Role of pharmacist in adverse drug reaction reporting: Enhancing antifungal safety and pharmacovigilance in cancer patients

Globally, adverse drug reactions (ADRs) are considered as a serious public health problem. Cancer patients are more prone to ADRs due to altered physiological environment and polypharmacy. This study aimed to assess the role of pharmacists in reporting adverse drug reactions in cancer patients exposed to antifungal therapy in Pakistan.

A retrospective cross-sectional study was conducted to gather data on systemic antifungal ADRs reported from 1^st January 2019 to 30^th December 2023 using electronic medical record. The Naranjo Algorithm causality scale, Common Terminology Criteria for Adverse Events severity scale and the hospital pharmacovigilance center criteria for seriousness were used to characterize the included ADRs. Clinical interventions regarding ADR management were also documented. Data were entered and analyzed by using SPSS version 25.0.The observed rate of antifungal ADRs was 0.7 per 1000 admissions. Majority of ADRs occur in adult patients (69.8%) with higher incidence in male (63.5%). Amphotericin B was associated with a high incidence of ADRs (90.5%), with nephrotoxicity being the most prevalent (50.9%). Most of the ADRs were classified as probable (92.0%), grade 2 (moderate) severity (69.8%) and medically significant (58.7%). Major intervention was discontinuation of drug (30.2%) and switched to another drug in (19.0%) patients. This study highlights the importance of pharmacist led pharmacovigilance activities in cancer patients. Future studies targeting diverse population in multiple hospitals should be conducted to further explore ADRs among cancer patients.