Helping pharmacy staff identify customers with vision impairments to reduce the risk of medication errors

What is FLAG-Me?

FLAG-Me community interest company (CIC) was set up in April 2023 and aims to develop medical technology that helps reduce inequalities in healthcare, especially those caused by hidden impairments.

FLAG-Me CIC is a spin-out from the University of Manchester, with initial entrepreneurial support provided by Masood Enterprise Centre. I was supported by one of the Healthy Ageing Challenge’s Catalyst awards, and I am a co-director along with Ms Kim Jaye, Mr Nishi Gangani?and Dr Leigh Wharton.

What is FLAG-Me Vision?

FLAG-Me Vision is a piece of software created to help pharmacy staff identify people who have sight impairments. This group of people are at increased risk of medication errors.?It works by searching patient electronic health records and displaying a logo on the pharmacy screen when it finds a match relating to a sight impairment. This then enables staff to offer 1:1 consultations, at which the pharmacist and the patient can discuss what additional safety measures could be put in place. Recognising that pharmacists requested additional training around this we collated resources onto our website.

How did it come about?

Our work funded by NIHR Greater Manchester Patient Safety Research Collaboration looked at ways of reducing medication errors. Recognising the importance of public and patient involvement and engagement, we held two co-design workshops which brought together participants with sight impairments and community pharmacists. The first workshop sought to understand peoples' experiences with their medication and what type of things were happening. The second workshop explored potential solutions that participants felt could help overcome these problems.

What will it help people to do?

At present, pharmacy staff can't always recognise who has a sight impairment. Not everyone has a guide dog, uses a long cane (white stick) or wears dark glasses. Our early fieldwork in five pharmacies revealed only half were known to them. When health professionals don't know who might need assistance, they can't offer help. FLAG-Me Vision automatically displays the shaded eye logo (by kind permission of The Partially Sighted Society) so alerts pharmacy staff to this.?

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What do you hope the impact will be?

Testing on Greater Manchester Care Record has shown there are around 35,000 people with sight impairments in Greater Manchester, this represents around 50 per community pharmacy. We hope our next stage integration into community pharmacies will lead to the alert being displayed and pharmacy staff offering patients a 1:1 consultation.

No two patients are alike so what might help one person with a sight impairment, e.g. providing prescription medication labels in large font, might not work for someone with severe sight loss who may need to receive information in audio format.

People with sight impairments often have multiple long-term conditions so might be on multiple medications including different formats (tablets, drops, medicine, injections).

The 1:1 consultation allows the pharmacist to sit down with the patient and go through their medication and providing a unique opportunity to ask questions. It is during this period that we hope to help people understand their medications and how to take them more safely.

What’s unique about the system?

FLAG-Me Vision is easy for pharmacists to use: they don't have to go scrolling though multiple screens, trying to pick out 'sight impairment' amidst reams of text, or ask all their customers if they have a sight impairment.

FLAG-Me Vision helps maintain patient confidentiality: Where the shaded eye logo is shown, patients will be discreetly offered a 1:1 consultation in private, much in the same way pharmacists may counsel a patient about a new medication, checking patients understand how it should be taken.

The FLAG-Me website collates resources to make medication safer, from adding tactile markers such as adding bump-ons (small, raised stickers) to tablet boxes or loom bands (mini elastic bands) to eye drop bottles it can help people use the right medication and the right time, and even in the correct eye.

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Is there anything else you’d like to say?

Each year 1,708 people die from avoidable medication error. This has a huge impact on the families and friends of those affected, and also costs the NHS ￡98.5 million each year.?

?The Accessible Information Standard (AIS 2016) means that patients have to be provided with information in a format they can access. Currently AIS posters asking people to let their healthcare professionals know if they require information in braille or large font aren’t accessible.?

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This article reflects the personal views of the individual quoted and should not be interpreted as an official statement from UKRI or Innovate UK.