adherence begins before treatment: exl adherence summit presentation

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

©2012 HealthEd Group, Inc 3

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


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


Our Focus: How the Brand Fits Into Patients’ and Caregivers’ Lives

Surrounding Environment

Values, Emotions, Beliefs, and Attitudes

Knowledge

Support NetworkSelf-efficacy


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

©2012 HealthEd Group, Inc

Begin by Mining Insights

BrandResearch


Focus Groups/IDIsEthnographies

BrandResearch

QualitativeResearch

LiteratureReview

Social Media

QuantitativeResearch

Insights MiningSources

Insights Inform the Patient Journey

Barriers

Drivers

SupportNeeds


Rheumatoid Arthritis


Hemophilia


Alzheimer’s


15©2012 HealthEd Group, Inc

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


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


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




• Perceived susceptibility

• Perceived severity• Perceived barriers• Perceived benefits• Perceived efficacy• Cues to action

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3. Understand the Clinical Encounter


The multidimensional dynamics of the healthcare environment and the influencers of patient success

25©2012 HealthEd Group, Inc 25

Recognize the Domino Effect

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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


ACTIVELY DISENGAGED

ACTIVELY ENGAGED

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Where to Find Measurement Opportunities


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


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


http://www.youtube.com/watch?v=dMAS2S51bM8




©2012 HealthEd Group, Inc. 34

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.


• Better comprehension = greater adherence• Greater financial impact• Required by governing bodies

Why Utilize Health Literacy Principles?


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


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


c

cPulling It All Together


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, [email protected]

For More Information, Please Contact:Marissa Addalia

Vice President908-379-2018

[email protected]

adherence begins before treatment: exl adherence summit presentation

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