New "virtual patient" computer models currently being employed in psychiatry could provide the key to better understanding patient non-adherence...
Recently, Albert Rizzo, a research scientist at the University of South Carolina’s Institute for Creative Technologies demonstrated that a pair of new “virtual” patients can help train psychologists and psychiatrists before treating real patients. A healthcare professional can make their initial diagnosis after asking this patient who is programmed with speech recognition software, a series of questions about their healthcare history.
These virtual characters can be modified for different uses, and Rizzo plans to use them to train military clinicians as funded by the U.S. Department of Defence. In addition to this virtual learning, healthcare trainees will benefit from group discussions with other students and supervisors as well as receiving observed on-the-job training with real patients.
As technology progresses, a comprehensive set of virtual patients with numerous diagnoses can be created. So why can we not use similar training for pharmaceutical companies and physicians in order to improve patient adherence?
As Astra Zeneca said previously, ‘taking medication isn’t always as simple as swallowing a pill’. In an eyeforpharma podcast about health psychology and non-adherence, John Weinman, head of the department of health psychology at the Institute of Psychiatry, Kings College London said that some patients ignore or modify treatment advice intentionally because as a human being, they think they know what is best for them. So, patient non-adherence is more than just forgetfulness, cost, ineffective communication or treatment side-effects.
Similarly, an Express Scripts’ 2011 Drug Trend Report showed that although many American patients recognise the importance of adherence, their behaviours do not match their intentions as less than half of them take their medication as prescribed. Furthermore, a UCLA study showed that physician-patient interactions ensured adherence for only 62% of 410 medications while in-depth questions about adherence were asked for only 4.3% of the medications, demonstrating that better methods to recognise non-adherence and change behaviour should be developed.
Additionally, the above research showed that non-adherence was viewed as ‘the patient’s problem’ which according to a Eularis study, is the same view taken by pharmaceutical companies. President of Eularis, a pharmaceutical analytics company, eyeforpharma columnist and author of the report, Dr Andree K Bates said that companies needed to analyse all non-compliance data of a particular brand and realise the financial effect of non-adherence before creating appropriate solutions.
A virtual patient system can create better solutions for patient adherence by mimicking the diversity of patient preferences and characteristics. Although it will only produce results depending on the information it is given, this system can build a range of rare and common symptoms over time.
The pharmaceutical industry could communicate with virtual characters through a series of questions to determine different ways to increase patient compliance whether it is through better communication, regimen guidelines or even packaging. By minimising the occurrence of patient adherence, the pharmaceutical industry would improve their return on investment while giving patients an optimal level of care.
In addition, trainee physicians should also be encouraged to use virtual patients in order to learn about the different kinds of questions that they should be asking to determine non-adherence issues with treatment. Physicians could learn how to discuss different treatment topics with patients such as side-effects, quality of life issues or the importance of sticking to a routine.
Furthermore, a virtual patient could display intentional non-adherent behaviours so that physicians can be taught how to pre-empt a real patient’s ‘I know better’ attitude. Through understanding how to better their communication and listening skills, physicians can change a patient’s behaviour towards their medication.
Patient adherence has always been a difficult issue to understand but a virtual patient system could help to ensure that non-adherence will be easier to tackle in the future. Initially, all current non-adherence data can be used to design various adherence programmes tailored for an individual patient. Over time, more data will be added to the system from interactions with various real patients and better solutions for non-compliance can be created with ease by the pharmaceutical industry and physicians.
Ben Steele talks with Eduardo Tchouhadjian, CEO of E. Tchouhadjian & Associates, about how...
NICE have announced the publication a new set of briefings designed to increase uptake of...
30% of pharma executives expect business as usual, as they admit to expecting blockbuster-type...