Aims To investigate the attitudes of UK hospital pharmacists towards, and their understanding, of adverse drug reaction (ADR) reporting. Methods A postal questionnaire survey of 600 randomly selected hospital pharmacists was conducted. Results The response rate was 53.7% (n=322). A total of 217 Yellow Cards had been submitted to the CSM/MCA by 78 (25.6%) of those responding. Half of those responding felt that ADR reporting should be compulsory and over threequarters felt it was a professional obligation. However, almost half were unclear as to what should be reported, while the time available in clinical practice and time taken to complete forms were deemed to be major deterrents to reporting. Pharmacists were not dissuaded from reporting by the need to consult a medical colleague or by the absence of a fee. Education and training had a signi®cant in¯uence on pharmacists' participation in the Yellow Card Scheme. Conclusions Pharmacists have a reasonable knowledge and are supportive of the Yellow Card spontaneous ADR reporting scheme. However, education and training will be important in maintaining and increasing ADR reports from pharmacists.

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WHAT IS ALREADY KNOWN ABOUT THIS SUBJECTADRs in hospital patients are a significant burden, though how often ADRs cause re-admission to hospital has not been well documented in the literature. WHAT THIS STUDY ADDS• One fifth of patients re-admitted to hospital within 1 year of discharge from their index admission were re-admitted due to an adverse drug reaction. • Admission to a medical ward, elderly age and prescription of anti-platelet agents or diuretics were identified as risk factors for re-admission due to ADRs.• Since up to 50% of these reactions were possibly avoidable, better methods of medication review in both hospital and primary care, in conjunction with a clinical review, are needed to enable improved prescribing practices that will be essential for improving the benefit-harm balance of medicines. AIMThe proportion of re-admissions to hospital caused by ADRs is poorly documented in the UK. The aim of this study was to evaluate the impact of ADRs on re-admission to hospital after a period as an inpatient. METHODSOne thousand patients consecutively admitted to 12 wards were included. All subsequent admissions for this cohort within 1 year of discharge from the index admission were retrospectively reviewed. RESULTSOf the 1000 patients included, 403 (40.3%, 95% CI 39.1, 45.4%) were re-admitted within 1 year. Complete data were available for 290 (70.2%) re-admitted patients, with an ADR contributing to admission in 60 (20.8%, 95% CI 16.4, 25.6%) patients. Presence of an ADR in the index admission did not predict for an ADR-related re-admission (10.5% vs. 7.2%, P = 0.25), or re-admission overall (47.2% vs. 41.2%, P = 0.15). The implicated drug was commenced in the index admission in 33/148 (22.3%) instances, with 37/148 (25%) commenced elsewhere since the index admission. Increasing age and an index admission in a medical ward were associated with a higher incidence of re-admission ADR. The most frequent causative drugs were anti-platelets and loop diuretics, with bleeding and renal impairment the most frequent ADRs. Over half (52/91, 57.1%) of the ADRs were judged to be definitely or possibly avoidable. CONCLUSIONSOne fifth of patients re-admitted to hospital within 1 year of discharge from their index admission are re-admitted due to an ADR. Our data highlight drug and patient groups where interventions are needed to reduce the incidence of ADRs leading to re-admission.

The national movement towards progress files, incorporating personal development planning and reflective learning, is supported by lecturers providing effective feedback to their students. Recent technological advances mean that higher education tutors are no longer obliged to return comments in the 'traditional' manner, by annotating students' work with red pen. This paper considers some of the options currently available for returning computer-assisted feedback, including the Electronic Feedback freeware. This MS Office application enables tutors to readily synthesise and email feedback reports to students. To further ascertain the value of this software, 169 1st-year Pharmaceutical Science and Pharmacy students completed a questionnaire to gauge their reaction to formative feedback on an extended laboratory report. This included 110 responses from students graded by three tutors who marked work using either handwritten annotations or the Electronic Feedback program. Principle component analysis (PCA) of the Likert scale responses indicates that the identity of the marker did not significantly affect the response of students. However, the type of feedback was a factor that influenced the students' responses, with electronic feedback being rated superior. A Mann-Whitney analysis of the satisfaction ratings (generated by PCA) indicates that four features of the assignment and feedback were considered significantly improved when the software was used to create feedback, namely; markscheme clarity, feedback legibility, information on deficient aspects, and identification of those parts of the work where the student did well. Modern academics face a number of challenges if they wish to return meaningful and timely feedback to students, among them large class sizes and infrequent face-to-face contact. It is pleasing to note, therefore, that assessors reported taking less time to mark when using the software. It is concluded that electronic formative feedback can be returned more quickly and may be used to synthesise relevant feedback that is both fair and balanced.

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