Pharmacy concern over NHS-backed prescription app

The smartphone app Echo enables patients to order repeat prescriptions that are posted free to their home, prompting concerns that it will lead to a reduction in the number of visits to pharmacies.

Someone using mobile phone

A smartphone app, which has been called the “Deliveroo for prescriptions”, has been criticised for taking business away from local pharmacies.

The app, called Echo, which is one of two repeat prescription apps listed on the NHS Digital apps library, enables patients to order repeat prescriptions that are posted free to their home. It also sends alerts to patients when their next dose is due and when supplies of their medicines are running low.

Commenting on the app, Ruth Buchan, chief executive officer of Community Pharmacy West Yorkshire, expressed concerns that Echo was potentially taking business away from local pharmacies.

“I am unsure whether patients realise that it means they are changing where they get their prescription from — that it is no longer being dispensed from their local pharmacy,” she said. “We don’t get any money for providing a good shared service but unlike GPs we don’t have a practice list, our income is based on the number of prescriptions we dispense.”

The idea behind the app — which has had 100,000 downloads in the past 12 months — is to “remove the barriers to [medicines] adherence through elegant user-focused design and technology”, according to its website.

Patients who register with the app must give details of their GP and the medicines they are taking either by scanning the barcode or searching the app’s database.

Patients can use the app to make a repeat prescription request which is forwarded to their GP for approval. The prescription is then sent electronically to one of the 15 partner pharmacies for dispensing. Medicines are posted via Royal Mail to anywhere in the UK; they arrive in a plain cardboard box that is designed to fit through a letterbox.

The app recently came under scrutiny from pharmacists and GPs in Calderdale, Yorkshire, after claims that a patient ordered the wrong strength of warfarin via the app by mistake.

The team behind Echo said it is not a prescribing app and said the patient had requested the wrong dose of warfarin, which was picked up by the prescribing GP who wrote the correct dose and the patient was dispensed the correct medicine. No official complaint was made, it confirmed.

Echo was founded by Sai Lakshmi, a former Apple business development manager, and Stephen Bourke, a former head of strategy at telecoms firm BT.

Source: RPS

Claire Anderson, vice chair of the English Pharmacy Board at the Royal Pharmaceutical Society, is one of the clinical advisers for the Echo prescription app

Claire Anderson, a member of the English Pharmacy Board at the Royal Pharmaceutical Society (RPS), is one of its three clinical advisers.

Anderson, who uses the app herself, told The Pharmaceutical Journal: “For people like me who are very busy professionals, it’s perfect. All I need to do is set it up, and my medicine is delivered, I get reminders when I need to take my medicine and I get told when I need to reorder — it’s a nice slick app.”

She said the app appealed particularly to young people who are used to shopping on the internet but was likely to be less popular with older people on multiple medicines.

Anderson was confident about patient safety: “You can contact a pharmacist 24/7 and they are very good at getting back to you. It’s just a different way of doing things and I think others will follow.”

Sandra Gidley, chair of the English Pharmacy Board at the RPS, said she had some concerns that medicines were being posted because packages can get lost or delivered to the wrong address, but she acknowledged that the public was increasingly buying goods online.

“A lot of people don’t see buying their medicines online as any different from, say, buying a book from Amazon,” she said. “I’d argue it is very different, but I think we have to take into account consumer choice. We have to find a way of making it easy for patients to order their medicines without breaking that all important link with their local pharmacist.”

Alistair Murray, Echo’s clinical director, a pharmacist and an independent prescriber, reassured clinicians and patients about the app’s safety standards. In a statement, he said: “There are at least nine separate checks before the medication is sent to the patients. We also verify the patient’s identity to avoid prescription misuse. We have tracking on everything we send out.”

Last updated
The Pharmaceutical Journal, PJ, May 2018, Vol 300, No 7913;300(7913):DOI:10.1211/PJ.2018.20204750

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