Poor Communication Equals Non-Compliance

In a recent post on Mind The Gap, a blog dedicated to investigate the quality, or in this case poor quality of communication between physicians and patients, I stumbled upon some alerting data about how much these shortcomings effect compliance. We long knew that being informed and engaged in health increases adherence. But the magnitude of consequences of not providing comprehensive information about new medication was shocking.

Here are some of the sobering facts (also shown on the infographic below):

  • While 50% of the US population takes at least one medication and 85% of seniors have one or more chronic conditions, only 50% of patients are taking their pills as directed.
  • Even more astonishing, that 70% of non-compliance is intentional. The reasons are the following: disbelief in diagnosis and severity of health problem, concerns about side affects – all of which could be discussed during a visit.
  • Doctors spend an average 49 seconds (yes, that’s not even a minute) giving information about a new drug they prescribe.
  • They only tell patients how long to take their pills 34% of the time. In as low as 35% of the cases they spend time mentioning the adverse effects and only 9% of the time they talk about the price of the drug.


(Source: Mind The Gap)

Patients Using Social Media – Dropping Numbers?

Recently I stumbled upon an article published on eMarketer.com titled “Patients Get Social About Their Health”. Based on the title I had a general idea of what I am going to read. I remembered numbers from earlier studies: 61% of the patients in the United States turn to the web for health information, another research said that rate was as high as 80%, 16% Americans use social media to search for medical advice, and more than half of patients sharing information about their conditions do so on blogs.

As a matter of fact, I stopped reading these kind of articles some time ago. As Bryan Vartabedian, MD wrote on his blog, 33charts.com:

I’m preparing a new presentation on doctors, patients and information.  I’ve decided that I’m no longer going to display quotes on health search.  I always felt that I had to make the case.  But it’s official:  lots of people search Google for health information.  It’s no longer remarkable.  It no longer changes the way an audience sees things.

I agreed, so I assumed every time I saw an article with the same title about how many people use the internet for health information, I am going to see the same data over and over again, presented maybe in a slightly different way. So when I read the post on Emarketer.com, I was surprised. Did the numbers drop? Did patients turn away from social media and other online sources, like blogs? According to the study used in the article as a reference, an carried out by the Deloitte Center for Health Solutions only 11% of American healthcare consumers use social media to find and share health-related information, and 8% of them turn to blogs.

I don’t think studies can be compared, since their sample, their method could be very different resulting in various conclusions. But one thing is for sure: you have to be a little suspicious when finding results that are way off of the regular pattern of past studies. And I am also certain that you can’t state that patients are getting social based on numbers as low as 11% and 8%.

(Source: eMarketer.com)



Mobile Medical App Regulations – Are They Necessary?

As I mentioned before, the FDA seemed to be moving faster with proposals to regulate medical applications than with the ever-dragging process of creating guidelines for social media in healthcare. Helthcare IT News surveyed 50 of its readers on what they thought of the sudden urgency the FDA addressed the issue of non-regulated mobile apps.

As you can see on the chart below, 46% of respondents thought that regulations are important for different safety reasons. But the rest of the readers, 54% said that too much regulation could be demotivating and problematic for developers. My question is: can one think both of these statements are right? I think you can agree that some sort of regulation is needed so an app doesn’t offer a band aid for a broken arm (excuse me for the simplified example), but it is also important that the developers can still be innovative and creative.

The article also mentions a concern that is not addressed in the survey. Mainly, that regulations are offered for doctors, so they don’t become too reliant on these applications. First of all, what do you call too reliant? Where do you draw the line? A recent study showed that in the United States every 2 in 5 doctors use mobile apps during a visit. Would you consider that too high? And second of all, isn’t it more of a concern that patients become too dependent on these tools? The doctor has a medical degree to help him/her decide what app to use and how. But what about the patient that follows any advice on a mobile device without seeing a doctor?

(Source: Healthcare It News)

Medicine In The Digital Era

With new devices constantly appearing on the market at a new speed, it is safe to say that the digital era has arrived. It also consumed the medical field with physicians enjoying the perks of having mobile access to the enormous amount of knowledge required while practicing medicine. While it was long obvious that mobile applications and devices influenced doctors in a major way, a recent infographic about U.S. hospitals and healthcare professionals included surprising numbers to prove just how much they became an integral part of practices.

According to the data below, more than 2 in 5 physicians go online during a patient’s visit mostly for drug references, new publications, disease associations or to look for a support group for patients. The most convincing fact was the high rate of doctors using consulting applications with 94% of them turning to these for information. The infographic also suggests that other mobile based technologies are welcomed as well. For example 86% of physicians are interested in accessing electronic health records, while 83% of them would like to use these devices as prescription tools.

The data also highlights the fact that more and more doctors go on social sites for professional reasons. At the 1188 hospitals observed Facebook seemed the most popular with 1018 pages created. These healthcare facilities shared overall 548 Youtube channels, 788 Twitter accounts and 458 LinkedIn profiles. One thing that stood out was the relatively low number of hospital blogs with only 137 listed for all 1188 hospitals. Despite the fewer blogs in these organizations, the infographic states that blogs are actually favored by doctors compared to private online physician communities.

The numbers once again show the significance of the “mobile movement” among healthcare professionals. Maybe this magnitude is why the FDA, while usually slow in similar cases, felt the urgency to address this phenomenon with its draft guidance for mobile medical applications.


(Source: Spinabifidainfo.com)

Non-Adherence – There’s An App For That

I was very surprised to read a blog post the other day about how mobile applications to increase compliance are “intrusive” and how the whole concept is shortsighted. After stating what an enormous problem non-adherence is, I think the only reasonable conclusion could be to try every possible tool to help patients stay on the right medicine regiment. When non-adherence causes 89,000 deaths and $100 billion dollars every year in hospital costs only in the United States we simply cannot turn our backs on a solution because of some negative reaction without further observation.

The post also mentions a study about an application for patients with Type 2 diabetes, that reportedly failed to provide help and was rather annoying in the eyes of the participants. There are no numbers or percentages to really measure how unsuccessful the experiment turned out to be, only a few examples of negative feedback to prove and emphasize how “aggressive” these applications are.

I however agree with the statement, that there isn’t one solution that is going to magically solve the problem of non-adherence. It has to be a very balanced mix of different components, that in the end help patients (and their physicians) with the dosages and tracking of medications. But I also believe that a smart and easy-to-use application could be a complimentary element in the mix. The article quotes the New England Journal of Medicine and its list of tools that could help increase patient compliance: tracking prescriptions, paying providers based on outcomes or having lower co-payments. As I said before, the fight against non-adherence has to combine different but equally important elements, so an app wouldn’t make these changes unnecessary. But all fails if patients don’t remember to take their medication.

The blog post includes a list of automated pill dispensers as the possible solutions to increase compliance. Here is one example:

The SIMpill Medication Adherence System text-messages the patient’s mobile phone if the patient does not take their medication or takes it at the incorrect time. If the patient still does not take their medication, an alert can be sent to their caregiver or healthcare provider. The system also monitors prescription refills and alerts the pharmacy when the patient is running low.

While I think this is a complex and wonderful solution of the problem, I can’t understand how a mobile application could be more “intrusive” than this. How can one state that an app is too aggressive and poorly perceived and then list automated tools with alarms, messages and alerts not only to the patients but to their providers. We can’t just say no to a possible solution because it didn’t work for a group of people. With adherence different methods work for different patients. That is why there is a great need for the invention of several complex applications and solutions, so everyone could choose what fits them best.

(Source: World of DTC Marketing)

Sharing Diagnosis – Sign Of Social Self-Expression?

According to a recent study by marketing firm Russell Herder from Minneapolis, patients are more likely to share information about their diagnosis these days. The research emphasizes that this is an enormous opportunity for healthcare providers to support patients and provide them with helpful online tools to communicate.

Researchers based their results on Facebook, Twitter, different forum and blog posts shared by almost 63.000 users. The most popular platforms for disclosing information about health related information or a diagnosis were blogs with more than 50 percent of the posts. Blogs were followed by message boards where 30 percent of diagnosis related information was disclosed. Both Facebook and Twitter had 7 percent of the posts observed. These lower percentages could be the result of more private profile settings.

40 percent of the health related information shared was in connection with cancer, while there was a high rate of diabetic patients disclosing their diagnosis. 10 percent shared information about chronic fatigue, 5 percent about asthma, STDs and AIDS.

The study points out that with so many patients looking for support online from their families, friends and patients similar to them, and with so many of them sharing their diagnosis, healthcare providers have the opportunity to reach out to these patients and connect with them online. “Given the growing demand for online access to health-related information and support, hospitals, clinics, and organizations should ensure they are providing the social media and website resources their patients and prospects are seeking.”

Jane Sarasohn-Kahn on Health Populi gives a very detailed analysis of the study stating that this level of sharing health related information on social media platforms shows how far we have come and how “more people are feeling more engaged in their health.” And while I do think that sharing a diagnosis is a first step of patient engagement, I also think being engaged in our health is more than that. It also involves asking for or providing help in a community of other patients, interacting with them, getting informed and helping to get informed. I think patients sharing their diagnosis shows more how our communication and actions moved online, from the close circles of family and friends to a wide group of people, how self-expression took an overly social form.

(Source: Informationweek Healthcare, Health Populi)

e-Patients And Their Health Habits

Social media could be a great staring point for clinical trials. According to a study carried out by Blue Chip Patient Recruitment, e-patients who are active social media users are 60% more likely to have participated in clinical trials.

The data published in the research suggest, that patients using social media are more active in other areas as well when it comes to their health. They are 37% more likely to agree that medication helped imrove their lives, and 21% more likely to be willing to try advanced medication. They are also 29% more likely to visit their doctor for check-ups. They are 39% more likely to state that their condition resulted in a limited lifestyle.

There is one area where patients didn’t seem so active: online communities. When asked about their activities in online communities 80% of the respondents (between the age of 25 and 54) stated that they are reading the posts of others while only a little more than 30% said that they take part in providing content. So sharing posts and comments is definitely less significant compared to looking for information.

(Source: World of DTC Marketing)

Teens Are Not Going To Google The Word “Contraceptive”

When talking about health information online, the issue of SEO comes up more and more. Recently I read an article about young people using search engines to find out more about sex and relationships. The piece brought up very interesting points about using medical terms and optimizing health content for search engines.

While more doctors feel the obligation to provide relevant and accurate health content online and guide patients through the massive amount of information, there is also the need to remember the simplest things. Like the fact that a teenage girl might be interested in birth control, but would not necessarily use the term contraceptive. Or the fact that our mother could be very up-to-date about using the internet to look up medical advice, but wouldn’t use the medical expression “tremor”. She would say “shaking”.

So while it’s very inspiring and much needed for doctors to provide medical information online, they should also remember that their advice is most of the time read by people who didn’t go to medical school, who don’t know what “neurological symptoms” are. You have to clarify certain things. When you are not sure about how well-known medical expressions are, give examples. If you say “neurological symptoms” and you go on giving examples “like numbness, tingling” you make your point clear and educate your readers.

And there is another advantage: your readers will find your content easier online. Just remember, they are not going to Google “tremor”, they are going to Google “hand shaking”.

(Source: HuffingtonPost.com)

Pharma Is Missing Out On Online Discussion

The findings of a recent study by NM Incite suggest that patient discussion online has a wide range of subjects. People mostly share their personal experience with conditions and treatments, let those be positive or negative. And while only 20% of the discussion is brand-specific, this doesn’t mean pharma marketers should ignore the volume and importance of online health discussions. Patients often talk about side effects and treatment efficacy, which could be a valuable feedback to pharma companies.

When observing discussions about individual conditions, NM Incite found that a large number of them are lacking the insight of healthcare professionals. The discussions are mainly carried out by patients. COPD was the condition with the highest rate of involvement by healthcare professionals, and even that showed only 6% share of discussion on their part. This data is in sync with the findings of the study by the Harvard Business Review which stated that only 47% of the observed companies are tracking reviews about their product regularly, and only 36% pay attention to conversations on social media networks.

It is clear that more monitoring and participation are necessary from pharma representatives and healthcare professionals. With 8 out of 10 people looking online for health information the medical content and most importantly their feedback need to be in check. For a while it was easier to defend the lack of online monitoring saying that the key audience, patients in their sixties and above were not present online. These days that argument doesn’t stand anymore. The study shows that 76% of people between of 57-65 and 58% between 66-74 go online, and their third most common activity is looking for health information on the internet.

Looks like there’s no more excuses to avoid the task of online monitoring. It’s time to listen and observe.

(Sources: NM Incite, H2online.hu)

Two-Way Decision-Making – Alone?

A couple of days ago I read an article about the Salzburg Global Seminar, attended by 58 healthcare professionals and researchers from all around the world. The panel had a discussion on patients’ role in healthcare decisions, and called them the future “co-producers of health”.

While I completely agree with their argument, that patients need to be more involved making big decisions about their own health management and treatment process, I feel like the seminar itself shows where healthcare fails to give patients the chance to participate. This was the perfect example of a decision-making process about the way healthcare and treatment should work. So where were the patients, or health advocates, leaders of patient communities?

The panel agreed, that “patients should vocalize concerns and questions”. As long as there is no communication between healthcare professionals and patients this remains a goal in theory.

(Source: MedPage Today)