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Jasdeep Singh
(Pharmacology)
Spontaneous
Reporting
System
THE SPONTANEOUS REPORTING
SYSTEM
 Passive surveillance system:
Health professionals are encouraged to
report adverse reactions which they believe
to be drug-related directly to
 the regulatory authority or
 the company marketing the suspected
product on a voluntary basis
The spontaneous
reporting system
process
1. Data acquisition
which depends largely on the input
of information derived from reports
submitted by the health professionals
who have encountered what they
suspect is an ADR
The spontaneous reporting
system
1.data acquisition
2.data assessment
3.data interpretation
The spontaneous
reporting system
processes:-
2. data assessment
which involves assessment of
the individual case reports and
assessment of pooled data
obtained from various sources
such as the international database
of the WHO
The spontaneous reporting
system
1.data acquisition
2.data assessment
3.data interpretation
The spontaneous
reporting system
processes:-
3. data interpretation
based on the available data and
the assessments made, a signal
related to the adverse reaction
may be generated
The spontaneous
reporting system
1.data acquisition
2.data assessment
3.data interpretation
 India – ‘Suspected Adverse Drug
Reaction Reporting Form’
 UK – ‘Yellow Card’, since 1964
 Australia – ‘Blue Card’ , since 1964
 US – ‘Med Watch’
Spontaneous reporting - UK
Lincencing authority: Ministers, including Sect., of state for
health .
 Authority’s key function: control of medicines by
the UK Medicines and Healthcare Products
Regulatory Agency (MHRA) formed on 1st April
2003 from merger of Medicines Control Agency
(MCA) and Medical Devices Agency (MDA).
 Key functions: safety, quality and efficacy of
medicines and safeguard public health.
Introduction of yellow card scheme
• Introduced in 1964 (Sir Derrick Dunlop) after
thalidomide tragedy
• Over 600,000 confidential reports have been
received in UK
• Doctors, dentists, pharmacists, coroners, nurses,
midwifes, health visitors
• Non medical prescribers and
now patients
• MHRA can detect duplicate reports
• Survey in 1984: Only 16% of doctors who were
eligible to report suspected ADRs to the Scheme
had actually submitted a Yellow Card between
1972 and 1980.
• Analysis of Yellow Card reports submitted
between 1992 and 1995 showed that around one-
third of practising doctors submitted report.
a.Introduction of the CSM(committee on safety of
medicines) drug safety bulletin Current
Problems in Pharmacovigilance
b.The inclusion of a yellow page in
prescription pads used by GPs
Reasons
Information to include on a
Yellow Card
 4 critical pieces of information that must be
included on the report :-




Suspected drug(s)
Suspect reaction(s)
Patient details
Reporter details
Suspected Drug(s)
• Name of medicine
• including brand and batch number if known
Route of administration
• Daily dose
• Date medicine started
and stopped if applicable
• Reason why the medication was given
• Multiple drugs can be listed if more than one
drug is suspected of causing the reaction
Suspect reaction(s)






Describe the reaction
Include a diagnosis if relevant
Include when the reaction occurred
whether the reaction was considered to be serious
and complete tick box for reasons why
Document if any treatment was given for the
reaction
Eventual outcome tick relevant box
Patient Details





Sex of the patient
Age at time of reaction
Weight if known
Do not need to know name or DOB as this could
identify patient and break patient confidentiality
Patients initials and local identification number
(hospital or practice number) which will identify
patient to you in the event of future
correspondence
Reporter details
 Must be completed in all cases
 Name and full address
Need to acknowledge receipt of report
and follow up further information if
necessary.
 Profession
Drug Safety Update
–Published monthly
Registerfor alerts
http://www.mhra.gov.uk/Publication
Drug Analysis Prints (DAPs)



Complete list of all suspected ADRs reported via
yellow card scheme for named suspect drug
Inclusion of a particular reaction does not
necessarily mean it has been caused by the drug
Certain reported reactions are conditions which
occur spontaneously
Reporting rates are influenced by seriousness of
ADR, ease of recognition, extent of use
www.mhra.gov.uk/daps

Where to find ADR information


Reference texts
British National Formulary (BNF)
Summary of Product Characteristics (SPC)
Martindale
AHFS Drug information
Meyler’s 'The Side effects of drugs
Davies’ textbook Adverse Drug Reactions
Lee’s textbook Adverse Drug Reactions
Journals
Adverse Drug Reaction Bulletin
Drug Safety Update
Medline/Embase/Pharmline search
Electronic sources
Micromedex
www.mhra.gov.uk
INDIA
• Indian Pharmacopoeia Commission (IPC), Ghaziabad is
functioning as a National Coordination Centre (NCC)
for Pharmacovigilance Programme of India (PvPI).
• 150 ADR monitoring centres (AMCs) were established
in various medical institutions/hospitals across India to
monitor and collect ADR reports under NCC-PvPI
What to Report
• PvPI encourages all types of suspected ADRs
reporting whether they are known, unknown,
serious, or nonserious, frequent.
• ADRs related with the use of allopathic
medicines, vaccines, traditional medicines, medical
devices, contrast media, etc., can be reported.
Where to Report
• All healthcare professionals (clinicians, dentists,
pharmacists, nurses) and patient/consumers can report
ADRs to NCC or AMCs.
• The pharmaceutical companies can also send
individual case safety reports for their product to NCC.
How to Report
• Suspected ADR reporting forms for healthcare
professionals and consumers are available on the
website of IPC to report ADR.
• To remove language barrier in ADR reporting, the
consumer reporting form are made available in 10
vernacular languages (Hindi, Tamil, Telugu, Kannada,
Bengali, Gujarati, Assamese, Marathi, Oriya, and
Malayalam)
References
1.Kalaiselvan V, Mishra P, Singh GN. Helpline facility to assist reporting
of adverse drug reactions in India. WHO South East Asia J Public
Health. 2014;3:194.
2.Kalaiselvan V, Prasad T, Bisht A, Singh S, Singh GN. Adverse drug
reactions reporting culture in pharmacovigilance programme of
India. Indian J Med Res. 2014;140:563–4. [PMC free article] [PubMed]
3.Vivekanandan K, Rishi K, Prasad T, Arunabh T, Singh GN. Status of
documentation grading and completeness score for Indian individual
case safety reports. Indian J Pharmacol. 2015;47:325–7.[PMC free
article] [PubMed]
Thank You.
ਧੰ ਨਵਾਦ।

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Spontaneous Reporting System

  • 2. THE SPONTANEOUS REPORTING SYSTEM  Passive surveillance system: Health professionals are encouraged to report adverse reactions which they believe to be drug-related directly to  the regulatory authority or  the company marketing the suspected product on a voluntary basis
  • 3. The spontaneous reporting system process 1. Data acquisition which depends largely on the input of information derived from reports submitted by the health professionals who have encountered what they suspect is an ADR The spontaneous reporting system 1.data acquisition 2.data assessment 3.data interpretation
  • 4. The spontaneous reporting system processes:- 2. data assessment which involves assessment of the individual case reports and assessment of pooled data obtained from various sources such as the international database of the WHO The spontaneous reporting system 1.data acquisition 2.data assessment 3.data interpretation
  • 5. The spontaneous reporting system processes:- 3. data interpretation based on the available data and the assessments made, a signal related to the adverse reaction may be generated The spontaneous reporting system 1.data acquisition 2.data assessment 3.data interpretation
  • 6.  India – ‘Suspected Adverse Drug Reaction Reporting Form’  UK – ‘Yellow Card’, since 1964  Australia – ‘Blue Card’ , since 1964  US – ‘Med Watch’
  • 7. Spontaneous reporting - UK Lincencing authority: Ministers, including Sect., of state for health .  Authority’s key function: control of medicines by the UK Medicines and Healthcare Products Regulatory Agency (MHRA) formed on 1st April 2003 from merger of Medicines Control Agency (MCA) and Medical Devices Agency (MDA).  Key functions: safety, quality and efficacy of medicines and safeguard public health.
  • 8. Introduction of yellow card scheme • Introduced in 1964 (Sir Derrick Dunlop) after thalidomide tragedy • Over 600,000 confidential reports have been received in UK • Doctors, dentists, pharmacists, coroners, nurses, midwifes, health visitors • Non medical prescribers and now patients • MHRA can detect duplicate reports
  • 9. • Survey in 1984: Only 16% of doctors who were eligible to report suspected ADRs to the Scheme had actually submitted a Yellow Card between 1972 and 1980. • Analysis of Yellow Card reports submitted between 1992 and 1995 showed that around one- third of practising doctors submitted report.
  • 10.
  • 11. a.Introduction of the CSM(committee on safety of medicines) drug safety bulletin Current Problems in Pharmacovigilance b.The inclusion of a yellow page in prescription pads used by GPs Reasons
  • 12.
  • 13. Information to include on a Yellow Card  4 critical pieces of information that must be included on the report :-     Suspected drug(s) Suspect reaction(s) Patient details Reporter details
  • 14. Suspected Drug(s) • Name of medicine • including brand and batch number if known Route of administration • Daily dose • Date medicine started and stopped if applicable • Reason why the medication was given • Multiple drugs can be listed if more than one drug is suspected of causing the reaction
  • 15. Suspect reaction(s)       Describe the reaction Include a diagnosis if relevant Include when the reaction occurred whether the reaction was considered to be serious and complete tick box for reasons why Document if any treatment was given for the reaction Eventual outcome tick relevant box
  • 16. Patient Details      Sex of the patient Age at time of reaction Weight if known Do not need to know name or DOB as this could identify patient and break patient confidentiality Patients initials and local identification number (hospital or practice number) which will identify patient to you in the event of future correspondence
  • 17. Reporter details  Must be completed in all cases  Name and full address Need to acknowledge receipt of report and follow up further information if necessary.  Profession
  • 18. Drug Safety Update –Published monthly Registerfor alerts http://www.mhra.gov.uk/Publication
  • 19. Drug Analysis Prints (DAPs)    Complete list of all suspected ADRs reported via yellow card scheme for named suspect drug Inclusion of a particular reaction does not necessarily mean it has been caused by the drug Certain reported reactions are conditions which occur spontaneously Reporting rates are influenced by seriousness of ADR, ease of recognition, extent of use www.mhra.gov.uk/daps 
  • 20.
  • 21. Where to find ADR information   Reference texts British National Formulary (BNF) Summary of Product Characteristics (SPC) Martindale AHFS Drug information Meyler’s 'The Side effects of drugs Davies’ textbook Adverse Drug Reactions Lee’s textbook Adverse Drug Reactions Journals Adverse Drug Reaction Bulletin Drug Safety Update Medline/Embase/Pharmline search Electronic sources Micromedex www.mhra.gov.uk
  • 22. INDIA • Indian Pharmacopoeia Commission (IPC), Ghaziabad is functioning as a National Coordination Centre (NCC) for Pharmacovigilance Programme of India (PvPI). • 150 ADR monitoring centres (AMCs) were established in various medical institutions/hospitals across India to monitor and collect ADR reports under NCC-PvPI
  • 23. What to Report • PvPI encourages all types of suspected ADRs reporting whether they are known, unknown, serious, or nonserious, frequent. • ADRs related with the use of allopathic medicines, vaccines, traditional medicines, medical devices, contrast media, etc., can be reported.
  • 24. Where to Report • All healthcare professionals (clinicians, dentists, pharmacists, nurses) and patient/consumers can report ADRs to NCC or AMCs. • The pharmaceutical companies can also send individual case safety reports for their product to NCC.
  • 25. How to Report • Suspected ADR reporting forms for healthcare professionals and consumers are available on the website of IPC to report ADR. • To remove language barrier in ADR reporting, the consumer reporting form are made available in 10 vernacular languages (Hindi, Tamil, Telugu, Kannada, Bengali, Gujarati, Assamese, Marathi, Oriya, and Malayalam)
  • 26.
  • 27. References 1.Kalaiselvan V, Mishra P, Singh GN. Helpline facility to assist reporting of adverse drug reactions in India. WHO South East Asia J Public Health. 2014;3:194. 2.Kalaiselvan V, Prasad T, Bisht A, Singh S, Singh GN. Adverse drug reactions reporting culture in pharmacovigilance programme of India. Indian J Med Res. 2014;140:563–4. [PMC free article] [PubMed] 3.Vivekanandan K, Rishi K, Prasad T, Arunabh T, Singh GN. Status of documentation grading and completeness score for Indian individual case safety reports. Indian J Pharmacol. 2015;47:325–7.[PMC free article] [PubMed]