Thalidomide Black Box Warning Awareness and Perceptions of Pharmacy Students

Background: Thalidomide, despite its history of severe teratogenicity, remains a vital treatment for multiple myeloma and leprosy. Its safe use is contingent upon strict adherence to Black Box Warnings (BBW) and Risk Evaluation and Mitigation Strategy (REMS) protocols. Objective: This study aimed to assess the baseline awareness and safety-related opinions of pharmacy-affiliated individuals and determine if educational level significantly impacts these factors. Methods: A cross-sectional survey was conducted (N=47). Data were analyzed using descriptive statistics and Pearson's Chi-Square tests (p < 0.05) to compare two education-based groups: Undergraduate and Postgraduate/Degree. Results: Findings revealed a significant knowledge gap, with 63.8% of respondents unaware of BBWs prior to their pharmacy program. However, a high professional consensus was found regarding safety; 95.5% agreed that patient counseling is essential and that BBWs significantly impact clinical decision-making. Chi-Square analysis showed no statistically significant relationship between education level and awareness (p = .728) or safety opinions (p = .840), though the limited sample size warrants cautious interpretation of these findings. Conclusion: While initial awareness of regulatory warnings is low, pharmacy education appears to align students and professionals toward a commitment to risk management. Strengthening early curriculum coverage of high-risk medications such as thalidomide may help address the initial knowledge gap identified in this study.