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Abstract

Objectives: To assess the current status of Adverse Drug Reaction (ADR) monitoring and reporting systems and to evaluate the level of awareness and key factors responsible for under-reporting among healthcare professionals, with emphasis on improving pharmacovigilance practices. Methods: A comprehensive review and analytical approach was used by combining evidence from pharmacovigilance systems and observational studies on ADR reporting. Data from healthcare settings, including questionnaire-based findings and national monitoring frameworks, were considered to understand reporting behavior and system effectiveness. Results: Structured pharmacovigilance systems are established and support drug safety; however, ADR under-reporting remains a major issue. Key barriers include lack of awareness, inadequate training, time constraints, and uncertainty in identifying ADRs. Although healthcare professionals frequently encounter ADRs, reporting rates are low. Pharmacists have an important role, but their contribution is not fully utilized. Conclusion: Despite the presence of organized pharmacovigilance systems, ADR reporting needs significant improvement. Increasing awareness, strengthening training programs, simplifying reporting procedures, and promoting active involvement of healthcare professionals especially pharmacists can enhance reporting rates and ensure better patient safety outcomes.

Keywords

Adverse Drug Reaction, Pharmacovigilance, healthcare Professionals, PvPI, Drug Safety

Introduction

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Adverse drug reactions (ADRs), as recognized with the aid of the arena fitness business enterprise, are a main subject in healthcare. They appreciably make contributions to infection, death, and elevated healthcare prices. Monitoring, detecting, and preventing ADRs are vital components of pharmacovigilance, which makes a specialty of ensuring the safe and powerful use of medicines.1

In India, organized efforts, which include national ADR monitoring programs, had been installed to accumulate, investigate, and examine records on adverse drug reactions. But, despite those systems, under-reporting of ADRs stays a serious problem. Healthcare professionals, along with doctors, pharmacists, and nurses, play an essential function in figuring out and reporting ADRs, but their involvement is frequently constrained2.  numerous reasons make a contribution to the below reporting of ADRs. Those include lack of knowledge approximately how to record ADRs, insufficient schooling, restrained time, and issues in spotting ADRs. Even when healthcare experts identify ADRs in medical exercise, many cases aren't reported, which reduces the effectiveness of pharmacovigilance systems.3 Consequently, growing awareness, enhancing training and education, and making reporting procedures simpler are important steps to reinforce ADR monitoring systems. This look at goals focuses on the importance of ADR reporting, looks at the demanding situations of under-reporting, and emphasizes the need for lively participation of healthcare specialists to enhance affected person protection4.

METHODS

The present study was designed as a descriptive and analytical review focusing on adverse drug reaction (ADR) reporting practices and pharmacovigilance activities among healthcare professionals in India. The study primarily aimed to evaluate the level of awareness, knowledge, and participation of healthcare professionals in ADR reporting, as well as to identify the factors responsible for under-reporting within the existing pharmacovigilance framework 5 . Data for the study were collected from various secondary sources, including published research articles, review papers, and official reports related to pharmacovigilance and ADR monitoring systems. Relevant literature was selected based on its focus on ADR reporting, awareness, and practices among healthcare professionals such as doctors, pharmacists, and nurses. Special emphasis was given to studies conducted in India, along with those addressing    global pharmacovigilance practices for comparative understanding. 6

In addition, findings from questionnaire-based and observational studies were analyzed to assess the knowledge, attitude, and practices (KAP) of healthcare professionals regarding ADR reporting. These studies provided insights into the frequency of ADR encounters, reporting behavior, and the common barriers faced during the reporting process. Information related to national pharmacovigilance initiatives, including ADR monitoring programs and reporting systems, was also reviewed to understand the structural and functional aspects of drug safety surveillance in India.7.

The collected data was systematically analyzed and categorized to identify key themes such as awareness levels, reporting patterns, challenges in ADR identification, and factors contributing to under-reporting. Common barriers such as lack of awareness about reporting procedures, insufficient training, time constraints, unavailability of reporting tools, and uncertainty in recognizing ADRs were critically evaluated.?.

Furthermore, the role of different healthcare professionals, particularly pharmacists, was examined in the context of improving ADR reporting practices. The study also considered strategies suggested in the literature to enhance pharmacovigilance activities, including educational interventions, training programs, and simplification of reporting systems. This methodological approach allowed for a comprehensive understanding of the current status of pharmacovigilance in India and the challenges associated with ADR reporting among healthcare professionals.?.

PHARMACOVIGILANCE PROGRAM IN INDIA

India has installed a structured pharmacovigilance system to monitor the protection of drug treatments. The countrywide initiative answerable for ADR monitoring is the Pharmacovigilance Programme of India. This program operates under the coordination of the Indian Pharmacopoeia fee and works in collaboration with the principal tablets preferred control business enterprise. The primary objective of this program is to gather and analyze reports of unfavorable drug reactions and make sure that drugs used by the public stay safe and effective.

The Pharmacovigilance Programme of India functions via a community of adverse drug reaction tracking centers positioned in hospitals and scientific establishments. Healthcare professionals operating in those centers collect ADR reports from patients and different healthcare carriers. Those reports are then transmitted to the national coordination center, in which they are evaluated and stored in a centralized database. This statistic facilitates picking out capacity safety signals and helps regulatory decision-making related to drug protection.11

India mounted a proper pharmacovigilance gadget to display screen ADRs and shield public health. The program was initiated in 2010 through the Ministry of Health and Own Family Welfare under the relevant pills fashionable manipulate enterprise (CDSCO). Later, the countrywide coordination center ended up shifting to the Indian Pharmacopoeia Commission (IPC) in Ghaziabad to enhance the system.

The programme consists of:

  1. National Coordination Centre (NCC)
  2. Nearby tracking Centres
  3. Adverse Drug response monitoring Centres (AMCs)
  4.  Healthcare professionals and purchasers

The ones centers acquire, man or woman Case safety reviews (ICSRs) and add them to the WHO global database through VigiFlow software. No matter the presence of a based pharmacovigilance device, the variety of ADR reviews in India is still lower than expected.¹².

Function of Healthcare Experts in ADR Reporting

Healthcare professionals play an important role in figuring out and reporting ADRs.

Physicians

Physicians are generally the primary ones to have a look at ADRs in the course of a remedy. They're chargeable for diagnosing negative reactions and submitting ADR reports to monitoring centers. However, many physicians do not report ADRs regularly because of lack of time and interest.

Pharmacists

Pharmacists are considered essential members of pharmacovigilance because of their expertise about medicines and drug protection. Research has proven that health center pharmacists often have better know-how and awareness regarding ADR reporting in comparison to other healthcare professionals.

Nurses

Nurses often examine patient responses to medications in the course of health center care. Their close interplay with sufferers allows them to stumble on early signs and symptoms of ADRs. However, their involvement in ADR reporting is regularly restrained due to insufficient training and absence of reporting guidelines.¹³.

Comparison of Knowledge, Attitude, and Practice (KAP) among Healthcare Professionals

PARAMETER

PHYSICANS

PHARMACIST

NURSES

Knowledge of Pharmacovigilance

Moderate

High

Moderate

Awareness of Reporting Forms

Low-Moderate

High

Low

ADR Reporting Practice

Limited

Moderate

Low

Participation in Training

Limited

Higher

Low

Pharmacists generally exhibit better knowledge and attitudes due to their educational background, while physicians remain key reporters due to their clinical involvement.¹?.

Factors Responsible for Under-Reporting of ADRs

Lack of Awareness: Many healthcare professionals lack adequate knowledge of pharmacovigilance systems and reporting procedures.

Lack of Training: Insufficient training in ADR identification and reporting limits active participation.

Workload and Time Constraints: Heavy clinical workload discourages healthcare professionals from reporting ADRs.

Fear of Legal Consequences: Concerns about legal liability and professional accountability may prevent reporting.

Inadequate Reporting Infrastructure: Limited access to reporting tools and lack of awareness about monitoring centers further contribute to under-reporting.¹?.

Strategies to Improve ADR Reporting

Conduct regular training and awareness programs.

Integrate pharmacovigilance into academic curricula.

Simplify and digitize ADR reporting systems

Promote the use of ADR reporting mobile applications.

Organize workshops and continuing medical education (CME) programs.

Provide feedback and recognition to reporters.

Educational interventions have been shown to significantly improve ADR reporting rates among healthcare professionals. ¹?

FUTURE PERSPECTIVES

The field of pharmacovigilance in India is undergoing a significant transformation driven by technological innovation and evolving healthcare practices. With the increasing adoption of digital reporting platforms, the process of adverse drug reaction (ADR) reporting is becoming more efficient, accessible, and user-friendly for healthcare professionals. The integration of electronic health records (EHRs) into pharmacovigilance systems is expected to play a crucial role in improving the accuracy and timeliness of ADR data collection. By enabling real-time data sharing and automated signal detection, these systems can facilitate early identification of potential drug safety concerns.17

Artificial intelligence (AI) and machine learning (ML) are emerging as powerful tools in the analysis of large pharmacovigilance databases. These technologies can assist in identifying hidden patterns, predicting adverse reactions, and prioritizing signals that require further investigation. In the future, AI-driven systems may significantly reduce the burden on manual reporting and enhance the overall efficiency of drug safety monitoring. Additionally, mobile health applications and online reporting portals are likely to encourage greater participation from both healthcare providers and patients, thereby addressing the issue of under-reporting, which remains a major challenge in India.18

Strengthening collaboration among key stakeholders, including regulatory authorities, healthcare institutions, pharmaceutical companies, and patients, is essential for building a robust pharmacovigilance framework. Continuous training programs, awareness campaigns, and incorporation of pharmacovigilance education into healthcare curricula can further improve reporting practices. Moreover, policy-level support and strict regulatory measures will be necessary to ensure compliance and standardization across the country.19

Looking ahead, the integration of advanced analytics, improved infrastructure, and enhanced stakeholder engagement holds great promise for the future of pharmacovigilance in India. These developments are expected to not only increase the quantity of ADR reports but also improve their quality, ultimately contributing to safer and more effective use of medicines.20

Annual Increase in ADR Reporting Efficiency in India²¹

CONCLUSION

Adverse drug reaction (ADR) monitoring remains a fundamental component of patient safety and effective healthcare delivery. In a country like India, where the use of medicines is rapidly increasing due to population growth and expanding healthcare access, a strong pharmacovigilance system is essential to minimize drug-related risks. Over the years, the establishment of structured initiatives such as the Pharmacovigilance Programme of India (PVPI) has significantly strengthened the framework for ADR reporting and surveillance. These efforts have contributed to improved awareness among healthcare professionals and have laid the foundation for systematic drug safety monitoring across the nation. Despite these advancements, several challenges continue to limit the full potential of ADR reporting in India. Under-reporting remains one of the most critical issues, often due to lack of awareness, time constraints, inadequate training, and uncertainty about reporting procedures among healthcare providers. Additionally, variations in infrastructure and resources across different regions further affect the consistency and quality of reporting. Addressing these barriers requires a multi-faceted approach that includes continuous education, simplification of reporting processes, and strengthening institutional support systems.

The future of pharmacovigilance in India appears promising with the integration of digital technologies and innovative approaches. The adoption of electronic reporting systems, mobile applications, and data integration platforms can significantly enhance the efficiency and accessibility of ADR reporting. Furthermore, emerging technologies such as artificial intelligence and big data analytics have the potential to revolutionize signal detection and risk assessment by enabling faster and more accurate analysis of large datasets. These advancements can lead to early identification of safety concerns and improved regulatory decision-making. Equally important is the role of collaboration among stakeholders, including regulatory authorities, healthcare professionals, pharmaceutical industries, and patients. Encouraging active participation from all these groups can help build a culture of reporting and accountability. Public awareness campaigns and inclusion of pharmacovigilance education in academic curricula can further promote responsible reporting practices. in conclusion, while India has made considerable progress in establishing a robust pharmacovigilance system, sustained efforts are required to overcome existing challenges and enhance reporting efficiency. Strengthening awareness, leveraging technology, and fostering collaboration will be key to improving ADR monitoring in the future. Ultimately, an effective pharmacovigilance system will ensure safer use of medicines and better health outcomes for the population.

REFERENCES

  1. World Health Organization. The importance of pharmacovigilance: Safety monitoring of medicinal products. Geneva; 2002.
  2. Biswas P. Pharmacovigilance in Asia. J Pharmacol Pharmacother 2013;4 Suppl 1:S7?19.
  3. L. Hazell, S. A. W. Shakir. Under-reporting of adverse drug reactions: A systematic review. Drug Safety. 2006;29(5):385–396.
  4. Ramesh M, Parthasarathi G. Adverse drug reactions reporting: attitudes and perceptions of medical practitioners. Asian J Pharm Clin Res. 2009;2(2):10-14.
  5. 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):200-206.
  6. A. R. Khan, M. A. Khan. Knowledge, attitudes and practice of doctors to adverse drug reaction reporting in a teaching hospital in India. Journal of Pharmacology and Pharmacotherapeutics. 2013;4(3):191–196.
  7. Santosh Palaian, Ibrahim MI, Mishra P. Health professionals’ knowledge, attitude and practices towards pharmacovigilance. Pharmacy Practice. 2011;9(4):228–235.
  8. Lopez-Gonzalez E et al. (2009). Determinants of under-reporting of adverse drug reactions: a systematic review. Drug Safety, 32(1), 19–31.
  9. Bhagavathula AS, Elnour AA, Jamshed SQ, Shehab A. Health Professionals' Knowledge, Attitudes and Practices about Pharmacovigilance in India: A Systematic Review and Meta-Analysis. PLOS ONE. 2016;11(3):e0152221. doi:10.1371/journal.pone.0152221
  10. Kalaiselvan V, Thota P, Singh GN. Pharmacovigilance Programme of India: Recent developments and future perspectives. Indian Journal of Pharmacology. 2016;48(6):624-628
  11. Aronson JK. Pharmacovigilance and adverse drug reactions. British Journal of Clinical Pharmacology. 2012;74(4):731-736.
  12. Indian Pharmacopoeia Commission.Pharmacovigilance Programme of India (PvPI). Guidance Document for Spontaneous Adverse Drug Reaction Reporting. Ghaziabad: IPC; 2019.
  13. Bharti D. Shewale, Pravin O. Patil, Surendra S. Agrawal, Satish B. Kosalge, Ravindra A. Fursule, Nidhi P. Sapkal. “Adverse Drug Reporting: Role of Health Care Professionals.” Journal of Pharmacy Research, Vol. 2, Issue 3, March 2009, pp. 327–330.ISSN: 0974-6943.
  14. Gajjar B, Mirza N, Gor A, Mistry M, Shah N. A qualitative study of knowledge, attitude and practice towards pharmacovigilance among doctors and nursing staff in a tertiary care hospital in India. Journal of Clinical and Diagnostic Research. 2017 Apr;11(4):FC01–FC03. DOI: 10.7860/JCDR/2017/24623.9647.
  15. Tandon VR, Mahajan V, Khajuria V, Gillani Z. Under-reporting of adverse drug reactions: A challenge for pharmacovigilance in India. Indian Journal of Pharmacology. 2015;47(1):65–71.
  16. Bisht M, Singh S, Dhasmana DC. Effect of educational intervention on adverse drug reporting by physicians: a cross-sectional study. ISRN Pharmacol  2014
  17. Thota A, Sarkar S, Guptha S, Thota P. Stimulated adverse drug reaction reporting in pharmacovigilance: Indian perspectives. Journal of Pharmacovigilance and Drug Research. 2021                        
  18. Dsouza VS, Leyens L, Kurian JR, Brand A, Brand H. Artificial intelligence (AI) in pharmacovigilance: A systematic review on predicting adverse drug reactions (ADR) in hospitalized patients. Research in Social and Administrative Pharmacy. 2025;21:453–462
  19.  Suke SG, Kosta P, Negi H. Role of pharmacovigilance in India: An overview. Online Journal of Public Health Informatics. 2015;7(2):e223.
  20. Singh H, Dulhani N, Tiwari P, Singh P, Sinha T. A pharmacovigilance study in a tertiary care hospital in India: Analysis of adverse drug reactions. Indian Journal of Pharmacology. 2010;42(2):95–98
  21. Indian Pharmacopoeia Commission. Pharmacovigilance Programme of India (PvPI): ADR Reporting Status Reports (2022–2026). Ministry of Health and Family Welfare, Government of India  

Reference

  1. World Health Organization. The importance of pharmacovigilance: Safety monitoring of medicinal products. Geneva; 2002.
  2. Biswas P. Pharmacovigilance in Asia. J Pharmacol Pharmacother 2013;4 Suppl 1:S7?19.
  3. L. Hazell, S. A. W. Shakir. Under-reporting of adverse drug reactions: A systematic review. Drug Safety. 2006;29(5):385–396.
  4. Ramesh M, Parthasarathi G. Adverse drug reactions reporting: attitudes and perceptions of medical practitioners. Asian J Pharm Clin Res. 2009;2(2):10-14.
  5. 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):200-206.
  6. A. R. Khan, M. A. Khan. Knowledge, attitudes and practice of doctors to adverse drug reaction reporting in a teaching hospital in India. Journal of Pharmacology and Pharmacotherapeutics. 2013;4(3):191–196.
  7. Santosh Palaian, Ibrahim MI, Mishra P. Health professionals’ knowledge, attitude and practices towards pharmacovigilance. Pharmacy Practice. 2011;9(4):228–235.
  8. Lopez-Gonzalez E et al. (2009). Determinants of under-reporting of adverse drug reactions: a systematic review. Drug Safety, 32(1), 19–31.
  9. Bhagavathula AS, Elnour AA, Jamshed SQ, Shehab A. Health Professionals' Knowledge, Attitudes and Practices about Pharmacovigilance in India: A Systematic Review and Meta-Analysis. PLOS ONE. 2016;11(3):e0152221. doi:10.1371/journal.pone.0152221
  10. Kalaiselvan V, Thota P, Singh GN. Pharmacovigilance Programme of India: Recent developments and future perspectives. Indian Journal of Pharmacology. 2016;48(6):624-628
  11. Aronson JK. Pharmacovigilance and adverse drug reactions. British Journal of Clinical Pharmacology. 2012;74(4):731-736.
  12. Indian Pharmacopoeia Commission.Pharmacovigilance Programme of India (PvPI). Guidance Document for Spontaneous Adverse Drug Reaction Reporting. Ghaziabad: IPC; 2019.
  13. Bharti D. Shewale, Pravin O. Patil, Surendra S. Agrawal, Satish B. Kosalge, Ravindra A. Fursule, Nidhi P. Sapkal. “Adverse Drug Reporting: Role of Health Care Professionals.” Journal of Pharmacy Research, Vol. 2, Issue 3, March 2009, pp. 327–330.ISSN: 0974-6943.
  14. Gajjar B, Mirza N, Gor A, Mistry M, Shah N. A qualitative study of knowledge, attitude and practice towards pharmacovigilance among doctors and nursing staff in a tertiary care hospital in India. Journal of Clinical and Diagnostic Research. 2017 Apr;11(4):FC01–FC03. DOI: 10.7860/JCDR/2017/24623.9647.
  15. Tandon VR, Mahajan V, Khajuria V, Gillani Z. Under-reporting of adverse drug reactions: A challenge for pharmacovigilance in India. Indian Journal of Pharmacology. 2015;47(1):65–71.
  16. Bisht M, Singh S, Dhasmana DC. Effect of educational intervention on adverse drug reporting by physicians: a cross-sectional study. ISRN Pharmacol  2014
  17. Thota A, Sarkar S, Guptha S, Thota P. Stimulated adverse drug reaction reporting in pharmacovigilance: Indian perspectives. Journal of Pharmacovigilance and Drug Research. 2021                        
  18. Dsouza VS, Leyens L, Kurian JR, Brand A, Brand H. Artificial intelligence (AI) in pharmacovigilance: A systematic review on predicting adverse drug reactions (ADR) in hospitalized patients. Research in Social and Administrative Pharmacy. 2025;21:453–462
  19.  Suke SG, Kosta P, Negi H. Role of pharmacovigilance in India: An overview. Online Journal of Public Health Informatics. 2015;7(2):e223.
  20. Singh H, Dulhani N, Tiwari P, Singh P, Sinha T. A pharmacovigilance study in a tertiary care hospital in India: Analysis of adverse drug reactions. Indian Journal of Pharmacology. 2010;42(2):95–98
  21. Indian Pharmacopoeia Commission. Pharmacovigilance Programme of India (PvPI): ADR Reporting Status Reports (2022–2026). Ministry of Health and Family Welfare, Government of India  

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Muskan
Corresponding author

Dreamz College of Pharmacy, Khilra, Sundernagar   

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Shivani Sharma
Co-author

Dreamz College of Pharmacy, Khilra, Sundernagar   

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Saroj
Co-author

Dreamz College of Pharmacy, Khilra, Sundernagar   

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Kavita Pathania
Co-author

Dreamz College of Pharmacy, Khilra, Sundernagar   

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Abhinay
Co-author

Dreamz College of Pharmacy, Khilra, Sundernagar   

Muskan, Shivani Sharma, Saroj, Kavita Pathania, Abhinay, A Review Article on Adverse Drug Reaction (ADRs) and Pharmacovigilance Practices among Healthcare Professionals in India, Int. J. of Pharm. Sci., 2026, Vol 4, Issue 5, 4650-4656. https://doi.org/10.5281/zenodo.20278927

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