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Adherence Begins Before Treatment:5 Strategies You Must Consider to Drive Effective Patient Interactions
ExL Pharma 2nd Patient Adherence SummitPhiladelphia, PA
February 23, 2012
Meet Your Presenters
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Marissa AddaliaVice President
Liz Carden, MPH, CHESManager,
Health Education
Integrated Insights Drive Our Educational Approach
Competitive Assessments
Analysis and Assessment of Buying Process
Segmentation and Market Sizing
Current Program and Communication Assets/Metrics
Brand Objectives, Strategies, and Plans
Health Literacy and Clear Communication
Clinical, Direct Care Experience
Online Conversation Mining
Insights Research
Channel Strategies
Adult Learning andBehavior Change Theory
Educational DesignPositioning
Brand Strategy
Health Education
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Traditional Marketing Focus:How Patients’ and Caregivers’ Lives Fit Into the World of the Brand
This perspective may not allow programs or content to address real world barriers as patients and caregivers make choices and decisions on how to manage their health.
RX
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Our Focus: How the Brand Fits Into Patients’ and Caregivers’ Lives
Surrounding Environment
Values, Emotions, Beliefs, and Attitudes
Knowledge
Support NetworkSelf-efficacy
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5 StrategiesYOU MUST CONSIDER TO
DRIVE EFFECTIVE PATIENT INTERACTIONS
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1. Map the Patient Journey
WHY?
Patient journeys distill insights and translate emotional and environmental barriers to wellness into visual, actionable frameworks
WHAT?An illustration highlighting:• Phases of the brand and/or disease journey• The patient and care partner experience• Landscape metaphors• Clinical treatment overview• Patients’ relationships with core clinicians• Key leverage points and aligned tactics
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Begin by Mining Insights
BrandResearch
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Focus Groups/IDIsEthnographies
BrandResearch
QualitativeResearch
LiteratureReview
Social Media
QuantitativeResearch
Insights MiningSources
Insights Inform the Patient Journey
Barriers
Drivers
SupportNeeds
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Rheumatoid Arthritis
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Hemophilia
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Alzheimer’s
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SNAPSHOTThe Metastatic Melanoma Patient Journey
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2. Identify and Execute a Behavior Change Model
Behavior change models explain people’s behaviors– as well as how they can be influenced to change
• Identify patterns and how educational programs can influence them
• Consider environmental, emotional, social, and behavior characteristics
• Expand understanding about barriers and motivators
• Allow us to “predict” behaviors when coupled with the journey to set up appropriate interventions
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Some of the Validated Behavior Change Models
Health Belief Model
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Social Cognitive Theory
Horne’s Model of Medication Adherence
Cognitive Dissonance Theory
Theory of Planned Behavior
Theory of Reasoned Action
Transactional Model of Stress and Coping
Health Action Process Approach
Stages of Change
…and more!
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Traditional Pharma Model
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Awareness Conversion Initiation Adherence
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The Health Belief Model
Construct Description
Perceived susceptibility
The patients believe they are at risk for the condition or for the condition getting worse
Perceived severity The patients believe the condition is severe and urgent
Perceived barriers The patients’ assessment of the influences that discourage the action
Perceived benefits The patients’ assessment of the influences that encourage the action
Perceived efficacy The patients’ belief that they can adopt the action
Cues to action External influences prompting the behavior
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SNAPSHOTThe Metastatic Melanoma Patient Journey
• Perceived susceptibility
• Perceived severity• Perceived barriers• Perceived benefits• Perceived efficacy• Cues to action
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SNAPSHOTThe Metastatic Melanoma Patient Journey
• Perceived susceptibility
• Perceived severity• Perceived barriers• Perceived benefits• Perceived efficacy• Cues to action
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3. Understand the Clinical Encounter
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The multidimensional dynamics of the healthcare environment and the influencers of patient success
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Recognize the Domino Effect
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SNAPSHOTThe Metastatic Melanoma Patient Journey
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4. Measure Patient Behavior
Focus on showing a measurable incremental positive impact
• Change in skills
• Change in knowledge
• Change in attitudes and behavior model metrics
• Change in behavioral intention
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ACTIVELY DISENGAGED
ACTIVELY ENGAGED
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Where to Find Measurement Opportunities
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Skills
• Enriching doctor-patient communication
• Improving patients’ ability to understand and follow treatment routine
Knowledge
• Increasing patients’ knowledge about their disease and skills to cope with their treatment
Attitudes
• Increasing patients’ perceived benefit of treatment and understanding of the reasons why medication is needed
• Increasing patients’ motivation to begin and stay on treatment
• Setting patients’ expectations about treatment
• Increasing patients’ confidence in their ability to follow treatment regimen
• Reducing fear of possible side effects
• Reducing feelings of stigma because of the disease
Behavioral Intention
• Driving patients to specific calls to action (e.g., join support program, refill script, make an appointment with HCP)
• Increasing patients’ intent to follow medical routine
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SNAPSHOTThe Metastatic Melanoma Patient Journey
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5. Incorporate Health Literacy More Than Reading Health-Related Information
Within healthcare, patients require health literacy skills to:• Find health information• Interact with healthcare providers (HCPs)
They also need the skills to:• Self-manage a health condition• Navigate the healthcare system
Health literacy is defined as:The ability to find, understand, and use basic health information and services needed to make appropriate health decisions
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Low Health Literacy: An Example
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http://www.youtube.com/watch?v=dMAS2S51bM8
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The Impact of Low Health Literacy
90 million Americans are at risk for not acting on health information because of low health
literacy, regardless of age, income, race, or background
The cost of limited health literacy to the nation’s economy is estimated to be between
$106 billion and $236 billion per year
1. Weiss BD. Health Literacy and Patient Safety: Help Patients Understand. 2nd ed. American Medical Association; 2007.2. Vernon JA et al. 2007. Low Health Literacy: Implications for National Health Policy. http://www.gwumc.edu; 2007.
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• Better comprehension = greater adherence• Greater financial impact• Required by governing bodies
Why Utilize Health Literacy Principles?
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Skin Care – Before/After
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Approach: IDPH simplified the language of the letter and adjusted the content to reflect patients’ perspectives
Challenge: To help increase enrollment in its Brain Injury Registry, the Iowa Department of Public Health (IDPH) Brain Injury Services promoted its services to Iowans with a recent brain injury
Using Health Literacy Principles to Improve Response Rates
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15% Response
Rate
4% Response
Rate
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Health Literacy Resources
Centers for Disease Control* www.cdc.gov/healthliteracy
Clear Health Communication www.pfizerhealthliteracy.com
Health Resources and Service Administration* http://www.hrsa.gov/publichealth/healthliteracy/index.html
US Department of Health and Human Services http://www.health.gov/communication/literacy/
Health Literacy Missouriwww.healthliteracymissouri.org
Florida Literacy Coalition www.floridaliteracy.org
A resource library of health literacy resources is also available atSurroundHealth®. Visit www.surroundhealth.net.
©2012 HealthEd Group, Inc*Denotes free training available
Summary
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c
cPulling It All Together
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5 Strategies to Drive Effective Patient Interactions
1.Map
the patient journey
2.Identif
y& execute a
behavior change model
3.Understan
dthe clinical encounter
4.Measur
epatient behavior
5.Incorporat
eHealth Literacy
Thank You!
Liz Carden, MPH, CHESe.carden@thehealthedgroup.com
For More Information, Please Contact:Marissa Addalia
Vice President908-379-2018
m.addalia@thehealthedgroup.com