How to improve the yellow card system

Yellow cards provide the Committees on Safety of Medicines (CSM) and Dental and Surgical Materials (CDSM) with their major source of information on the occurrence of adverse drug reactions. Of the many forms of post-marketing surveillance now in use, it is the most widely applied and probably the cheapest. Three-quarters of the 23,000 reports received by the Committees in 1978 and 1979 were through the yellow card system. However, probably only 10% of serious adverse reactions are reported to the Committees.1 Why is reporting reactions important, and how can doctors help to make the system work better?

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Yellow card system given the red card?

Reactions Weekly ◽

10.2165/00128415-199203950-00005 ◽

1992 ◽

Vol &NA; (395) ◽

pp. 4

Author(s):

&NA;

Keyword(s):

Yellow Card ◽

Card System

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Inherent Limitations of the Yellow Card System for the Detection of Unsuspected Adverse Drug Reactions

Human Toxicology ◽

10.1177/096032718400300402 ◽

1984 ◽

Vol 3 (4) ◽

pp. 261-269 ◽

Cited By ~ 7

Author(s):

I. Crombie

Keyword(s):

Adverse Reaction ◽

Adverse Drug Reactions ◽

Adverse Reactions ◽

Single Case ◽

Drug Reactions ◽

Yellow Card ◽

Yellow Card Scheme ◽

Card System ◽

Hospital Doctors ◽

Almost All

The number of cases of an adverse reaction which could be seen by individual doctors was investigated taking realistic values for the frequency of drug prescribing and a range of frequencies of adverse drug reactions. The results indicated that, for almost all drugs, general practitioners (GPs) will seldom see other than single cases of an adverse reaction. It is argued that doctors will be unlikely to recognize an adverse reaction from a single case (unless it presented with some striking clinical features) so that potential new adverse reactions will rarely be reported by GPs under the Yellow Card scheme. A similar analysis for hospital doctors indicated that clinicians working in some specialities, may have a greater chance of seeing more than one case of an adverse reaction. A review of the identification of several important adverse reactions revealed that all the reports from British doctors were submitted by clinicians with hospital appointments. This study suggests that the major part of the operation of the Yellow Card system will contribute little to the identification of adverse reactions and that its organization and activities need to be reassessed. A modified system designed to encourage reporting by hospital clinicians could be of greater value.

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