Alarming Level Of Non-Adherence

Recently I came across an alarming data on non-adherence: according to the American Association of Retired Persons (AARP) 25% of people above 50 are not taking their medications as prescribed if they take them at all.

Rather than worrying about the sky-rocketing healthcare costs and revenues we should ask, what makes patients stop a treatment and go against their physician’s advice. Is it only the price of the medication or is it a consequence of miscommunication? And if so, what is pharma doing to find a solution for whatever the problem might be?

  1. First of all the cause of non-complience has to be clear. To be able to act on it one needs to know the real nature of the problem. It might sound obvious, but surprisingly it is often overlooked. To determine the reason for non-adherence pharma and healthcare need feedback from patients. This of course requires communication and listening which to this day seem to be challenging.
  2. Communication: The reason behind stopping a treatment could be the lack of information about certain drugs. A lot of patients end up leaving the doctor’s office not entirely understanding what they have been told. With the constantly decreasing visit times accurate knowledge about a treatment is hard to provide. It has to be a crucial goal to get through to patients and make sure they have all the information they need to successfully complete or maintain a treatment.
  3. Financial solutions: Non-complience can also root from financial difficulties. Healthcare providers, pharma, insurance companies have to be able to work together to find a better system to help patients in need to pay for their medication. To imply that patients come first and not collaborating for a more sufficient way for them to finance their medications is simply misleading.
  4. Marketing tools for adherence: Marketers often focus on the great results and advantages of taking a certain drug. They often forget to emphasize that partial treatment is not a treatment. Through conventional marketing, social media platforms and educational portals pharma has great tools to inform patients and advertise adherence. These tools could be the base of comprehensive compliance campaigns.

(Source: World of DTC Marketing)

Comments On Pharma’s Engagement With Healthcare Professionals

Recently I stumbled upon a thought-provoking article online on pharma’s engagement with healthcare professionals. I found the questions and the subject of the post highly interesting. Reading the article made it even more clear for me that without set goals and selecting the most effective tools, we are going to ask ourselves the same question for years to come: “What has pharma really done to engage with healthcare professionals?”

The article is a bit contradictory in the sense that first it states that pharma is not actively involved in healthcare professional communities, but then goes on the emphasize pharma’s online engagement. In the beginning it argues: “The HCP communities are all independent, pharma’s not involved. Setting aside the fact that most survive commercially through industry sponsorship and funding.” First of all you can’t ignore pharma’s financial involvement. It influences the discussions and the operation of these communities. But is funding the right kind of engagement? Is it engagement? I don’t think so. Unless you are an active participant of the conversations happening online, you are not engaging. You might be providing the platform for the discussion, but you are not part of it. Financial tools are not social tools.

The article states that pharma is indeed engaging. But with whom? Patients? Healthcare providers? With each other? The post doesn’t clarify. This has to be decided. Pharma has to have a clear goal about who to engage with. Patients, healthcare professionals require completely different ways of communication and engagement.

The post also argues, that pharma is engaging online since “we are all patients. (…) the paradigm shifts in how we all manage our healthcare needs, as well as how we interact with healthcare providers.” While I don’t think this argument is 100% true I found the comparison between pharma and patients more problematic. Pharma shouldn’t engage online as a patient. It has an entirely different role in discussions. It should not operate in social media as patients, but for them. Pharma could certainly learn a lot about patients from the way they connect online, the way they use social platforms for health-related issues. But pharma has numerous other responsibilities that have to be considered. As the article mentions, this is a highly regulated industry, and so social media action has to stay align with all regulations. This is another reason why we can’t compare pharma and its online engagement to patients and their online presence.

So while further debating the role of pharma in social media and online engagement, we have to build on those debates and act on them. Discussions between social media moguls and marketing professionals about the importance of social sites and communication is not enough. It is also a classic case of preaching to the convinced. If pharma wants to connect with healthcare professionals it has to use the right tools. Not only the financial, but the social ones. The platforms to do so are already there.

(Source: PMLiVE)

Basic Attributes For Collaborative Healthcare

We can agree that more and more patients look for information themselves, or look into what their doctor says during a visit – but that doesn’t mean that trust between physician and patient is not important, that the empowered patient doesn’t need to be convinced that his/her doctor is competent and caring. Just the opposite. A great deal of trust needed in a time when achieving health becomes a shared goal and experience for doctors and patients.

But what is this trust based on? How do patients develop this trust for their physician, what do they take into consideration? According to a recent blog post on Mind The Gap the trust in doctors is based on three attributes:

  • The physician’s clinical skills
  • The physician’s communication skills
  • The patient is the number one concern of the doctor (without any other motives involved)

Because patients are usually not clinically trained (although more and more informed), they rely mostly on the second and third attributes when trusting their doctors. And that’s why it is crucial to spend enough time focusing on the dialogue with the patients, asking and answering questions and discussing any kind of concern they may have.

It is not surprising that communication is key for patients at this point. We are far gone from the idea that patients are not allowed to have an opinion, or any kind of knowledge about their condition or treatment options. Healthcare became more like a collaboration and as such people participating (doctors and patients) have to find a way to talk, communicate and discuss.

This is why it is alarming to see that the amount of time spent on a visit is rapidly decreasing. This is why it is frightening to know that even an important subject like taking a new drug is discussed in 49 short seconds. It is not enough to possess clinical skills and a great amount of information. Physicians also need to know how to pass on that information and earn their patients’ trust to achieve better outcomes and a well-operating collaborative healthcare.

(Source: Mind The Gap)

Why Would You Say No To Social Media?

Recently I read an article that questioned the relevance and the justification of social media in healthcare. I would like to go through some of the interestingly put, misinterpreted and weirdly positioned arguments the post included to prove my point, that social media in fact has (or should have) an important role in healthcare.

Talking about today’s pharmaceutical era the article states that:

  • most consumers do not want to connect with drug companies on social media
  • most drug companies don’t have the resources to talk to people via social media

What do we base the first statement on? The fact that consumers don’t connect with pharma on social sites could apply that the conditions need to be changed. Maybe the drug companies need to be willing to communicate as well? Just a thought. And to say that drug companies don’t have the resources to talk to consumers via social media is almost comical. An multi-trillion industry that spends billions of dollars on TV and print ads can’t hire a few dozen people to set up Facebook pages for free and monitor them?

Reading the article I had the feeling that a relatively big section of the text contradicted the title of the article. How can you make a statement, that social media is not the answer and has no future in healthcare, then write the following:

Social media is a way of looking at marketing and realizing that today consumers want more control about what they purchase, why they purchase it and especially what goes in their bodies. Hell now there is even conflicting news stories about common OTC products that may not be completely safe !

The drug industry has long ignored consumers who want to be heard and give feedback. To them it’s all about push marketing with message testing and while that may meet some brand objectives it’s not enough at a time when less people are going to their doctor and less are filling Rx’s.

If you realize that there is a demand for more information and control over purchases, you realize that consumers want to ask questions and give feedback and that these demands are being ignored for the most part by pharma companies, how can you deny the importance and convenience of social media as a tool.

It is true that social media in itself can’t change healthcare, you need informed and creative people to operate social channels as tools. But the answer is not to take out social media from the equation, but add the right professional forces. It is definitely not the comfortable solution since it’s time-consuming and involves a great deal of work, but on the long run it is still more productive than to say no to social media based on fabricated and contradictory reasons.

(Source: DTC Marketing)

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)

The Digital Era Of Healthcare

I have said before that quoting numbers from studies endlessly and keep proving that we live in the era of social networks is pointless. After a while people can say: “Ok, we get it! A lot of us use Facebook, Twitter, Youtube, etc.” Even the role of online content and social engagement in healthcare don’t really need further proof to be taken seriously.

Despite all that I wanted to share this video below. First of all because it includes all of the most important data about social media use and how that effects healthcare and patient information. Secondly because I believe that for whatever reason the same facts presented in a fast pace video can grab people’s attention better than any results in written words.

To make it easier for viewers to follow, here are the key findings included in the video:

  • There are 2.08 billion internet users worldwide
  • That number increased 11% in the last year only
  • There are 476,213,935 internet users in Europe
  • There are over 156 million blogs online
  • Over 200 million people on Twitter sending out 40 billion tweets per year
  • Wikipedia has over 3.65 million articles that would take more than 123 years to read
  • Facebook has over 750 million users – if it were a country, it would be the third largest in the world after China and India
  • Every second someone joins LinkedIn
  • Youtube serves 1 billion videos everyday
  • Google logs 2 billion searches daily
  • Healthcare is the second most search for topic on Google
  • Healthcare is the third largest web activity across all generations
  • 85% of online Europeans turn to the internet and other technology for health and prescription information
  • In a survey of 4,000 physicians 88% said they used internet resources to search for professional information
  • 48% claimed to visit Wikipedia more than once a week compared to only 16% visiting BMJ online
  • 50% of patients discuss what they have found online with their doctors
  • Patients who visit a brand website are more likely to request a drug by name
  • 44% of physicians prescribe a requested drug
  • 49% of physicians will recommend a website to patients – 80% for disease or condition education and awareness, 62% for patient support, 56% for health or lifestyle change, 37% for drug and product specific information, 22% for online communities for patients with the same condition
  • 95% of physicians use handheld devices and smartphones to download applications and access medical information

(Source: Pharma Marketing: The Weekly Dose)

Facebook Comments Don’t Hurt The Socially Engaged

Well the results of the commenting changes on Facebook are everything but surprising. They can be summed up very easily: companies already using Facebook to engage with patients don’t mind letting their fans actually participate. Others who delete their pages most likely were not using the social site to communicate anyway. It’s a really obvious statement: commenting changes don’t hurt the socially engaged.

This is what Silja Chouquet proved in one of her recent posts on whydotpharma.com. According to her summary that observed the Facebook activity of five pharma companies, organizations, for instance Boehringer or Johnson & Johnson, who are actively involving their audience on their page welcomed comments long before the changes. Their posts are directly addressed to their fans and they encourage them to comment. And as the results show, followers respond to their questions and their shared content. Others, like Novartis closed down their fan pages, saying no to the Facebook commenting changes. The charts below show how many posts the five companies (Pfizer, Johnson & Johnson, GSK, Boehringer and Novartis) shared and how many likes and comments they received in the last week. The connection is obvious:

Either you engage with patients, or you don’t. You either need Facebook, or you don’t. If you decide to have a dialogue with your audience, than the policy changes don’t effect you. If you decide not to have a discussion with your followers, you don’t really need Facebook, so once again, the changes don’t effect you. They only matter to companies, who needed that last push to really dive into social media and use the tools what they are created for. Like Pfizer, who had the highest number of fans but only started posting more frequently and receiving feedback.

(Source: Whydotpharma.com)

For more, check out whydotpharma.com and follow Silja (@whydotpharma) on Twitter.

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)

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)