GPs are urged to report adverse drug reactions after a 37% slump over nine years

BMJ 2013; 346 doi: (Published 01 February 2013) Cite this as: BMJ 2013;346:f690
  1. Jacqui Wise
  1. 1London

GPs and the UK public are being urged to increase their reporting of suspected side effects of drugs through the “yellow card” scheme after the latest figures showed that reporting was down among these groups.

The Medicines and Healthcare Products Regulatory Agency (MHRA) collects around 25 000 reports each year under the scheme, which was set up in the 1960s after the thalidomide scandal. But reports from GPs fell from 5578 in 2003 to 3511 in 2012. Reports from members of the public fell from a high of 3584 in 2006 to 1789 in 2012.

Mick Foy, group manager of vigilance, intelligence, and research at the MHRA, told the BMJ: “Ten years ago GPs were the bedrock of yellow card reporting. Since then we have introduced reporting to nurses and patients, so maybe GPs feel they don’t need to report so much. But it is vitally important that they continue to report adverse reactions, and they should not worry about duplicating reports.”

He added: “We know GPs are incredibly busy, so we are working on making reporting easier through electronic yellow cards.”

An initiative to embed yellow card reporting in SystemOne software, which has around 20% of the market share of GPs’ computer systems, has started to reverse the decline in reporting among GPs. The agency is now working with Connecting for Health, the NHS’s IT infrastructure division, to incorporate electronic yellow card reporting into all GP computer systems.

The MHRA is also launching a new awareness strategy. This includes a series of videos that will be shown in pharmacies and made available through YouTube, Facebook, and Twitter. The agency is also working in partnership with professional bodies such as the Royal College of General Practitioners to embed pharmacovigilance in continuing professional development schemes such as BMJ Learning.

Foy said that the agency also hoped to develop yellow card reporting apps for tablet computers and smartphones, as doctors in secondary care have said that these would be useful.

Adverse drug reactions are a major burden on the NHS. A 2004 study in the BMJ showed that adverse drug reactions accounted for one in 16 hospital admissions and for 4% of hospital bed capacity and estimated the cost to the NHS in admissions as £466m (€540m; $740m) each year.1

The MHRA said that the yellow card scheme had helped to identify a number of safety concerns over the years, including serious haemorrhages associated with the blood thinning drug dabigatran and the need to closely monitor kidney function in patients taking the drug. The scheme also helped to spot the risk of seizures with the smoking cessation drug bupropion when taken with other drugs such as antipsychotics and antidepressants.

GPs and patients can submit yellow card reports at


Cite this as: BMJ 2013;346:f690