For many years, pharmacists have been recognised as reporters to national spontaneous reporting schemes in a number of countries (Griffin, 1986), and there is published evidence suggesting a role for both hospital and community pharmacists in the monitoring and reporting of ADRs (e.g. Roberts et al, 1994; Smith et al, 1996).
The CSM's RMCs have played a key role in conducting pilot studies into the potential contribution of hospital and community pharmacists to the Yellow Card Scheme. A pilot scheme for hospital pharmacist reporting, conducted by the Northern RMC, showed that, in comparison with hospital doctors, hospital pharmacists submitted a higher proportion of reports of serious ADRs, and reports from the two groups of reporters were of similar quality. Additionally, a survey of consultants whose patients had been the subject of a pharmacist report during the pilot study showed a high level of support for the continuation of the scheme (Lee et al., 1997). This study led in April 1997 to the extension of the Yellow Card Scheme nation-wide to include reporting by hospital pharmacists (Anon, 1997a). A subsequent evaluation of hospital pharmacist reports made in the first year following this extension generally confirmed the findings of the pilot study, and indicated that reports received from hospital pharmacists were additional to those received from hospital doctors, rather than simply replacing them (Davis et al., 1999). Following the nation-wide extension, by the end of 2001, in excess of 4800 reports had been received directly from hospital pharmacists; in 2001, approximately 6.2% of Yellow Cards were submitted by this group.
A pilot study of community pharmacist reporting was conducted by all four RMCs; an evaluation of reports received during the first 12 months of the pilot showed that community pharmacists submitted reports which were comparable to those received from GPs, with regard to both the quality of the reports and the seriousness of reactions reported. Furthermore, community pharmacists submitted a higher proportion of reports for herbal products compared with GPs (Davis and Coulson, 1999). An attitudinal survey carried out in Wales, one of the areas in which the pilot study was conducted, demonstrated a high degree of support among both GPs and community pharmacists for a role of the latter group in reporting suspected ADRs to the Yellow Card Scheme
(Houghton et al, 1999). In light of these findings, and the assumption that community pharmacists are well placed to inform patients about, and be made aware of, any ADRs experienced in association with "over the counter'' products, nationwide reporting by community pharmacists was introduced in November 1999 (Anon, 1999). Following this extension, by the end of 2001 the MCA had received almost 900 reports directly from community pharmacists; in 2001, around 2% of Yellow Cards were received from this group.
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