Pharmacovigilance in medical cannabis therapy among physicians in Poland: pharmacovigilance knowledge, ADR reporting practice and cannabis-related safety reporting.

Kopciuch D.; Kapcińska A.; Kus K.; Russo E. · Frontiers in public health · 2026

**Background & Methods** This cross-sectional analytical survey assessed pharmacovigilance (PV) knowledge, adverse drug reaction (ADR) reporting practices, and attitudes toward medical cannabis among 253 clinically active physicians in Poland using anonymous self-administered questionnaires. The survey evaluated demographic characteristics, PV knowledge and awareness, general ADR reporting behavior, clinical cannabis exposure, and cannabis-related safety perceptions, with multivariable logistic regression analysis identifying factors associated with ADR reporting. **Key Findings** - Most respondents (81.0%) reported clinical exposure to medical cannabis, yet only 13.4% reported adequate formal education in this area, revealing a substantial knowledge gap despite widespread clinical use. - Knowledge of pharmacovigilance purpose demonstrated the strongest association with ADR reporting (crude OR 46.58; adjusted OR 24.71), along with medical specialization (aOR 9.97) and hospital/university workplace (aOR 5.72) remaining significant predictors after multivariable adjustment. - Cannabis-specific ADR reporting was uncommon (only 19 events), despite high clinical exposure, indicating a notable exposure-reporting gap that suggests underrecognition or underreporting of cannabis-related adverse events in routine practice. **Dosage & Administration** Not reported. **Safety & Adverse Effects** Not reported. The study focused on pharmacovigilance reporting practices and knowledge rather than documenting specific adverse effects associated with medical cannabis therapy. **Evidence Quality** This study is a cross-sectional survey with inherent limitations: reliance on self-reported data and recall bias, inability to establish causal relationships, sparse cannabis-specific ADR data (n=19) limiting statistical power for cannabis-specific conclusions, and potential selection bias from voluntary participation. The authors explicitly state observational findings should not be interpreted causally. Strengths include use of appropriate statistical methods (Benjamini-Hochberg false-discovery-rate adjustment) and multivariable analysis. As a review-type observational study in a single country, it provides descriptive evidence (Level 3-4) regarding PV practices rather than efficacy or safety comparative data. The significant exposure-reporting gap identified warrants hypothesis-generating interpretation for future prospective pharmacovigilance studies with structured adverse event capture systems.

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