Digital persuasive game innovation to improve patient management of UTIs in the NHS and Africa

Transformative Technology funding awarded in 2023-24

Urinary Track infections (UTI) are one of the most prevalent bacterial infections treated in the NHS affecting mostly women. Traditionally, UTI are treated using antibiotics prescribed by GPs and nurses in primary care, however, recently, to alleviate the pressure on the NHS prescribers, registered healthcare professionals are authorized to prescribe and manage UTI in the community. Subsequently, evidence shows that following the guidelines by non-prescribers is a major concern.

Mobile serious persuasive games are a cutting-edge digital decision support intervention that demonstrated the potential to change antibiotics prescription behaviour and educate healthcare professionals at the point of care. They could provide much needed reassurance in complex UTI management decisions, and successfully address guideline adherence gap in the NHS.

The award-winning Centre for Digital Public Health in Emergencies, with years of digital innovation expertise, leads this multi-disciplinary cross-boundary international team including a consultant pharmacist and antibiotic stewardship (AMS) lead in the NHS, and a clinical microbiologist in Nigeria who will ensure the prototype designed for the NHS could be easily adapted and localised for UTI management. This seed project has the potential to make a truly global long-term impact while also contributing to the fight against antimicrobial resistance.

Digital persuasive serious games technology has demonstrated high effectiveness in enabling behaviour change and holds great potential in educating healthcare professionals on UTI management and addressing guideline adherence gaps (Luedtke 2023). UTI transformative technology will also support training, supervision of non-prescribers through a dashboard, deliver audit of quality of care, demonstrate AMR prescription decision behaviour change, increase compliance and provide seamlessly app-collected data for robust evaluation of effectiveness.

This project consortium builds of a fruitful interdisciplinary collaboration between UCL dPHE Centre and the Whittington Health NHS Trust having identified a unique synergic opportunity for digital intervention to transform pressing challenges around prescribing and management of UTI by non-prescribers that could improve the quality of care for thousands of patients in North Centre London through Dr Lim’s leadership on AMS in this area. A specification and a mock-up serious game app was successfully presented to consultants and pharmacists in Whittington Health NHS Trust in autumn 2023 and enthusiastically received.

Through this funding, this research aims to roll out a large sustainable digital innovation initiative, leveraging the perfect consortium at UCL, NHS and Africa, enhanced by the new social enterprise, dramatically transforming the management of UTI and AMR UTI prescribing for thousands of patients in high and LMIC settings on two continents over the next decade.

This project addresses this hidden gender aspect of this common debilitating condition improving quality of care and preventing recurrence of UTI for thousands of female patients in the NHS and in Africa. While the NHS has been subject to drastic cuts, this project when scaled up will improve the quality of patient care delivered in the community by non-prescribers saving valuable consultants time for more complex cases and conditions. This will address inequality, gaps in care, and challenges in guidelines compliance witnessed at the moment. In Africa, the project will bring the importance of UTI management to the forefront of community care and dramatically improve the training and prescription compliance in line with local UTI guidelines appropriate for resource constrained settings. Finally, this project addresses one of the most pressing global societal challenges faced by humanity today – antimicrobial resistance (AMR) expected to amount to 10 million deaths and cost the global economy £66 trillion by 2025, according to WHO.