Keith Petrie, a professor of health psychology at the University of Auckland and a speaker at eyeforpharma’s upcoming Patient Compliance and Communication Europe conference in London June 11-12, 2008, says when patients are diagnosed with an illness, they generally develop an organized pattern of beliefs about their condition that can be a key determinant of how they manage their illness. Petrie, who works closely with Atlantis Healthcare (www.atlantishealthcare.com) – platinum sponsors at the compliance event, says it is a dynamic process that changes in response to shifts in patients’ perceptions of their illness.
But despite the importance of the patient perspective, their views of their illness or symptoms are rarely sought in medical interviews and often are not discussed by patients with their doctors. Better understanding how patients view their illness could open up significant opportunities for the pharma industry to improve patient adherence to medications.
Mental models
Petrie says that patients, when faced with a new health threat, actively build mental “models “of the threat that determine how they will respond. The models are based on their own medical knowledge and personal experiences with others, such as family members, with similar symptoms or diagnoses.
The patient’s model of his or her illness, he says, often guides the patient to minimize the danger of the symptoms or illness and prompts coping strategies aimed at reducing the emotional response to their condition. And there is a consistent pattern to the way patients make their mental models, Petrie says, based on five main interrelated components: identity of their illness and beliefs about its cause, timeline, control or cure and consequences.
When people are diagnosed with a condition, they soon develop beliefs about the symptoms caused by the illness, Petrie says, but their views regarding symptoms may vary significantly from those of the medical staff treating their condition. Patients, he says, often misattribute side effects of their treatment or even other commonly occurring, but unrelated symptoms to their illness.
Soon after being diagnosed with an illness, patients develop beliefs about the cause of their illness, which often include perceived impacts of modern life such as stress and pollution. Petrie says causal beliefs are important in some illnesses because they can influence the types of treatments that patients seek or the lifestyle changes patients make.
Patients also develop “timeline” beliefs ranging from acute to chronic, Petrie says. Many patients see their illness as cyclical, depending on external influencers such as stress. These beliefs can have important impacts on patient adherence to medication, he says, with those who perceive their illness as acute being more likely to abandon their medicines and other treatments.
These timeline and causal beliefs also are closely associated with what patients believe about the control and cure of their illness and the consequences of their illness and treatment, Petrie points out.
Just ask
But in clinical settings, patients are rarely asked about their view of their illness, despite studies that show perceptions are closely related to health outcomes, he says. Studies show that patients with negative perceptions of their illness have increased chances of future disability and slower recoveries, regardless of the severity of their condition, Petrie says.
This begs the question of whether patients’ recoveries can be improved if their illness perceptions can be modified early in the recovery process, he says. Recent research suggests that illness perceptions may be changed with appropriate interventions.
The first step, he says, is to understand how patients view their own illness. Often patients lack basic knowledge about their condition, Petrie stresses. And that opens real opportunities for healthcare stakeholders, like the pharma industry, to step in and alter illness beliefs and patients’ compliance with their medications.
“Historically, pharma’s focus has been on doctors, but that needs to shift more toward patients and how they view their illness,” he says. “If we can help patients determine a long-term view of their illness, they’re much more likely to be adherent.”
To learn more about how patients think about illness and how to improve patient compliance, be sure to hear Petrie speak at eyeforpharma’s Patient Compliance and Communication Europe conference in London June 11-12, 2008.
Contact Atlantis Healthcare:
Zoe Williams - zoe.williams@atlantishealthcare.com
Josh Taylor - josh.taylor@atlantishealthcare.com
+44 (0) 207 937 9793
Author: Lisa Roner, editor, eyeforpharma
