Fewer than one in ten patients carry anticoagulation safety card

The findings of the latest community pharmacy oral anticoagulant safety audit have prompted NHS England to propose the creation of a digital version of the yellow cards for smartphones.
Pack of warfarin tablets

An audit has revealed that just 8% of patients prescribed an anticoagulant were found to be carrying their yellow anticoagulant card when they visited their community pharmacy.

The finding emerged as part of the latest community pharmacy oral anticoagulant safety audit, which took place as part of the 2021/2022 pharmacy quality scheme between September 2021 and March 2022, with data from 131,526 patients attending 9,303 pharmacies.

The anticoagulant card, which includes details about the patient and their anticoagulant treatment, should be carried by patients at all times. Although the audit found that 65% of patients reported having a yellow card, only 8% of them were carrying them at the time of the audit.

In recommendations published as part of the audit results, NHS England said that community pharmacists should “educate all patients regarding the importance of carrying yellow anticoagulant cards and offer all patients a card at the point of dispensing”.

It also recommended that the NHS consider developing a digital yellow anticoagulant card and booklet that patients can keep on their smartphone.

Under the audit, 97% of patients who reported not owning a yellow anticoagulant card were offered one by a pharmacy team member.

The audit also revealed that 8% of patients using anticoagulants were not aware that they needed to speak to a doctor or pharmacist before taking over-the-counter (OTC) medicines; 5% could not describe the symptoms of over-anticoagulation and 4% were not even aware they had been prescribed an anticoagulant.

Reporting the findings, NHS England said: “There has been no improvement in patient knowledge since the audit completed by pharmacy teams in 2017/2018, when 15% of patients were unaware of the potential interactions with OTC medicines.

“Fewer patients were also found to be carrying their yellow anticoagulant cards.

“Pharmacy teams can play a key role in this via information provision and effective counselling at the point of dispensing; however, there is a wider discussion to be had about the role of the wider multidisciplinary team.

“This is particularly important for patients on direct oral anticoagulants, who may be less familiar with their anticoagulant and receive less contact from healthcare professionals due to fewer monitoring requirements.”

Last updated
The Pharmaceutical Journal, PJ, April 2023, Vol 310, No 7972;310(7972)::DOI:10.1211/PJ.2023.1.180442

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