Spontaneous reporting of adverse drug reactions (ADRs) is an important method of monitoring the safety of medicines throughout their marketed life. In the United Kingdom this is achieved via the Yellow Card Scheme. This previously restricted reporting to doctors, dentists and coroners. However, in recent years the scheme has been expanded to include hospital pharmacists, community pharmacists and nurses. Reporting from community pharmacists was considered particularly important because of the expanding range of over-the-counter drugs, including herbal products and other complimentary medicines. However, since the launch of community pharmacist reporting in 1999 [1], the numbers of reports received have been few, amounting to 3% of the total in the fiscal year 2002–3 [2]. The reasons for this have not been established.

To establish the views and experiences of community pharmacists about adverse reactions and the yellow card scheme, a questionnaire was sent to a random selection of community pharmacies in the North East of England.

A total of 770 forms were sent and 217 were returned (28%). Of all respondents, 82% had been qualified at least 5 years, 48% worked in large multiple pharmacies and 73% sold herbal or complimentary medicines. Of all respondents, 212 (98%) were aware that community pharmacists were able to submit yellow card reports and 49 (23%) had previously submitted a report. Seventy-nine (36%) had encountered at least one adverse drug reaction in the previous year, 41 (19%) had observed at least 4 and 31 (14%) did not respond to the question. For herbal or complimentary treatments, equivalent figures were 28 (13%), 4 (1.8%) and 32 (15%). Fifty-three (24%) respondents had observed at least one serious suspected ADR in the previous year. On a scale of 0–4, the most important reasons for not reporting suspected ADRs were that the reaction was already recognized (mean score 3.29), lack of access to the patients records (2.73), uncertainty about causation (2.39), lack of confidence about reporting (1.82) and lack of time (1.59). Non-availability of yellow cards (mean score 0.78) was the least important of the listed potential barriers to reporting. Further training and availability of a telephone advice service were considered potentially useful by 76% and 77% of respondents respectively.

Although conclusions from these data must be limited by the low response rate, community pharmacists encounter reportable adverse reactions and have an important role in supporting the yellow card scheme. The numbers of appropriate reports received from this source may be enhanced by better training aimed at improving reporter confidence and concentrating in particular on the types of reaction that are appropriate for reporting.

1. Anon. Pharmacol J 1999; 263 : 776.
2. Medicines Control Agency. Annual Report and Accounts 2002/3. HMSO, London, 2003.