Pavlov Had a Point
How can we help patients to overcome the emotional barriers to taking their medicines?
When patients are first diagnosed with a condition, it can be a frightening and disruptive time in their lives. It may also require them to make significant changes in the way they live, which can be difficult to embrace. Whether they are taking a daily pill, giving themselves injections, or going to a health center for treatments, these new treatment regimens — along with diet and exercise mandates — need to be incorporated into their daily routine. All of this requires a behavior change, which may be especially challenging for patients who are not fully on board with making the lifestyle changes needed to positively affect their overall health.
This isn’t just a problem for patients. If biopharma companies, physicians and payers want to improve adherence rates and drive down the cost of healthcare, they need to start thinking about the role they can play in driving behavior changes in these patients.
In a recent customer workshop I led on patient activation at the eyeforpharma Clinical Excellence in May, we met with industry stakeholders to discuss the benefits of taking a more collaborative approach to patient support and creating new touchpoints to help patients get on the right path to their care. The idea of behavior modification as a component of this process came up early in our conversations as a compelling unmet need in the care environment.
We talked about the importance of behavior modification to adherence, the challenges of measuring this element of the care process, and how to overcome resistance to change through customized solutions designed to fit the patients’ needs.
There are many reasons why patients don’t immediately adapt their behavior and conform to their new treatment regimens. For some, their resistance is based in fear about taking medication, for others, it can be driven by procrastination, forgetfulness, or an unwillingness to admit they are sick.
At the workshop, we acknowledged that no single solution, however innovative, would be effective unless it was linked directly back to the obstacle preventing that individual from moving forward with their care. For example, building an app that reminds a patient to take their medicine may be great for someone who is forgetful, but it might not have the same effect for someone who refuses to accept their illness. Similarly, a Fitbit style device might motivate one patient to exercise more, but will be quickly abandoned by someone else who feels too depressed to get up and walk.
We have found that one of the best ways to drive behavior modification is by providing them with access to experts, such as certified nurse educators or a nurse hotline, who can help them understand and overcome their emotional barriers to care.
These programs are successful because the nurse educators are trained to accelerate behavior modification through effective communication and identify the emotional barriers that prevent patients from following through with their therapy. They also can take the time that physicians don’t have to talk at length with the patient about what is preventing them from making good choices. Once nurses are able to tease out these concerns, they can assess their level of risk for non-compliance and give them the tools and confidence they need to move forward on that care journey.
These early live engagements can get patients on the right path to medical adherence at which point these support programs can transition those patients to lower-touch support measures, like email reminders, or follow up calls to ensure patients are staying motivated and to celebrate their successes.
By giving patients early access to an expert and following up with less expensive measures, industry stakeholders can scale their support programs to meet the needs of larger populations of patients with a relatively modest investment.
The ROI of compliance
If industry leaders genuinely want to see adherence rates rise and healthcare costs fall, they need to start taking a more collaborative and engaged approach to providing them with the support they need to handle their disease. Because getting patients to change their behavior doesn’t just benefit those individuals; it lowers the overall cost of care for payers. Patients are less likely to be readmitted to the hospital due to non-adherence to their therapy, and it increases revenues for biopharma companies because those patients are actually filling and taking their prescriptions; maybe even advocating for their therapy to family and friends.
That is a win-win-win scenario that is definitely worth pursuing.
About the Author
Paul Harney, VP, Business Development, Commercial North America, QuintilesIMS