Knowledge, attitude, and practice studies on hemovigilance in India: A critical appraisal

Hemovigilance is essential for monitoring, analysing, and preventing adverse transfusion reactions. Hemovigilance Programme of India (HvPI), launched in 2012, aims to improve transfusion safety. However, challenges such as limited knowledge and underreporting persist, necessitating a critical appraisal of existing Knowledge, Attitude, and Practice (KAP) studies to guide future interventions. A systematic literature search was conducted using Google, PubMed, Scopus, Web of Science, and Google Scholar, focusing on KAP studies on hemovigilance in India published post-2012. Keywords included "hemovigilance," "blood transfusion safety," "adverse transfusion reactions," and "KAP studies," combined with "India" and "healthcare professionals." Filters for peer-reviewed, English-language studies were applied, and references were reviewed. Studies were appraised using the AXIS tool. Thirteen studies, with 1684 participants from teaching hospitals and tertiary care centres, were included. Most studies were conducted by pharmacology departments (84.6%), predominantly in western India (79.8%). While awareness of transfusion reactions was high, knowledge of reporting mechanisms and hemovigilance programmes was poor. Barriers included lack of training, time constraints, and fear of legal repercussions. Only one study met an acceptable quality score (≥16/20) on AXIS tool, while others demonstrated methodological weaknesses, inadequate sample size justification, lack of non-responder analysis, and insufficient statistical rigour. Despite highlighting the importance of KAP assessments in hemovigilance, the studies' geographical limitations and methodological constraints hinder generalisability. Future research should employ robust methodologies, expand geographical representation, and include diverse populations to enhance hemovigilance practices in India. Strengthening hemovigilance systems through coordinated efforts is essential for improving transfusion safety nationwide.