Find Logo And Give MEdication advice (FLAG-Me): Improving medication safety for people with sight impairment in community pharmacy

Context: Around 3.2 million people in the UK currently have a sight impairment, and this is set to rise to 3.8 million by 2032. 80% of people are aged 65 years or older, creating an issue for older people with multiple medications. Around 1,708 deaths occur each year from avoidable medication errors costing the NHS £98 million. People with sight loss are at increased risk of these errors and we set out to understand why. The Challenge: Our co-design workshops brought together people with sight impairments and community pharmacists. We learnt i) the major issues people struggled with were telling medications apart, and accessing medication labels and product information (safety) leaflets. It meant medication may be taken incorrectly, putting them at increased risk of errors, we then brainstormed ii) potential solutions that ranged from 1:1 consultations with community pharmacists, creating of an in my shoes video and additional training for community pharmacists. In trying to map 1:1 consultations we realised community pharmacy had no failsafe way to identify people with sight impairments since not everyone has a guide dog or uses a long cane (white stick). Our solution: FLAG-Me Vision software was co-produced to enable community pharmacists to identify people with sight impairments form existing information already coded in the health record. This then alerts the pharmacy staff, allowing them to offer additional assistance in the form of a 1:1 consultation around medication safety. This 'safe space' allows pharmacists guided by our website of resources to discuss suitable strategies such as adding tactile markers, providing large font labels or audio version of safety information, which should lead to a reduction in errors in this at risk group. The software has been integrated within open source software. We are currently funded by a Confidence for Translation award (MRC IAA until May 2025) to integrate our software with a leading pharmacy software supplier using one of our four proposed integration models. The search element of the software underwent testing on Greater Manchester Care Record identifying 35,000 cases of sight impairment - within 12-15% of RNIBs predicted prevalence rate. We will then test its’ operability in one real-world community pharmacy setting. Aims & Objectives: This Healthy Ageing Accelerator award would allow us to run a brief 3-month pilot in a further 10 community pharmacies to collect: - user feedback via think aloud interviews (pharmacists) and qualitative interviews (pharmacists and patients) - service use including the % uptake of 1:1 consultations and to document any safety adaptations made to medications - staff grade and time spent delivering the 1:1 to allow costing the potential delivery of this service which could be of interest to local ICBs. Potential applications and benefits: Identification of people with sight impairments would allow a more person-centred tailored approach to medication safety - already highlighted as a global strategy. Our software team have created a similar product FLAG-Me Sound to help identify people with hearing impairments, and we expect to include memory & concentration, and British Sign Language users in later proposals. Although developed for use in community pharmacy, we have interest from hospital pharmacies and clinical pharmacists based in GP practices. Flagging hidden impairments would help redress health inequities more widely in terms of promoting better access to services more widely.