Pharmacy bodies endorse a novel approach to heart valve disease detection

The Farnborough PCN community pharmacy heart valve detection pilot project shows promising results

Community pharmacy could play an important role in proactive detection of heart valve disease (HVD), which remains under-recognised and under-detected in England, suggested a new report published by Wilmington Healthcare.

Pharmacy bodies, including Royal Pharmaceutical Society (RPS), National Pharmacy Association (NPA) and Community Pharmacy England (CPE), have also endorsed the report, which encourages Integrated Care Boards (ICBs) to consider the innovative approach of detecting HVD with the help of community pharmacists.

Despite HVD detection being a priority listed in the NHS Long Term Plan, a large number of people with HVD remained undiagnosed and untreated in the country due to lack of awareness of the disease prevalence.

In June 2022, a pilot study was launched in Farnborough Primary Care Network (PCN), Hampshire, to evaluate the feasibility of using e-stethoscopes (digital auscultation) to detect this heart condition by a community pharmacist.

For the project, community pharmacist James Martin, from Chapel Pharmacy, was trained to use an e-stethoscope which assists with murmur detection using artificial intelligence (AI) software.

Over the six-month study period, total 86 patients underwent digital auscultation within the community pharmacy, out of which 39 patients (45 per cent) were identified as having murmurs and referred to echocardiography.

During the same period, auscultating manually, general practices (GPs) in the area made 24 referrals to echocardiography for suspected murmurs.

Following echocardiography, it was found that James referred 70 per cent more patients with mild or moderate/severe HVD than the GPs in the area (17 vs 10 patients).

“This shows that community pharmacy referrals, made outside the usual GP/hospital route, could result in successful diagnoses of otherwise undetected serious disease and the accessibility of this community service could be a powerful asset to the HVD pathway,” the report reads.

According to James, the heart valve detection pilot study truly demonstrates the value of community pharmacy.

“The potential value of this service is immense, both to patients and the NHS. Increasing the detection rate of valve disease at an early stage will increase the quality of life of millions of patients, and reduce the burden not just on GPs but on the NHS.

“Embracing digital technology, and collaborative working with general practice is the future of pharmacy and it is exciting to be a part of this change,” he added.

While digital auscultation by community pharmacists is seen as a promising first step towards transforming outcomes for people with HVD, the paper also acknowledges the need to address challenges facing community pharmacy including funding, facilities, and digital integration, to scale up the service.

Because HVD primarily affects older people, it is becoming more prevalent as the population ages.

Experts have warned that the disease, if left untreated, has a poor prognosis and a high mortality rate, similar to most common metastatic cancers.