Improving concordance: Its all about how you say it
Effectively promoting concordance relies on well tailored and implemented communication with patients and healthcare providers, Eugene Osei-Bonsu, senior product manager at Shire Pharmaceuticals told attendees at eyeforpharmas recent Patient Compliance Europe 2008 event.
But to effectively communicate with patients and their physicians, pharma companies must first understand the magnitude and complexity of the problem, he says.
A 2003 study by the World Health Organization concluded that at least 50% of the medicines prescribed for long-term illnesses are not taken as directed in developed countries and the problem is even worse in developing nations. And Osei-Bonsu says the report confirms that effective interventions are elusive.
Practical and perceptual barriers
Non-adherence, he says, stems from a variety of barriers. Practical barriers, including difficulties with treatment regimens and complex dosing, result in forgetfulness leading to unintentional non-adherence by patients. But the difficulties dont end there for many patients, Osei-Bonsu says. Many also struggle with perceptual barriers, including beliefs about the medicine itself, such as harmful long-term effects, and their disease state, that lead to intentional non-adherence.
In a survey conducted in 2006 by the UKs National Kidney Federation, many patients with kidney disease needed more information about hyperphosphatemia and its consequences, using medicines well and treatment and lifestyle options, he says. And materials providing patient information needed to:
Be accessible and engaging
Act as a trigger for discussion between patients and healthcare professionals
Address areas where research showed gaps in patient understanding
Fill the gap in an easy to use format
So Shire, with the help of Transart and McCann, developed a patient communication program called KidneyCare. The programs content was designed with input from both patients and healthcare providers.
Osei-Bonsu says patients contributed greatly by sharing their experiences and tips in plain English, making it easier to keep patients and stakeholders I the loop and to focus on their needs. We really wanted to hear from patients and caregivers, he says.
Simply effective
KidneyCare relies on a folder with a CD-ROM that communicates effectively with patients by encouraging an active approach to learning that engages patients, Osei-Bonsu says. It offers flexible ways to learn, utilizing video, animations, and interactive learning tools, he says.
The program also makes the risk of non-compliance clear in unthreatening ways, Osei-Bonsu says, particularly via its for patients, by patients approach.
In parallel, KidneyCare enables healthcare professionals to guide patients to information specific to their needs, creating a context and trigger for discussion on concordance challenges such as medication, diet and lifestyle, he says. The materials help physicians structure and manage discussions with patients, thereby improving communication and overall concordance, Osei-Bonsu says.
Through features such as practical self-reporting tools that help patients track their treatment and lifestyle better, patients are empowered to take a more active role in their treatment and make more informed choices. The program also brings issues, such as managing water intake, to life with learning tools that are easy to use, engaging and informative.
Osei-Bonsu says effectively rolling out a program like KidneyCare relies on quickly embedding it with key customer care teams in the field. Shire distributed KidneyCare to select pilot units in March 2008, he says, in time for World Kidney Day.
So far, Osei-Bonsu says, patient and physician feedback has been very positive. Patients report the program is easy to use, relevant, helped to improve their knowledge of kidney disease. But perhaps the best news when it comes to improving adherence is that patients say the program helped them feel more comfortable and not so scared about their condition, he says.
Clearly Shire has found a way to effectively communicate with its patients that is delivering the kind of value necessary to move the needle on patient concordance.
To learn more about patient compliance programs, make plans to attend eyeforpharmas Patient Adherence USA conference in Boston, October 23 -24. For more information and to register, visit www.eyeforpharma.com/pcusa08/
Author: Lisa Roner, editor, eyeforpharma