Bhutan's climb to medicines safety
Pharmacovigilance is the science and activities relating to the detection, assessment, understanding and prevention of adverse drug reactions (ADRs, also known as side effects) to medicines.
Ms Tshering Choden is a hospital pharmacist at one of Bhutan’s three regional pharmacovigilance centres, the Eastern Regional Referral Hospital in Monggar.
(Source: Uppsala Reports)
By Alexandra Hoegberg | Uppsala Reports
There are only five professionals working with pharmacovigilance – the science of analysing and preventing side effects to medicines – in all of Bhutan. One of them, Ms Tshering Choden, sat down with Uppsala Reports and shared an optimistic view of the country’s chances to improve medicines safety.
Q: What are the challenges to pharmacovigilance in Bhutan and what can be done about it?
Being a small country, one constraint in Bhutan is that we have less manpower. Right now, we are approximately 50 pharmacists in the country – with time I think there will be more. If we had more professionals who knew about the safety of medicines, we could expand pharmacovigilance activities in our hospitals, so having pharmacy professionals in hospitals is essential – they know what to do and have a knowledge of pharmacovigilance and adverse drug reactions (ADRs).
We have to build capacity with good education – we need more people to be trained in pharmacovigilance, and not only pharmacists. Previously we only focused on training pharmacy professionals, but if we want to have a good system in place in Bhutan, we should train all healthcare professionals, starting with nurses and doctors. We’re now in the process of training all health workers – nurses, doctors, pharmacists, pharmacy technicians and health assistants – in all hospitals and primary healthcare units in Bhutan, on the importance of reporting ADRs, how to fill in the forms, and where to send the reports.
If we had more manpower I think we could make everyone report adverse effects. We could reach each household and learn about their knowledge of pharmacovigilance, and also talk to our healthcare professionals to check their knowledge of medicines safety. If we were all committed it would be really easy for us to report ADRs and we could strengthen pharmacovigilance activities in hospitals.
Q: How are you working to improve pharmacovigilance at your hospital?
One of the challenges we face at the Eastern Regional Referral Hospital is that most people have been unaware of pharmacovigilance. They don’t think it’s necessary to report ADRs because it’s already written in the package leaflets – they think it’s in the nature of the drug to cause the reaction, hence they don’t report the ADRs.
Under-reporting is one of the biggest problems in under-developed countries. To encourage my colleagues to report, we made it mandatory in my centre to report ADRs, and they have to submit a minimum of three reports. We have free access to all the reporting forms in the hospital. I have distributed reporting forms to all the wards and explained to the staff how to report, what to write, and how they can submit to the reporting centres. I also developed a simple ADR notification form for my hospital, which led to increased reporting, and most of the staff in my hospital are aware of ADRs now.
Q: Why do you think it’s important to spread awareness of medicines safety?
Awareness of pharmacovigilance is very important because safety comes first in treatment. Without knowing the safety of the drug, we cannot treat the patient. Patients should know what pharmacovigilance means, what the effects of medicines are, and that there won’t be any pharmacological effect without any side effects. And for healthcare professionals it’s essential to know about pharmacovigilance when treating patients.
Q: What’s next for medicines safety in Bhutan?
Bhutan has a very young pharmacovigilance system, so we are moving at our own pace to develop and to get our own place established for pharmacovigilance in the Ministry of Health. Everything needs time to fall into place. We are not in a hurry, we are not being so ambitious, but we are working on it and hope to strengthen the pharmacovigilance system in Bhutan.
This article was first published in Uppsala Reports and has been edited for the Daily Bhutan.
