Square Hospital Limited: A Journey Toward Medicine Safety in Bangladesh

The Directorate General of Drug Administration (DGDA)—with technical assistance from the USAID-funded SIAPS program, implemented by MSH—officially launched Bangladesh’s national pharmacovigilance (PV) program in 2013. After being first introduced at 20 private and public hospitals, and 13 pharmaceutical companies, the DGDA and SIAPS have organized trainings for focal persons to build their skills and knowledge on PV and increase adverse drug event (ADE) reporting.

Pharmacist Md. Jahidul Hasan serves as PV focal person at Square Hospital Limited, a 400-bed tertiary-care private hospital in Dhaka, that serves an average of 1,200 outpatients each day.

After his 2014 training, Hasan shared his new knowledge with the hospital’s Pharmacy and Therapeutic Committee (PTC) to show how PV can be incorporated into its clinical activities. Although the committee monitors ADEs among in-patients, it did not have a clear reporting structure until 2013.

According to Hasan, “At first things were slow, but gradually the wheel started to move and PV took on a stronger shape . We developed our own reporting flow for ADEs. Every doctor and nurse, when they start at the hospital, is given an orientation about pharmacovigilance. We also keep emergency contact numbers and the name of the PV focal person hanging up on the notice boards of each ward, so on-duty nurses can promptly report if any ADE occurs.”

He adds proudly, “Every event must now be reported—this is how PTC focuses on PV now.”

Currently, 30 hospitals and 30 pharmaceutical companies with designated PV focal points are working as “sentinel surveillance sites” to implement these interventions under the DGDA. To strengthen the ADE reporting system, SIAPS also helped the DGDA develop guidelines and tools and form an Adverse Drug Reaction Advisory Committee (ADRAC) to evaluate, analyze, and make recommendations on ADEs. To follow up on activities, a team comprised of DGDA officials and SIAPS’ technical advisors schedules regular monitoring visits to implementing facilities.

As of April 2017, the DGDA had received more than 1,300 ADE reports. Of these, 393 complete reports were reviewed by ADRAC and uploaded to the World Health Organization’s VigiFlow database, which allows users to view data on suspected side-effects from various medicinal products.

According to the DGDA, Square Hospital Limited is one of the facilities regularly submitting ADE reports, standing as a model for other private and public hospitals in the country for its commitment to ensuring medicine safety.