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GPs sometimes fail to diagnose coeliac disease properly and the longer it’s left untreated the worse it gets  

Innovative screening and diagnostic tests are giving pharmacists more power to detect a number of health problems early and improve outcomes

While customers may know that pharmacies stock a wide range of over-the-counter medicines, there’s still a need to improve their understanding of the in-store clinical services and DIY health testing kits that pharmacies can offer. “The widespread adoption of fertility and glucose monitoring over the last 20 years are great examples of showing how health tests and monitoring can become an everyday occurrence,” says Dr Osian Meredith, operations director at Mode Health.

“Offering a range of health tests can help deepen the customer relationship, allowing the pharmacist to personalise recommendations of appropriate tests. By focusing on promoting products for a specific body system, it’s easier for the consumer to visualise how they might use the test as part of their lifestyle. For example, bowel health testing can be promoted alongside gastrointestinal-related nutraceuticals and other products. We feel that health monitoring should become part of a lifestyle rather than segmented into a separate health testing section.”

NHS Health Checks

The NHS Health Check is promoted as ‘the midlife MOT’, to assess people’s risk of type 2 diabetes, heart disease, stroke, kidney disease and certain types of dementia. Everyone between the ages of 40 and 74 who hasn’t yet been diagnosed with one of these conditions is invited for a five-yearly check-up. A third of local authorities report that they now commission pharmacies among their NHS Health Check providers.

“We are seeing a year-on-year increase in the number of people receiving their NHS Health Check, which is very promising,” says Jamie Waterall, national lead for the NHS Health Check Programme, part of Public Health England. “Community pharmacies already provide public health services in many areas and, given their ideal positioning in the community and extended accessibility, they are critical in reaching those who will benefit most from health interventions such as the NHS Health Check.”

However, implementation of the NHS Health Check programme remains poor. The latest national NHS data reveals that in 2014 to 2015, less than 20 per cent of the eligible population was offered an NHS Health Check; of these, less than half actually received one.

Bowel cancer screening

The NHS bowel cancer screening programme in England began in July 2006 and is currently attempting to screen everyone between the ages of 60 and 74 every two years. But, as with the NHS Health Checks, uptake of the screening programme is slow. In March 2015, only around half of those invited take part in the programme, were taking up the offer, meaning opportunities to detect cancer early are being lost.

“When the national bowel cancer screening programme was launched, no one realised that stool sampling may be considered distasteful and embarrassing, especially in some ethnic minorities,” says Professor Roger Jones, a member of United European Gastroenterology’s colorectal cancer task force. “Pharmacists can help to raise the awareness of bowel health by taking part in national awareness campaigns and circulating leaflets and posters.”

MODE Health recently launched the UK’s first digital home testing kit for the early stages of bowel cancer. The measure Bowel Health Test isn’t intended to replace the NHS screening programme, but makes it simpler and easier for people to self-check for early indications of the disease. MODE plans to launch the kit to independent pharmacies by the autumn.

“We are very supportive of the current national screening programme,” says Dr Meredith. “First, because screening can identify early disease in people who otherwise have no symptoms, and second, because bowel cancer is one of the easiest cancers to cure when caught early. MODE is planning to introduce eye-catching in-store materials that will both attract and inform potential buyers, including a consumer leaflet and poster for the consulting room and window.”

Diagnostic checks

According to Donna Wilson, TENA training and brand manager, bladder weakness and urinary tract infections are both very common and, more often than not, the two can be linked. “Up to half of women in the UK experience bladder weakness and one in two will experience a UTI,” she says. “The TENA u-test innovation is a fully integrated solution for collecting and analysing urine for the detection of infections.”

TENA u-test is placed directly onto a clean bladder weakness pad for a simple and convenient diagnosis. “Once the results have been collected, pharmacy staff are in an ideal position to refer customers to their GP, or to offer practical lifestyle advice and product recommendations for customers experiencing bladder weakness.”

One in 100 people in the UK are known to have coeliac disease, but only 24 per cent of them are diagnosed. To help fast track diagnosis, Coeliac UK recently launched its online assessment tool on a dedicated website – www.isitcoeliacdisease.org.uk.

Biocard, a home testing kit for coeliac disease that’s available from pharmacies, uses finger-prick blood samples to determine whether IgA antibodies are present. In an independent trial, it proved 96 per cent accurate compared with hospital-based tests such as intestinal biopsy. If Biocard shows a positive result, it’s essential that the customer visits their GP as soon as possible to ask for a formal medical diagnosis.

“The gold standard for 99 per cent of coeliac patients is the presence of these antibodies,” says Tom MacDonald, professor of immunology and dean for research at Bart’s and the London University medical schools. “The test is useful because GPs sometimes fail to diagnose coeliac disease properly and the longer it’s left untreated the worse it gets, leading to complications such as anaemia.”

Omron is proud to introduce Stroke Association stickers and inbox leaflets across a number of its bestselling blood pressure monitors (including the M2, M3, M3 IT and the M6 Comfort). This ties in with the Stroke Association’s successful ‘Know Your Blood Pressure’ Campaign.

“We hope that this packaging initiative will raise awareness that high blood pressure is the single biggest controllable risk factor for stroke,” says Laura McGuinness, senior marketing officer for stroke prevention at the Stroke Association. “Too many people have no idea that their health might be at risk because high blood pressure is symptomless. Keeping an eye on your blood pressure is quick and painless, taking action to reduce it is a simple way to reduce the likelihood of having a stroke.”

Omron has also introduced a ’60-day challenge’ for the M6 Comfort (HEM-7321-E), to ensure that customers are satisfied with their purchase. The 60-day challenge provides pharmacies with an added benefit when promoting the Omron M6 Comfort to customers, without any additional product return administration.

Future plans

The first legally approved HIV self-testing kit – BioSure HIV Self Test – went on sale in the UK in April 2015. The kit uses a small amount of blood from a finger pinprick sample to detect the presence of HIV antibodies, and offers a result in just 15 minutes. People can test when and wherever is convenient. All positive test results need to be confirmed by a healthcare professional and it’s recommended that those in high-risk groups are tested every three months.

Currently, the test is available online only. But BioSure founder Brigette Bard hopes that the kit will be available from pharmacies later this year. “Pharmacists will definitely play the key role in the general market of self-testing and add a really interesting dynamic to HIV self-testing,” she says. “Although a person may want a level of discretion around their self-testing, we know that a pharmacist is able to provide a level of professionalism and comfort that’s the perfect middle ground between being on your own and being completely immersed in the NHS. We expect our Biosure HIV Self Test to be available on the high street before the end of the year and would really welcome any feedback or thoughts from pharmacists in anticipation of the launch.”