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Digital apps have the potential to be great tools for boosting connections between pharmacies and patients, as well as promoting self-care

The NHS Long Term Plan, published in 2019, anticipated that by 2029, people would be “helped to stay well, to recognise important symptoms early, and to manage their own health, guided by digital tools”. But already, health apps and digital technology are playing a significant role within healthcare.

How does this impact community pharmacy and its customers? According to research carried out by the Organisation for the Review of Care and Health Apps (ORCHA), pharmacy staff have a great deal of influence when it comes to their customers’ use of health apps. It suggests that “people are 70 per cent more likely to use an app when a healthcare professional has recommended it, and so many health tracking apps could be used with the direct support of a healthcare professional such as the community pharmacy team”.

A 2023 self-care audit carried out by PAGB revealed shifts in the public’s use of apps and other digital interventions to help manage their health. Michelle Riddalls, PAGB chief executive, believes that digital apps and interventions are vital in helping to empower the public to learn more about and manage self-treatable conditions at home. She says: “Every year, at least 25 million GP appointments and five million A&E appointments are used for self-treatable conditions; this unnecessary use of NHS resources is avoidable through better use of self-care.”

PAGB research also revealed that people often feel overwhelmed by the amount of digital content available and don’t always know which sources are trustworthy. “We need to see the Government empower self-care through harnessing digital tools to provide easily accessible information on the importance and methods of accessing trusted self-care advice,” continues Riddalls.

“There is an appetite from the public for the NHS and healthcare professionals to recommend health apps, and working with organisations such as ORCHA, that are leading the way in digital health interventions, is a great first step in realising the potential of apps and online self-care resources.

“Our 2023 digital audit recommendations call for the development of a self-care hub, accessible via the NHS app and website, which includes a library of accredited and trusted health apps, alongside information on self-care and accessing appropriate over-the-counter medicines, so people can be reassured that they are accessing reliable, accurate and useful information.”

Riddalls points out that many manufacturers of OTC products also support people with self-care by providing trusted advice and information directly to consumers via their own digital tools. This includes websites that are accessible by phone, tablet and computer, and branded apps developed to be used in conjunction with products themselves.

In the March budget, the Government announced an additional £3.4 billion earmarked for the NHS to invest in new tech and digital transformation, with Health and Social Care Secretary Victoria Atkins saying that she wanted to see access to NHS services made faster, simpler and fairer. She said the Government planned to transform access to services across the NHS, “including by investing in the latest technology and embracing the benefits of AI”. Customers seem to love an app. Even older demographics are turned on – as demonstrated by the success of the NHS prescription app.

ORCHA’s research suggests that almost six million GP attendances and 600,000 A&E admissions a year could be prevented with support for digital tools and home-based healthcare management. But how can you make sure your customers are downloading good quality, safe apps that will help and not hinder their health?

ORCHA warns that high download numbers and reviews on app stores aren’t always a reliable indicator. One currently available diabetes app with over 500K downloads includes a bolus calculator for calculating insulin dosage, but according to the Evidence Standards Framework, there has been no randomised clinical trials or observational trials on the app, leading ORCHA to score it just 36 per cent for professional assurance (65 per cent is the pass rate). 

When customers ask for advice on choosing safe and effective apps, you can recommend ORCHA’s ‘SAFE’ guidance: 

-     Security: Ensure the app has robust security measures to protect personal data and privacy. Look for apps with encryption and secure login features 

-     Accreditation: Check if the app has been accredited or certified by reputable organisations (like ORCHA) or regulatory bodies. This ensures it meets certain standards of safety and effectiveness

-     Functionality: Evaluate the app’s functionality and user interface to ensure it meets your needs and is easy to use. Look for apps with clear instructions and intuitive design

-     Evidence-based: Look for apps that are evidence-based, meaning they are backed by scientific research or endorsed by healthcare professionals. This increases the likelihood of the app being safe and effective.  

“By following these guidelines, customers can make informed decisions and choose apps that prioritise their safety and well-being,” suggests Liz Ashall-Payne, founding chief executive of ORCHA.

She emphasises the importance of pharmacy teams staying up to date with the latest health tracking apps, advising: “Engage with digital health specialists and experts (like ORCHA) in the field of digital health and technology. These specialists can provide insights into the latest trends, developments and best practices related to health tracking apps, helping you make informed recommendations to patients.”

It’s important to understand patient needs and take time to understand the specific health needs and goals of customers, with Ashall-Payne commenting: “This will help you recommend appropriate health tracking apps tailored to their individual requirements. Incorporate discussions about health tracking apps into patient consultations. Ask patients about their use of technology and interest in health tracking and provide recommendations accordingly.”

November 2023 saw iPLATO launch its PillTime app, designed to encourage people with multiple prescriptions to get proactive with medication adherence by offering reminders, alerts and more. It is estimated that between 30 and 50 per cent of medicines prescribed for long‑term conditions are not taken as they should be, resulting in negative health outcomes. The app allows people to order medication for home delivery in pouches, labelled with correct doses, dates and times.

iPLATO and Healthera have also been working in partnership and are planning to release an online booking option for common condition consultations and services. Patients using the Healthera app can complete a digital questionnaire or set up a video call via the app, which refers them to any of the 1,600 signed up partner pharmacies. The pre-consultation questionnaires include all the necessary questions to decide whether a patient meets the criteria for Pharmacy First conditions.

The Versus Arthitis Arthritis Tracker app was co-created by young people with juvenile idiopathic arthritis, but it has grown into an empowering tool for people of all ages and with any form of arthritis. Using short daily rating scales and an interactive body map, people with arthritis can visualise their pain, flare-ups and the impact their condition has on their lives. Additionally, they can access Versus Arthritis’s health information, support and services through the app.

Zoë Chivers, director of services and influencing at Versus Arthritis, says: “The Arthritis Tracker – which provides 24/7 access to our trusted information and advice for people with arthritis – helps them to rate and record their arthritis symptoms in seconds and track their pain, medication side effects, fatigue, physical activity, sleep and emotional wellbeing. We wanted people with arthritis’s voices front and centre throughout this project and their contribution has been essential: from idea, to prototype to the app we have today.”

Pharmacy staff can make a real difference simply by asking people how their arthritis affects them, and whether there’s anything they might need help with. “People really appreciate being asked, and you may uncover other ways to offer help,” says Chivers. “A good pharmacy might work with local GP practices to have a list of resources to share with people.”

Embracing the NHS app

The NHS has embraced apps, with more than 2.7 million people already using the new prescription feature in the NHS app since its launch in January. The function allows patients to see when their prescriptions have been issued in addition to being able to check prescribed medication. Medication details are shared with their chosen pharmacy electronically. The number of repeat prescriptions ordered on the app is increasing – rising 44 per cent between 2022 to 2023.

Pensioners are the most active users of the NHS app, with almost two-thirds (62 per cent) of registered users aged over 66 having accessed the app within the past three months. This includes more than 250,000 users in their 80s and over 17,000 who are aged 90 or over. “Feedback on the app for ease of use is around 3.8 out of 5,” says Karen Faughey from NHS England.