The importance of pharmacovigilance in healthcare

In celebration of World Patient Safety Day 2021, Beacon Pharmaceuticals Limited and The Daily Star jointly organised a three-part webinar series from September 16 to 18, 2021. The theme for this year's World Patient Safety Day is "Safe maternal and newborn care", where the World Health Organization (WHO) urged all stakeholders worldwide to "Act now for safe and respectful childbirth!"

Episode 1 of the special webinar series,titled "We are responsible for the safe storage and distribution of medicines", brought in specialists from the field of pharmacy to share their expertise.

Dr Sitesh C Bachar, Professor, Department of Pharmacy, University of Dhaka, explained the meanings of adverse drug reactions and pharmacovigilance: "An adverse drug reaction is a pathological condition created by a drug, regardless of its nature, for circumstances of its occurrence. Such reactions can be evaluated and prevented using pharmacovigilance."

Mohammad Abdur Rahman, Deputy General Manager, Pharmacy, Evercare Hospital Dhaka, shared the proper steps to ensure the drug safety of new patients: "The first step is medication reconciliation, i.e., gaining information about the patient's drug history and whether they should continue taking the drugs. Then, we check whether they have signs and symptoms of any adverse drug reaction. If hypersensitivity is found, the patient is provided with a drug allergy card to simplify future treatment plans."

Constant communication between nurses and pharmacists can prevent adverse drug reactions, as described by Md Jahidul Hasan, Coordinator, IPD Pharmacy, Department of Clinical Pharmacy, Square Hospital. "Nurses should be continually given updated information about drugs from the pharmacy department so that the drugs are administered and stored properly. Sometimes, adverse reactions are disease-related instead of drug-related, so pharmacists must work together with doctors and nurses to identify the cause of the reaction," he said.

Mahmudul Hoque, In-charge, Pharmacy Department, National Institute of Cancer Research and Hospital, explained the process of developing drug indications of use: "Data is collected from patients after drug administration and sent to specialised committees to come up with new indications to be registered."

Episode 2 of the webinar series was titled "Safety, risk and dosage of taking medicine" and invited a new set of experts to share their opinions. 

Mamun Al Mahtab, Professor & Chairman, Department of Hepatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), shared, "A drug goes through multiple clinical trials before hitting the market, but that still does not ensure its safety. The drug has to be monitored even when it is in the market and used by the mass population. Many drugs are removed from the market if new adverse side effects are found."

When asked about the importance of drug safety in cancer treatment, Major General Prof Dr Md Azizul Islam, Consultant Physician General, Bangladesh Armed Forces, Ministry of Defence, Dhaka Cantonment, said, "Ensuring drug safety in cancer treatment is crucial because cytotoxic drugs can cause both immediate and late side effects, some of which are life-threatening."

Dr Sajjad Mohammad Yusuff, Professor, Radiotherapy Department, Chittagong Medical College Hospital, mentioned, "If drug safety is not maintained, distrust is created within the healthcare industry. Pharmaceutical companies should therefore make great investments in the research and development of drugs. Each company should also have a pharmacovigilance team with experts of global standard."

Describing the state of pharmacovigilance activities in the country, Prof Dr S M Abdur Rahman, Dean, Faculty of Pharmacy, University of Dhaka, shared, "Through the Directorate General of Drug Administration (DGDA), an adverse drug reaction monitoring (ADRM) cell has been established that deals with pharmacovigilance teams of different companies. The Adverse Drug Reaction Advisory Committee (ADRAC) analyses and reports cases of adverse drug reactions."

Episode 3 of the webinar series was titled "Taking safe medicine during pregnancy", where specialists in obstetrics and gynaecology shared their insights.

Dr Farhana Dewan, Professor and Head, Gynaecology & Obstetrics Department, Ibn Sina Medical College Hospital, & President Elected, OGSB, explained how hospitals could carry out pharmacovigilance activities: "Hospitals should have written policies clarifying the effects of each drug on different types of patients. This information can also be in a checklist or module that all medical personnel can follow."

Prof Dr Sabera Khatun, Founder Chairman & Head, Department of Gynae Oncology, BSMMU, shared an example of adverse drug reaction in obstetrics: "The drug thalidomide was used to treat morning sickness in pregnant patients. Later it was found that it caused babies to be born with limb deformations. Pregnant women should save themselves from such adverse drug reactions by avoiding over-the-counter medicine."

Sharing his vision for a country with enhanced drug safety, Dr Akter Hossain, Deputy Director, DGDA, and Focal Point of ADR said, "All actors responsible for pharmacovigilance are those who register drugs, DGDA, marketing authorisation holders or companies, and healthcare professionals. If they all work together, Bangladesh will be on track for creating an environment where patients feel comfortable sharing their issues with drug use, and pharmacovigilance is ensured."