Thousands suffer in absence of monitoring
Munima Sultana | Wednesday, 29 June 2016
Hundreds of thousands of patients suffer from various kinds of adverse reaction of drugs prescribed by physicians every day in the absence of a monitoring system in the country.
Sources said neither the doctors are conscious about prescribing wrong medicines nor the victims have any place to lodge complaints with for their sufferings.
As a result, patients face adverse reactions like cardiac problems, disorientation, vomiting and asthma problem - many of which may turn out to be fatal, it is alleged.
Victims alleged that there is no place to lodge allegation with when they face adverse consequences of taking any medicine on doctors' prescription.
"We often are prescribed so many medicines to cover one reaction to another that we feel even loss of breath, strength to lead normal life and so on," said Shamima, a patient of a private clinic.
She said in most cases, they find no place to complain with other than doctors who then focus more on hiding their faults than reporting those.
Sources said the government formed a cell on adverse drug reaction (ADR) in 2013 to address this kind of cases. As the cell is not functional fully, companies go on producing such drugs and pocketing money at the cost of public health.
They said the ADR cell was formed first in 1992 after the World Health Organisation (WHO) advised the government to ensure safety and efficacy of drugs as part of its global campaign to bring discipline in medical practice.
But the cell remained totally non-functional until 2013 when the Director General of Drug Administration (DGDA), the regulatory authority, reorganised it in 2013.
Admitting the inaction of the ADR cell, Titu Miah, general secretary of the Bangladesh Society of Medicine, said there is a lack of orientation among physicians and patients about the adverse reaction of drugs for which such cases are hardly reported.
"We do monitor patients and solve many reaction-related cases through our own management like sharing with other doctors. There is no system of notification to the proper authority or taking necessary actions in this regard," he told the FE.
Md Saiful Hasan Shamim, assistant registrar of Oncology Department of Dhaka Medical College Hospital (DMCH), said reports of immediate reaction in patients are dealt with by respective department of the hospital but patients from far-flung areas are most vulnerable to the situation as they take help of local pharmacies to solve after-effects.
However, Dr Robed Amin, associate professor of the medicine department of the DMC said the medical college was provided a format to keep record of ADR by the DGDA office but there is no follow-up nor has a system been developed to address the issues uniformly.
DGDM officials, however, said they oversee ADR cases in 30 medical college hospitals and 30 pharmaceutical companies seeking reports and take necessary actions.
DGDA Director Mohammad Golam Kibria said after the ADR cell was made active in 2013, they have addressed more than 200 cases based on reports sent by 30 listed hospitals and companies and took actions after evaluation
On being advised by the ADR Advisory Committee, the DGDA is taking immediate actions like informing companies or uploading information to WHO Upsala Monitoring Cell in cases of adverse consequences. It cited examples of banning Rosigitazon and Pioglitazon, the two anti-diabetic drug for having cardiac effects.
He, however, admitted that no mechanism has yet been developed to address complaints from patients directly throughout the country.
The WHO addresses four kinds of adverse reaction which are life-threatening or fatal, which cause or prolong hospital admission, persistent incapacity or disability and concern misuse or dependence.
Professor of Pharmacy Department of Dhaka University ABM Faruk emphasised on engaging graduate pharmacists in this process of addressing and reporting ADR cases citing the usual worldwide practice.
"Many drugs have inherited reaction and patients may be sensitive to any drug. It is the duty of pharmacists to alert the people while selling drugs in pharmacies and ensure efficacy of taking medicines," he said.