were collected using a structured questionnaire covering demographic characteristics, pharmacovigilance knowledge, attitude, reporting practice, and barriers. Descriptive statistics, Chi-square test, and multivariable logistic regression were used for analysis. Results: The mean age of participants was 31.8 ± 7.2 years, and males constituted 56.0%. Previous pharmacovigilance training was reported by 41.3%. Adequate knowledge was observed in 45.3%, whereas 80.7% showed a positive attitude. Although 72.0% had encountered suspected adverse drug reactions, only 32.7% had ever reported one. Among doctors who encountered adverse drug reactions, 67.6% had not reported them. Major reasons for under-reporting were uncertainty about causality, workload, lack of awareness about reporting procedure, non-availability of forms, and lack of training. Independent determinants of under-reporting were absence of pharmacovigilance training, unawareness of the nearest monitoring centre, workload, and uncertainty about causality. Conclusion: Doctors demonstrated favourable attitudes toward adverse drug reaction reporting, but reporting practice remained low. Regular training, simplified reporting pathways, visible reporting forms, and feedback-based institutional pharmacovigilance systems are required to reduce under-reporting.

Keywords: Adverse drug reaction; Pharmacovigilance; Under-reporting; Knowledge; Attitude; Practice; Doctors; Tertiary care hospital.