An overview of Yellow Card reporting by NIMH practitioners

ContextThe NIMH Yellow Card Scheme was initiated in 1994 as a means for reporting adverse events directly relating to herbal medicines individually prescribed by herbal practitioners in the clinical setting. Current research in herbal medicine relies mostly on studies investigating the efficacy and adverse effects of over the counter manufactured products or isolated constituents. It does not take in to account the complex intervention of clinical herbal practice.ObjectivesTo provide an overview of adverse reactions as reported by qualified herbalists by the NIMH Yellow Card Scheme to inform clinical practice and disseminate information to the wider healthcare community.SettingClinical experience as reported by NIMH professional herbal practitioners.ResultsNo serious adverse events have been reported by the NIMH Yellow Card system meaning there have been no fatalities or lasting serious harmful effects of herbal medicines prescribed by herbal practitioners. The outcomes in all 60 reports are reported as a full recovery. Symptoms usually resolve within hours to a few days after stopping the medicine. Common reactions reported include headache; gastric disturbance; skin irritation; sleep disturbance; agitation; hypersensitivity or allergic reaction. In the event of an adverse reaction it is difficult to identify one herb involved as it is common to herbal practice to prescribe medicines on an individual basis in combination and other factors such as individual sensitivities, diet and lifestyle changes are often involved.ConclusionsThe reports provide an important information source of clinical experience and relevance to practitioners and safety issue concerns. Clinical data combined with traditional empirical documentation enhances knowledge of evidence based practice.