Oropharyngeal Adverse Drug Reactions: Knowledge, Attitudes, and Practice (KAP) among Italian Healthcare Professionals and Students

Gaetano La Mantia ^1,2,3,4 Giulia Marcon ⁵ Martina Coppini ^2,3,4* Fortunato Buttacavoli ^2,4 Vera Panzarella ² Giuseppe Colella ⁶ Annalisa Capuano ⁷ Liberata Sportiello ⁸ Gaspare Parrinello ⁹ Ilaria Morreale ¹⁰ Giacomo Oteri ³ Giuseppe Bellavia ¹¹ Vittorio Fusco ¹² Rodolfo Mauceri ^2,4 Monica Bazzano ² Giuseppe Seminara ^2,4 Olga Di Fede ² Giuseppina Campisi ¹³

• ¹ University of Palermo, Palermo, Italy
• ² Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.) University of Palermo, Italy, Palermo, Italy
• ³ Dipartimento di Scienze Biomediche, Odontoiatriche, Morfologiche e Funzionali per Immagini, Università degli Studi di Messina, Messina, Sicily, Italy
• ⁴ Unit of Oral Medicine and Dentistry for fragile patients, Department of Rehabilitation, fragility, and continuity of care" University Hospital Palermo, Palermo, Italy, Palermo, Italy
• ⁵ Department of Engineering, University of Palermo, Palermo, Italy
• ⁶ Multidisciplinary Department of Medical, Surgical and Dental Specialties, University of Campania “Luigi Vanvitelli”, Napoli, Italy
• ⁷ Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Napoli, Italy
• ⁸ Department of Experimental Medicine – Section of Pharmacology “L. Donatelli”, University of Campania “Luigi Vanvitelli”, Napoli, Italy
• ⁹ Biomedical Department of Internal and Specialist Medicine, University of Palermo, Palermo, Sicily, Italy
• ¹⁰ Clinical Pharmacology Unit, Department of Hospital General Services, University Hospital "Paolo Giaccone", Palermo, Italy
• ¹¹ Department of Drug - ASP Agrigento, Agrigento, Italy
• ¹² Oncology Unit, Azienda Ospedaliera Di Alessandria SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
• ¹³ Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, Palermo, Sicily, Italy

Introduction. Pharmacovigilance plays a vital role in ensuring drug safety and protecting public health. Oropharyngeal adverse drug reactions (O-ADRs) are found to be under-reported, especially by oral health professionals, limiting the identification and management of these events.Aims. This study aimed to evaluate the knowledge, attitudes, and practices (KAP) of healthcare professionals and students regarding O-ADRs and to assess their specific expertise by a self-elearning test.Methods. A cross-sectional survey was conducted using a KAP questionnaire between April 2023 and April 2024, involving 943 participants, including physicians, dentists, dental hygienists, and students. Additionally, three sets of self-e-learning tests on O-ADRs were administered. The study employed descriptive statistics, Kruskal-Wallis tests, and logistic regression to analyze factors affecting KAP and reporting behaviors.Results. Significant gaps in KAP were identified. Only 26.5% of participants demonstrated frequent best practices for reporting O-ADRs, with dentists and dental hygienists showing lower reporting rates (13.8% and 9.3%, respectively) compared to physicians (18.8%). The results of logistic regression analyses showed that practical knowledge was significantly associated with work experience (OR = 2.15, p = 0.026). Students exhibited the lowest levels of practical knowledge and reporting proficiency, with only 17.6% demonstrating competence. The self-e-learning test highlighted knowledge deficits: only 22.9% of participants correctly identified O-ADR associated with antiseptic mouth rinses, additional 30.2% recognized those linked to antimicrobial drugs.Conclusions. This study highlights the need for targeted educational interventions to address gaps in O-ADR knowledge and practice. Tailored training, user-friendly digital tools, and a strong pharmacovigilance culture are crucial for improving reporting rates and ensuring patient safety.