Parvinder K. Dalay is an undergraduate fourth-year pharmacy student at the University of Wolverhampton. Bruce Burnett is a Senior Lecturer in Pharmacy Practice at the University of Wolverhampton. He has a Masters of Medical Sciences degree in Clinical Oncology from the University of Birmingham. His areas of interest include adverse drug reaction reporting, particularly in an oncology setting. He supervised Parvinder in this undergraduate final year project.

In the UK, healthcare professionals, patients and the public can voluntarily report a suspected adverse drug reaction (ADR) to the Yellow Card Scheme operated by the MHRA. It is recognised that pharmacists play a key role in ADR reporting and it remains essential to teach about ADR reporting in pharmacy undergraduate curricula. Furthermore, the aim of the study was to determine undergraduate fourth-year pharmacy students’ awareness and understanding of ADR reporting, as it currently remains unknown. rnrnA cross-sectional survey was distributed to the University of Wolverhampton, University of Central Lancashire, Kingston University, and Liverpool John Moores University.rnrnOf 78 respondents, 50 students were unable to define an ADR. The majority of students’ demonstrated partial understanding of what can be reported and included on a Yellow Card. The majority of students’ understood when to report an ADR and recognised the benefits to reporting. There was an overall awareness of the Yellow Card Scheme, reporting methods, who can report and the available resources for ADR information. The null hypothesis was accepted; the method and timing of teaching did not have an impact on the level of awareness and understanding of ADR reporting among students.rnrnThe study concluded that fourth-year pharmacy students have an overall awareness and partial understanding of ADR reporting. It is recommended to implement a refresher lecture, workshop or tutorial throughout the undergraduate pharmacy course. The aim of this being to maintain undergraduate knowledge about ADR reporting, which may improve their ADR reporting rate and patient safety as practicing pharmacists. rn

Djouhar Belgaid has completed her third year in Medicine at Barts and the London School of Medicine, achieving merits in her studies. She is undertaking an Intercalated Bachelor of Medical Science (BMedSci) Degree in Molecular Therapeutics at the renowned William Harvey Research Institute in the upcoming year to further her interest and experience in research.

Atrial fibrillation (AF) is the most common type of arrhythmia affecting 800,000 people in the UK. One of the most serious complications of AF is that it results in a fivefold increase in the risk of stroke. 90% of the cases of stroke secondary to AF was a result of a clot forming in the left atrial appendage which then embolisms and forms a clot in the blood vessels supplying the brain. This then blocks off the blood supply to the brain leading to a stroke.\r\nAnticoagulants such as warfarin is currently being used to minimise the risk of stroke in patients with AF. However, there are several side effects that are a result of its long term use. This includes internal bleeding, patients\' compliance, drug-drug interactions and the need to constantly monitor levels in blood. This has resulted in compliance issues resulting in only 50% of eligible patients actually taking warfarin in an attempt to prevent the risk of stroke. In order to avoid these side effects and since the most common site of blood clots resulting in stroke is the left atrial appendage, blocking it is a valid alternative. \r\nA similar trial (Protect Trial) has been carried out previously. Results of that trial showed that at the 45 months follow up, the device was superior to warfarin due to its long term side effects. This highlighted the fact that unwanted side effects could be avoided with mechanical intervention, but more data is required. There was also early safety risk issues in the previous trial, such as procedural stroke related air embolism, so extra safety measures were taken in this trial. \r\nThe patients selected for the Prevail trial were at a higher risk of stroke, compared to previous trials. More patients in this trial were over the age of 75 and had diabetes mellitus or a previous incidence of stroke. This trial used similar guidelines to the previous Protect trial in terms of assessing the risk of developing stroke after undergoing either of these interventions. \r\nIt was important that this trial was carried out in order to improve the results previously obtained comparing warfarin therapy to LAA occlusion. In addition, the trial design had to be modified to ensure the safety of the participants, therefore the endpoints were redefined. \r\n