{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T06:07:15Z","timestamp":1789020435011,"version":"build-2803163510"},"reference-count":50,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"\n Background<\/jats:title>\n Medical cannabis is increasingly used in routine care, but its pharmacovigilance profile remains difficult to monitor because products, formulations, doses, routes of administration and clinical indications vary substantially. This study assessed pharmacovigilance knowledge, adverse drug reaction (ADR) reporting practice and attitudes toward medical cannabis among physicians in Poland, with particular attention to factors associated with ADR reporting.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We conducted a cross-sectional analytical survey among 253 clinically active physicians in Poland using an anonymous self-administered questionnaire. The survey covered demographic and professional characteristics, pharmacovigilance knowledge and awareness, general ADR reporting, clinical exposure to medical cannabis and cannabis-related safety perceptions. Crude associations were examined using chi-square tests, Fisher's exact tests for cannabis-specific sparse-data comparisons, Cramer's V, odds ratios (ORs) and 95% confidence intervals, with Benjamini\u2013Hochberg false-discovery-rate adjustment. For the primary outcome of general ADR reporting, a forced-entry multivariable logistic regression included PV-purpose knowledge, any medical specialization, professional experience greater than 10 years, hospital\/university workplace, medical cannabis exposure and sex. Cannabis-specific reporting was analyzed separately using exact methods because only 19 events occurred.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Most respondents reported clinical exposure to medical cannabis (81.0%), whereas only 13.4% reported adequate formal education in this area. In crude analysis, knowledge of the purpose of pharmacovigilance showed the strongest association with ADR reporting (OR 46.58; 95% CI 21.20\u2013102.32;\n p<\/jats:italic>\n &lt; 0.001;\n q<\/jats:italic>\n &lt; 0.001). In the adjusted model, PV-purpose knowledge (adjusted OR [aOR] 24.71; 95% CI 9.40\u201364.96), any medical specialization (aOR 9.97; 95% CI 3.66\u201327.20) and hospital\/university workplace (aOR 5.72; 95% CI 2.10\u201315.55) retained positive associations with general ADR reporting. Professional experience greater than 10 years, medical cannabis exposure and sex were not statistically significant after adjustment. Cannabis-specific ADR reporting was uncommon.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n In this sample, PV-purpose knowledge, medical specialization and hospital\/university workplace retained positive associations with general ADR reporting after multivariable adjustment. Crude associations for longer professional experience and medical cannabis exposure were attenuated after adjustment. The combination of frequent medical cannabis exposure and rare cannabis-specific ADR reporting suggests an exposure-reporting gap. The observational findings support practical, therapy-specific pharmacovigilance training but should not be interpreted causally.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1915903","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T05:31:55Z","timestamp":1789018315000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Pharmacovigilance in medical cannabis therapy among physicians in Poland: pharmacovigilance knowledge, ADR reporting practice and cannabis-related safety reporting"],"prefix":"10.3389","volume":"14","author":[{"given":"Dorota","family":"Kopciuch","sequence":"first","affiliation":[{"name":"Department of Pharmacoeconomics and Social Pharmacy, Poznan University of Medical Sciences","place":["Poznan, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agata","family":"Kapci\u0144ska","sequence":"additional","affiliation":[{"name":"Department of Pharmacoeconomics and Social Pharmacy, Poznan University of Medical Sciences","place":["Poznan, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krzysztof","family":"Kus","sequence":"additional","affiliation":[{"name":"Department of Pharmacoeconomics and Social Pharmacy, Poznan University of Medical Sciences","place":["Poznan, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilio","family":"Russo","sequence":"additional","affiliation":[{"name":"CRUISE Research Center, Department of Health Sciences, University Magna Graecia of Catanzaro","place":["Catanzaro, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1007\/s00406-024-01880-2","article-title":"Cannabis, cannabinoids and health: a review of evidence on risks and medical benefits","volume":"275","author":"Hoch","year":"2025","journal-title":"Eur Arch Psychiatry Clin Neurosci."},{"key":"B2","doi-asserted-by":"publisher","first-page":"e072348","DOI":"10.1136\/bmj-2022-072348","article-title":"Balancing risks and benefits of cannabis use: umbrella review of meta-analyses of randomised controlled trials and observational studies","volume":"382","author":"Solmi","year":"2023","journal-title":"BMJ."},{"key":"B3","doi-asserted-by":"publisher","first-page":"afae261","DOI":"10.1093\/ageing\/afae261","article-title":"Adverse events caused by cannabinoids in middle aged and older adults for all indications: a meta-analysis of incidence rate difference","volume":"53","author":"Velayudhan","year":"2024","journal-title":"Age Ageing."},{"key":"B4","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1007\/s00520-024-09087-w","article-title":"Adverse events associated with the use of cannabis-based products in people living with cancer: a systematic scoping review","volume":"33","author":"Cheah","year":"2025","journal-title":"Support Care Cancer."},{"key":"B5","doi-asserted-by":"publisher","first-page":"e085166","DOI":"10.1136\/bmjopen-2024-085166","article-title":"Overview of global monitoring systems for the side effects and adverse events associated with medicinal cannabis use: a scoping review using a systematic approach","volume":"14","author":"Wang","year":"2024","journal-title":"BMJ Open."},{"key":"B6","doi-asserted-by":"publisher","first-page":"S664","DOI":"10.2105\/AJPH.2024.307712","article-title":"The Food and Drug Administration's safety surveillance of adverse event cases involving cannabinoid hemp products, 2019\u20132023","volume":"114","author":"Wolf","year":"2024","journal-title":"Am J Public Health."},{"key":"B7","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1186\/s42238-025-00310-x","article-title":"Trends in cannabis adverse reaction reports: a descriptive analysis of spontaneous reporting data submitted to the Canada Vigilance Program since legalization and regulation of cannabis for non-medical purposes in Canada","volume":"7","author":"Plebon-Huff","year":"2025","journal-title":"J Cannabis Res."},{"key":"B8","doi-asserted-by":"publisher","first-page":"e70074","DOI":"10.1111\/fcp.70074","article-title":"Medical cannabis use in France: an observational safety study based on the RECANN Registry and the pharmacovigilance\/addictovigilance system from 2021 to 2024","volume":"40","author":"Chevallier","year":"2026","journal-title":"Fundam Clin Pharmacol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1792520","DOI":"10.3389\/fphar.2026.1792520","article-title":"Adverse events associated with medical cannabis reported within a centralized call center","volume":"17","author":"Illamola SM Lyu","year":"2026","journal-title":"Front Pharmacol."},{"key":"B10","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1016\/j.ejim.2018.01.004","article-title":"Practical considerations in medical cannabis administration and dosing","volume":"49","author":"MacCallum","year":"2018","journal-title":"Eur J Intern Med."},{"key":"B11","doi-asserted-by":"publisher","first-page":"1547","DOI":"10.1002\/ejp.1297","article-title":"European Pain Federation (EFIC) position paper on appropriate use of cannabis-based medicines and medical cannabis for chronic pain management","volume":"22","author":"Hauser","year":"2018","journal-title":"Eur J Pain."},{"key":"B12","doi-asserted-by":"publisher","first-page":"773","DOI":"10.1177\/0269881120986393","article-title":"Cannabis based medicines and cannabis dependence: a critical review of issues and evidence","volume":"35","author":"Schlag","year":"2021","journal-title":"J Psychopharmacol."},{"key":"B13","doi-asserted-by":"publisher","first-page":"1463871","DOI":"10.3389\/fpubh.2025.1463871","article-title":"International perspectives on physician knowledge, attitudes, and practices related to medical cannabis","volume":"13","author":"Syed","year":"2025","journal-title":"Front Public Health."},{"key":"B14","doi-asserted-by":"publisher","first-page":"4545","DOI":"10.3390\/jcm10194545","article-title":"Polish physicians' perspectives on medical cannabis policy and educational needs: results of an online survey","volume":"10","author":"Hordowicz","year":"2021","journal-title":"J Clin Med."},{"key":"B15","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1093\/fampra\/cmab108","article-title":"Primary care physicians' attitudes and knowledge regarding medical cannabis and willingness to prescribe it: the Israeli experience","volume":"39","author":"Adler","year":"2022","journal-title":"Fam Pract."},{"key":"B16","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1089\/can.2021.0032","article-title":"Assessing health care providers' knowledge of medical cannabis","volume":"7","author":"Kruger","year":"2022","journal-title":"Cannabis Cannabinoid Res."},{"key":"B17","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1089\/can.2019.0051","article-title":"Knowledge, practices, and attitudes of Washington State health care professionals regarding medical cannabis","volume":"5","author":"Kaplan","year":"2020","journal-title":"Cannabis Cannabinoid Res."},{"key":"B18","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1186\/s42238-024-00242-y","article-title":"The attitudes, knowledge and confidence of healthcare professionals about cannabis-based products","volume":"6","author":"Russo","year":"2024","journal-title":"J Cannabis Res."},{"key":"B19","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1159\/000546264","article-title":"Physicians' knowledge, attitudes, and perceptions about medical cannabis in the United States: a scoping review","volume":"8","author":"Yusupov","year":"2025","journal-title":"Med Cannabis Cannabinoids."},{"key":"B20","doi-asserted-by":"publisher","first-page":"625","DOI":"10.1007\/s40264-023-01302-7","article-title":"Factors associated with underreporting of adverse drug reactions by health care professionals: a systematic review update","volume":"46","author":"Garcia-Abeijon","year":"2023","journal-title":"Drug Saf."},{"key":"B21","doi-asserted-by":"publisher","first-page":"198","DOI":"10.4274\/tjps.galenos.2022.28034","article-title":"A systematic review of healthcare professionals' knowledge, attitudes, and practices regarding adverse drug reaction reporting in Ethiopia","volume":"20","author":"Anbeo","year":"2023","journal-title":"Turk J Pharm Sci."},{"key":"B22","doi-asserted-by":"publisher","first-page":"e0285811","DOI":"10.1371\/journal.pone.0285811","article-title":"Evaluation of health care professionals' knowledge, attitudes, practices and barriers to pharmacovigilance and adverse drug reaction reporting: a cross-sectional multicentral study","volume":"18","author":"Khan","year":"2023","journal-title":"PLoS ONE."},{"key":"B23","doi-asserted-by":"publisher","first-page":"e034553","DOI":"10.1136\/bmjopen-2019-034553","article-title":"Healthcare professionals' knowledge, attitude and practice of adverse drug reactions reporting in Ethiopia: a cross-sectional study","volume":"10","author":"Gidey","year":"2020","journal-title":"BMJ Open."},{"key":"B24","doi-asserted-by":"publisher","first-page":"823944","DOI":"10.3389\/fphar.2022.823944","article-title":"Knowledge, attitude and practice of hospital pharmacists in Central China towards adverse drug reaction reporting: a multicentre cross-sectional study","volume":"13","author":"Hu","year":"2022","journal-title":"Front Pharmacol."},{"key":"B25","doi-asserted-by":"publisher","first-page":"20420986221116468","DOI":"10.1177\/20420986221116468","article-title":"Awareness, knowledge, and attitude toward adverse drug reaction reporting among healthcare professionals in Ghana","volume":"13","author":"Yawson","year":"2022","journal-title":"Ther Adv Drug Saf."},{"key":"B26","doi-asserted-by":"publisher","first-page":"751","DOI":"10.1177\/0018578720957968","article-title":"Assessment of knowledge, attitude and practice of adverse drug reaction reporting among healthcare professionals working in primary, secondary and tertiary healthcare facilities in Ekiti State, South-West Nigeria","volume":"56","author":"Adegbuyi","year":"2021","journal-title":"Hosp Pharm."},{"key":"B27","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1080\/21556660.2019.1566137","article-title":"Healthcare professionals' pharmacovigilance knowledge and adverse drug reaction reporting behaviour and factors determining the reporting rates","volume":"8","author":"Guner","year":"2019","journal-title":"J Drug Assess."},{"key":"B28","doi-asserted-by":"publisher","first-page":"1104","DOI":"10.1007\/s11096-015-0165-5","article-title":"Knowledge and attitude of health-care professionals in hospitals towards pharmacovigilance in Saudi Arabia","volume":"37","author":"Alshammari","year":"2015","journal-title":"Int J Clin Pharm."},{"key":"B29","doi-asserted-by":"publisher","first-page":"1034","DOI":"10.1007\/s11096-023-01592-y","article-title":"Factors associated with underreporting of adverse drug reactions by patients: a systematic review","volume":"45","author":"Costa","year":"2023","journal-title":"Int J Clin Pharm."},{"key":"B30","doi-asserted-by":"publisher","first-page":"1015","DOI":"10.3390\/healthcare10061015","article-title":"Under-reporting of adverse drug reactions in Finland and healthcare professionals' perspectives on how to improve reporting","volume":"10","author":"Sandberg","year":"2022","journal-title":"Healthcare."},{"key":"B31","doi-asserted-by":"publisher","first-page":"413","DOI":"10.3390\/ijerph19010413","article-title":"The importance of direct patient reporting of adverse drug reactions in the safety monitoring process","volume":"19","author":"Sienkiewicz","year":"2022","journal-title":"Int J Environ Res Public Health."},{"key":"B32","doi-asserted-by":"publisher","first-page":"e40080","DOI":"10.2196\/40080","article-title":"Reporting, monitoring, and handling of adverse drug reactions in Australia: scoping review","volume":"9","author":"Fossouo Tagne","year":"2023","journal-title":"JMIR Public Health Surveill."},{"key":"B33","doi-asserted-by":"publisher","first-page":"1193","DOI":"10.1080\/14740338.2022.2118712","article-title":"A new paradigm in adverse drug reaction reporting: consolidating the evidence for an intervention to improve reporting","volume":"21","author":"Li","year":"2022","journal-title":"Expert Opin Drug Saf."},{"key":"B34","doi-asserted-by":"publisher","first-page":"2377","DOI":"10.1111\/bcp.15791","article-title":"Improving the spontaneous reporting of suspected adverse drug reactions: an overview of systematic reviews","volume":"89","author":"Routledge","year":"2023","journal-title":"Br J Clin Pharmacol."},{"key":"B35","doi-asserted-by":"publisher","first-page":"102293","DOI":"10.1016\/j.japh.2024.102293","article-title":"Systematic review and meta-analysis on effectiveness of strategies for enhancing adverse drug reaction reporting","volume":"65","author":"Mongkhonmath","year":"2025","journal-title":"J Am Pharm Assoc."},{"key":"B36","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1007\/s40199-024-00508-z","article-title":"Educational interventions in pharmacovigilance to improve the knowledge, attitude and the report of adverse drug reactions in healthcare professionals: systematic review and meta-analysis","volume":"32","author":"Cervantes-Arellano","year":"2024","journal-title":"Daru J Pharm Sci."},{"key":"B37","doi-asserted-by":"publisher","first-page":"e071079","DOI":"10.1136\/bmjopen-2022-071079","article-title":"Strategies and interventions to strengthen pharmacovigilance systems in low-income and middle-income countries: a scoping review","volume":"13","author":"Menang","year":"2023","journal-title":"BMJ Open."},{"key":"B38","doi-asserted-by":"publisher","first-page":"1420914","DOI":"10.3389\/fphar.2024.1420914","article-title":"Impact of multifaceted interventions on the knowledge, attitude, and practice of adverse drug reactions reporting among healthcare workers in Vietnam: a comparative intervention study","volume":"15","author":"Pham","year":"2024","journal-title":"Front Pharmacol."},{"key":"B39","doi-asserted-by":"publisher","first-page":"S31","DOI":"10.4103\/sja.SJA_543_18","article-title":"The STROBE guidelines","volume":"13","author":"Cuschieri","year":"2019","journal-title":"Saudi J Anaesth."},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2020.03.012","article-title":"Cross-sectional studies: strengths, weaknesses, and recommendations","author":"Wang","year":"2020"},{"key":"B41","doi-asserted-by":"publisher","first-page":"481","DOI":"10.7861\/clinmedicine.16-5-481","article-title":"Adverse drug reactions","volume":"16","author":"Coleman","year":"2016","journal-title":"Clin Med (Lond)."},{"key":"B42","first-page":"604","article-title":"Why, when and how to adjust your P values?","volume":"20","author":"Jafari","year":"2019","journal-title":"Cell J."},{"key":"B43","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/00031305.2019.1583913","article-title":"Lazar NA. Moving to a world beyond p <005","volume":"73","author":"Wasserstein","year":"2019","journal-title":"Am Stat."},{"key":"B44","doi-asserted-by":"publisher","first-page":"010502","DOI":"10.11613\/BM.2021.010502","article-title":"Sample size, power and effect size revisited: simplified and practical approaches in pre-clinical, clinical and laboratory studies","volume":"31","author":"Serdar","year":"2021","journal-title":"Biochem Med (Zagreb)."},{"key":"B45","doi-asserted-by":"publisher","first-page":"100578","DOI":"10.1016\/j.rcsop.2025.100578","article-title":"Knowledge, attitude, and practice among community pharmacists toward adverse drug reaction reporting and pharmacovigilance: a nationwide survey","volume":"18","author":"Alwidyan","year":"2025","journal-title":"Explor Res Clin Soc Pharm."},{"key":"B46","doi-asserted-by":"publisher","first-page":"e70134","DOI":"10.1111\/cts.70134","article-title":"Knowledge, attitude, practice, and barriers of adverse drug reaction reporting among healthcare professionals in Timor-Leste: a cross-sectional survey","volume":"18","author":"da Costa","year":"2025","journal-title":"Clin Transl Sci."},{"key":"B47","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1186\/s12913-025-13364-7","article-title":"Knowledge, attitude, and practice of pharmacovigilance among healthcare professionals at a tertiary level hospital, Sudan: a cross-sectional study","volume":"26","author":"Hamid","year":"2026","journal-title":"BMC Health Serv Res."},{"key":"B48","doi-asserted-by":"publisher","first-page":"6630404","DOI":"10.1155\/2021\/6630404","article-title":"Nurses' knowledge, attitudes, and practice in relation to pharmacovigilance and adverse drug reaction reporting: a systematic review","volume":"2021","author":"Salehi","year":"2021","journal-title":"Biomed Res Int."},{"key":"B49","doi-asserted-by":"publisher","first-page":"102328","DOI":"10.1016\/j.ctim.2020.102328","article-title":"Cannabis education needs assessment among Canadian physicians-in-training","volume":"49","author":"St Pierre","year":"2020","journal-title":"Complement Ther Med."},{"key":"B50","doi-asserted-by":"publisher","first-page":"e1761","DOI":"10.1016\/S2214-109X(25)00299-2","article-title":"Adverse drug reaction reporting with the Med Safety app in Uganda: a cluster-randomised, controlled trial","volume":"13","author":"Kiguba","year":"2025","journal-title":"Lancet Glob Health."}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1915903\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T05:31:56Z","timestamp":1789018316000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1915903\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,10]]},"references-count":50,"alternative-id":["10.3389\/fpubh.2026.1915903"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1915903","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,10]]},"article-number":"1915903"}}