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Not enough pharmacists are aware of the yellow card scheme

"Medication safety week is an opportunity for pharmacists to focus on reporting adverse reactions"

Every pharmacist must report adverse drug reactions using the yellow card scheme, says chair of the Community Pharmacy Patient Safety Group Janice Perkins

Polypharmacy, when different medications are used by an individual at the same time, is becoming increasingly common because people are living for longer and with multiple different illnesses. One study, published in 2018 by the Oxford University Press, found that over half (54%) of those aged 65 years and above who took part in the study had two or more long-term conditions, for which they could have been taking a range of medicines.

Polypharmacy can help many people manage their different conditions. This can improve their quality of life and extends their life expectancy, allowing them to get on with the things that really matter.

However, polypharmacy can also cause a range of problems. Not only can complex medicine regimes impair medication adherence as patients suffer from ‘pill burden’ – the more drugs a patient takes, the higher their risk of serious adverse drug reactions. People taking several medicines concurrently are some of those most at risk of experiencing an adverse drug reaction. Such reactions can have serious consequences.

Reporting reactions

Adverse drug reactions relate to 7% of hospital admissions in adults, a BMJ study published in 2004 suggests. Reducing the harm caused by polypharmacy is everyone’s responsibility. Community pharmacists play a key role in this by speaking to their patients about the side effects of their medicines and, crucially, reporting side effects via the yellow card scheme.

The yellow card scheme, which is run by the Medicines and Healthcare products Regulatory Agency (MHRA), collects information submitted by patients, carers and healthcare professionals. It can make a big difference to patient care.

Around 88% of community pharmacists are aware of the yellow card scheme as the place to report a suspected adverse drug reaction, according to 2019 MHRA data. Our challenge is to get this figure to 100% so all pharmacists’ valuable information can be captured and shared.

We know that community pharmacists and their teams are doing a great job in reassuring and advising patients on drug reactions. However, some of this data isn’t being captured due to under-reporting. Worryingly, between 2017 and 2018, reporting to the yellow card scheme by community pharmacists decreased by 14%, according to the MHRA.

Community pharmacists should report serious or harmful side effects as well as side effects associated with new drugs and vaccines (which display the black triangle ▼ symbol). Clearly, we’ve got some work to do. Medication safety week is a great opportunity for us all to focus on this.

There are actions we can take to support and encourage reporting:

  1. Spread awareness among colleagues by supporting this year’s medication safety week. More details are available at Gov.UK and through the MHRA’s social media channels.
  2. Make use of the new medicine service, which is a great way to review any new medicine.
  3. The MHRA’s drug safety update is a fantastic way to stay in the loop on medicine safety matters, including any insights the MHRA has gathered through yellow card report. Sign up here so you’re always up to date.

Janice Perkins is chair of the cross-sector Community Pharmacy Safety Group, which includes representatives of all of the larger pharmacy chains


Ronald Trump, Pharmaceutical Adviser

If you're a pharmacist and you've not heard of the yellow card scheme then you should immediately go to a quiet corner of the pharmacy and gently slap yourself in the forehead. I would hypothesize that under-reporting is due to lack of time to fit it in to the working day, as dispensing Mr Blogg's prescription in under 10 minutes is more of a priority for stakeholders. Maybe the government should incentivize yellow card reporting- but then id expect Well and the other multiples would only set targets that pharmacists feel pressurised to hit, then we would end up doubting the validity and quality of the reports. 

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