Wednesday, 13 January 2010

The Yellow card scheme and the new “Yellow card” scheme.



In a recent surgery one of us here at ND Central saw a patient who had had a severe allergic reaction to the swine flu immunization.

For those who are not familiar with the Yellow Card scheme, this is a voluntary scheme whereby doctors, and now patients, can report suspected adverse reactions to drugs via a Yellow Card in order to identify any problems with drugs.

Most drugs, before they go into practice, undergo years of trials but it is only when drugs are released into the general population that the real “clinical” trial begins. The Yellow Card scheme allows information to be collected about drugs when real doctors start prescribing drugs outside of the relatively controlled drug trial environment.

Since medical school we have had the Yellow card scheme instilled into us as a good way of identifying problems with drugs once they hit the market. An example we recall is that one of us saw a few days after the release of the non steroidal anti inflammatory drug (NSAID) Meloxicam a patient who we admitted with a gastrointestinal bleed.

At the time Meloxicam was being marketed as safer from the gastrointestinal bleed point of view than older NSAIDs but after a year, and we suspect other such Yellow card reports, the prescribing advice changed.

The Yellow card scheme has been around for a while and we thought let us print off a form and send our suspected reaction to the swine flu immunization in. So we Googled Yellow card scheme and got the following site.

Note that the opening sentence: “This site can be used to report suspected side effects to medication.”

Then look at the box below. Are the drugs listed in fact not “medications” or is something else going on with the swine flu immunizations and anti swine flu drugs? Click the link.

This got us wondering as to why the distinction between anti swine flu medication and other drugs. Perhaps we should be sending in Yellow cards for those people who have had antivirals prescribed by the National Swine Flu Pandemic flu hot line who did not have swine flu as examples of erroneous prescribing?

Some how we doubt the Party will be engaging in any objective assessment of their policies particularly in the run up to an election but then could this distinction regarding Yellow Cards for these drugs be part of this run up?

As the Witch Doctor, a medical blogger with a distinctive slant on the human medical world, would say perhaps this is an intertwinglement?

Praise be to the Party for are all drugs’ side effects equal or, are some now more equal than others? Perhaps our Chief Medical Officer could explain the distinction to us simple grunts on the ground?

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