Sprightly Plus

Insights

1. Early Identification and scanning of malnutrition is key, especially for cases where the elderly live in isolation . Supporting someone from the start of weight loss, helping them to stabilize weight even when they are not underweight can help prevent all the consequences of deteriorated physical condition yet the health care system is failing to do that. Additionally interventions to keep elderly from losing weight is proved to be more effective than fixing the chained effect that occur at a later stage.
2. A sustainable value exchange model is key to program retention and coping with shortage of funding. For example, Apetito, which has partnered with local councils to provide meal on wheel services, has terminated its partnership with several councils in 2023 because the program is causing them to lose money. Other efforts made to scan older population at scale faces challenges because of their dependence of voluntary engagement.
3. Interventions for scanning malnutrition require finding appropriate setting for the target population and reducing their social stress. Because malnutrition and social isolation are closely intertwined, malnourished people are more likely to live alone and lack a social life, and in extreme cases they even resist entering bright and crowded areas such as supermarkets and shopping malls. This is the reason why many local initiatives such as lunch club, social club and food buddy have limited impact.

Approach

Use the uniqueness of pharmacies in the community to generalize screening for malnutrition, raise public awareness through natural and friendly dialogue.

Why Pharmacy?

1. Research suggests that over 80% of people over the age of 65 are on at least one regular medicine, pharmacies are often patients’ first point of contact, and, for some, the only contact with a healthcare professional. Pharmacists have regular contact with patients (especially those with long term conditions) and the general public and are therefore well placed to screen, prevent and manage malnutrition.
2. Pharmacy's record of patients prescription enables them to better pinpoint older people with ongoing weight loss. For example patients that regularly pickup prescription to treat pain, dementia, mental illness or chronic gastrointestinal diseases are at a higher risk of malnutrition.
3. Compared to touchpoints in other part of the community, such as community centers and social events organized by local charities, slow checkout lanes in supermarkets, and home visits by carers and volunteers, Pharmacy is better suited to open up the topic of health and illness and is part of the daily path of the target population, thus reducing their social pressure.
4. Pharmacist Knowledge to advise on types and usage of oral nutritional supplements (ONS) offers a value exchange for the pharmacy to engage in identification of Malnutrition. Pharmacist are also more trust worthy with more healthcare knowledge compared to volunteers.

Key points to address:

1. Privacy of conversation in public space.
2. Non-judgmental safe environment.
3. Cognition gap.
4. Communication difficulties.

Solution

Sprightly Plus is a program adapted by pharmacies in collaboration with NHS, charitable association, research institutions to promote diagnosis and awareness of malnutrition, as well as the acceptance of oral nutritional supplements (ONS). The service includes these key features:

• Pharmacist pinpointing customer of higher risk of malnutrition based on a collection of factors: type of medication the patient is on, medical history, appearance, delay or absence of appointment.
• Toolkit and framework designed based on PANC/MUST/Nutrition Wheel for scanning that take the cognition cap and communication difficulties into consideration.(needs to be created and tested further with group of interest) .
• Option of private/later/phone conversation acknowledged by customer.
• Signposting to services(GP, Dietitian, care centre etc.) and resource sharing (lunch clubs, meal services etc.) based on the assessment result. Recording in digital system (potentially combined the current Patient Medication Record (PMR) systems) maintain patients profile and share statistics with research association and institute. Information booklets and malnutrition awareness posts outside counter available for every customers to take away.
• Explain, promote and recommend the use of OTC oral nutritional supplements (ONS).