AimsThe effect of a distance-learning package linked to educational credits on the rate and quality of spontaneous adverse drug reaction (ADR) repor ting by general practitioners (GPs) and pharmacists in Wales was investigated. MethodsIn April 2000, 477 GPs and 261 pharmacists enrolled in the 12 month programme. ResultsThe number and quality of yellow card reports improved compared with those of a control region in England (Northern Region). ConclusionsWe conclude that an educational initiative in drug safety linked to incentives may be associated with a significant but perhaps short-lived improvement in the rate and quality of ADR reporting.

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We used the HealthWise Wales (HWW) platform to explore public knowledge about the UK Yellow Card scheme (YCS), the spontaneous reporting scheme for suspected adverse drug reactions (ADRs) and whether a short information video could improve awareness. Members of the public in Wales (n = 1606) completed a questionnaire about the YCS, watched the information video and then completed a follow‐up questionnaire. Almost half (46.5%) of respondents said they had previously experienced an ADR (>90% of the ADRs involving prescribed medicines). Before the video, 18% of respondents knew how to report an ADR via the YCS and of these, 34% were from allied‐health professions. Immediately after watching it, 71% participants reported knowing how to report and 82% reported being confident to report. If this awareness were maintained, such an approach could contribute to improved reporting of suspected ADRs by the public.

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There are a limited number of pathological responses to noxious stimuli, including drugs, and drug-induced (iatrogenic) disease may be difficult to distinguish from other causes. We describe the case of a woman who had two different serious reactions in association with two courses of the antibiotic nitrofurantoin given 16 On specific questioning about whether she might be taking any medications, particularly for prevention of cystitis, she recalled that she had been prescribed by her general practitioner a urinary, 'antiseptic' tablet which she had taken at night for more than a year but she had not considered it to be a drug. It was subsequently identified as nitrofurantoin 50 mg. A working diagnosis of nitrofurantoininduced interstitial pulmonary fibrosis was made, the drug was stopped and she improved gradually such that eight weeks later her tCO had risen to 16.93 and her chest X-ray is shown in the figure (B)