Understanding Community Pharmacists' Intentions to Report Adverse Drug Reactions in Saudi Arabia: A Theory of Planned Behavior Analysis

Fahad T. Alsulami^1*Yousef Saeed Alqarni²Wadia Saad Alruqayb¹Mohammed S. Alharthi¹Mohammad S. Alzahrani¹MAJED A. ALGARNI¹Musaad M. Althobaiti³Saad Mohammed Almalki⁴Nawaf Abid Altowarqi⁴Hussain Ali Mathkur⁴Anas Muslih Althumali⁴Ayman Mohammed Alharthi⁴Haifa Abdulrahman Fadil⁵Adel A. Altowairqi⁶Mubarak S. Alharthi⁶

• ¹Clinical Pharmacy Department, College of Pharmacy, Taif University, Taif, Saudi Arabia, Taif, Saudi Arabia
• ²Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Damam, Saudi Arabia
• ³Department of Pharmacology and Toxicology, College of Pharmacy, Taif University, Taif, Saudi Arabia
• ⁴College of Pharmacy, Taif University, Taif, Saudi Arabia
• ⁵Department of Pharmacy practice , College of Pharmacy, Taibah University, Almadinah Almunawarah, Saudi Arabia
• ⁶University Medical Clinics, Taif University, Taif, Saudi Arabia

Introduction: Adverse drug reaction (ADR) reporting is critical for ensuring medication safety.However, underreporting remains a global concern, particularly in community pharmacy settings.This study explores the behavioral factors influencing community pharmacists' intention to reportADRs in Saudi Arabia, using the Theory of Planned Behavior (TPB) as a guiding framework.Aims and Objectives: This study aimed to estimate factors affecting community pharmacists'intention to report ADRs to the Saudi National Pharmacovigilance Center (NPC) through a TPB-based analysis.Methods: A cross-sectional survey was conducted to collect data on pharmacists’ intentions,attitudes, subjective norms, perceived behavioral control, and moral obligation regarding ADRreporting. Descriptive statistics summarized the sample characteristics. Binary logistic regressionwas used to evaluate the influence of TPB constructs on reporting intentions.Results: Among 452 participating community pharmacists, 88% were aware of the NPC, but only27.4% had reported ADRs in the past year. Pharmacists who were non-Saudi, aware of the NPCand its procedures, and trained in ADR reporting demonstrated significantly higher intentions toreport (p < 0.05). Attitudes (OR = 1.141, 95% CI: 1.09–1.18, p < 0.001), subjective norms (OR =1.280, 95% CI: 1.16–1.40, p < 0.001), perceived behavioral control (OR = 1.168, 95% CI: 1.03–1.31, p = 0.010), and moral obligation (OR = 1.417, 95% CI: 1.05–1.89, p = 0.019) were allsignificantly associated with reporting intention.Conclusion: Findings reinforce the importance of targeting TPB constructs(particularly attitudes,social norms, and perceived control) and perceived moral obligation in designing interventions toimprove ADR reporting. Strategies such as structured training, institutional support, andpromoting moral responsibility may bridge the gap between awareness and actual reportingpractices among community pharmacists in Saudi Arabia.