Pharma

Patient Adherence and Compliance – A 360 Degree View

by Fleming. Team

The pharmaceutical industry is undergoing changes, and is shifting towards patient centricity. The question is: can patient centricity work for pharma? It involves a lot of “buts”.

It can improve pharma’s reputation and improve the long-term dynamic between patient and doctor, but doctors are busy.It can lead to great outputs for qualitative and quantitative research, but there is the question of privacy and data security.In long run, it can help open innovation, ergo developing new products, but it takes time and personal and financial investment.It can lead to informatisation, but thanks to excessive use of social media and discussion groups, it can also lead to so-called “cyberchondria”, believing the internet more than doctors, et cetera et cetera…BUT it is not all doom and gloom : patient centricity has it perks and yes, it works for pharma! The challenge here is generating satisfaction and patient compliance. Rethink the care - keep it proactive and personalised. Follow the patient on his journey. Ongoing, two-way interactions are the right mindset.

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A paper from doctors Armantier and Namoro titled Prescription drug advertising and patient compliance: A physician agency approach, introduces an analysis of both doctor and patient behaviour in an agency model that accounts for the interplay between two highly debated health issues: drug advertising toward doctors and/or patients, and the serious problem of patient non-compliance with their doctors’ prescriptions. Establishing trust by not only talking but being able to listen, not neglecting follow-up care and not posing as a “salesman” will do the trick. Doctor and patient should form a team : this is called patient empowerment.

Never forget to be sensitive to a patient's beliefs and preferences, but be sure to include interventions that target the three components of medication adherence: initiation, implementation, and persistence with medication taking. To summarise, when there is a will to take the medicine but there are obstacles in the way, this is an adherence issue. When there are no obstacles but no will or belief, it is called non-persistence.

In Europe, medication non-adherence costs governments an estimated €125 billion and contributes to the premature deaths of nearly 200,000 Europeans a year. The main reason for not taking medication was simple forgetfulness which was cited by 71% of those surveyed; followed by lack of belief that the medication was needed (20%) and the belief that the condition has improved and hence medication is not needed (16%), according to EFPIA's Annual Review of 2011 and Outlook for 2012.

To improve non-adherence, one of the biggest problems of this value-driven pharma environment, it is important to incorporate patient centricity regularities and to understand why it occurs. Firstly, understand your customer. Frankly, if you think of him/her as a person coming to get treatment, you are thinking in an old style in new era. According to an Ogilvy Common Health Blog from October 2014, the customer needs to be considered through the 4P framework: Prescribers (physicians targeted by reps), Payers (mostly insurance carriers), Patients and Policymakers (associations, government). A multi-perspective approach and creating links and relationships between stakeholders are very important.

The future lies in building sustainable, people-centred and collaborative health care. Improvement of health literacy is also one of the goals. In the 21st century, it can be reached with a “little digital help”.

Even doctors have their own social networks (Sermo, Doximity). Patients use several channels to communicate with each other (discussion forums and special networks such as the Cancer Survivors Network) or look for information or treatment (Facebook is reported as the fourth most popular source of health information in the U.K, as stated by June Dawson in her publication: Doctors join patients in going online for health information). Engaging patients through these channels is a priceless opportunity for feedback. Also, patients are the end users and they know best, what channels they prefer, what medication and approach they prefer.Lately, there have been a lot of buzzwords and hashtags surrounding patients and their healthcare needs like #patientengagement, #digitalpatient and #PX (patient experience). Use them. Reciprocity is the key: be visible, accessible and responsible.

And last but not least, long-term patients play a key role in getting the information for patient adherence and compliance. They have individual needs and meet challenges brought by a strict daily medication regime (Parkinson's, autoimmune disorders, cancer…). Using data from digital health media can be an asset for the creation of personalized regimes for them.

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