patient profiling - psoriasis · • patient history with psoriasis ... plot your scores on the...
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Patient profiling
Dr Anthony Bewley
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Who is your patient and what do they want to hear?
• What are your patient’s ideas, concerns, expectations (ICE)?
• How much do they already know about their psoriasis?
• Is your patient more concerned about appearance, itching or the inconvenience of applying treatments?
• What do they expect from their treatment and are they likely to adhere to the treatment regimen?
• Given limited consultation time, being able to profile your patient should improve the quality of consultations as well as making that time more effective
• Understanding that your patient’s profile may change over time will enable you to tailor their management accordingly
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Large, multinational study to help understand different patient types who might benefit from individualised interventions
Identifying patients who are in need of additional support
Countries participating in the study
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Research insights: study design
UK FR DE ES IT US CA Tot
608 571 488 577 358 609 611 3822
Stage 1 – Qualitative
• Ethnographic study of 56 patients with psoriasis
• 42 respondents studied for 1 day
• 14 respondents studied for 2 days
• Countries: UK, France, Germany, Italy, Spain, USA, Canada
• Online methodology, 40 minutes
• 3822 patients with psoriasis*
• Markets:
• Patient criteria
• 18 years old or over
• Suffer from psoriasis and/or psoriatic arthritis
Qualitative stage guided development of the quantitative questionnaire and sample
Stage 2 – Quantitative
Stage 1 – Qualitative
*Includes the 1884 patients currently using prescription treatments for psoriasis that are reported in Bewley et al. J Eur Acad Dermatol Venereol 2014;28:763–770
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Profiles are based on key intrinsic, behavioural and attitudinal characteristics
• Patient history with psoriasis
• Burden of disease/treatment (Quality of Life; QoL)
Intrinsic characteristics Differentiating behaviours
Differentiating attitudes
◦ Treatment choice
◦ Frequency of HCP visits
◦ QoL impact
◦ Satisfaction with current medication
◦ Receptivity to new treatments
◦ Trust in HCPs
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Research insights: understanding patients
Self-manager40%
Why me?28%
Help me16%
Activelyengaged16%
High
High
Low
Low
Burden of disease
Engagement with treatment
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Four patient profiles developed
Why me?
40%
16%28%
Self-manager Actively engaged
16%
Help me
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The four segments all have distinct problems with prescription topicals
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Self-manager
Irregular treatment (mix
and match/fire fighting)
caused by a fear of side
effects and an unmet
need for more specific
treatments
Actively engaged
The burden of treatment
is high (time, yuckiness),
but due to satisfaction
with efficacy, PTs are
used compliantly
“I must improve my condition,
so compliance is essential.” “I know cortisone creams help –
but I use them only sometimes.”
“There are no creams that help,
so why bother then?”
“Creams are creams, a waste of
time – I want real medicine.”
LOW DISEASE IMPACT HIGH DISEASE IMPACT
Why me?
Dropped out after a
frustrating experience
of trial-and-error with
PTs
Help me
Deep disappointment
with efficacy of PTs,
therefore not considering
them as proper medical
treatment
PTs are still a compromiseAmong PTs, there are not enough choices
Overall low involvement with medicine Given up on PTs and the HCS
HCS, healthcare system; PT, psoriasis treatments
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Profile: Self-manager
Self-manager
40%
• Tend to have the most positive outlook on life• Psoriasis has least impact on quality of life• Not as likely to be current users of prescription medicine;
would avoid using treatments unless necessary• Least receptive to new treatments• Refer to psoriasis information least frequently• 72% have mild psoriasis
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Why me?
28%
• Psoriasis not as severe as ‘Help me’ group;
however, not coping that well with psoriasis
• 50% use prescription medicine; 33% use
non-prescription medicine
• Not as satisfied with topicals; would try to avoid
prescription medicine unless necessary
• Least trusting of their HCPs
• Least adherent segment (41%)
• 53% have moderate psoriasis; 35% mild
Profile: Why me?
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Profile: Help me
Help me
16%
• Tend to have the most negative outlook
• Highest percentage of body affected by psoriasis
• Psoriasis has highest impact on quality of life
• Tend not to have a good relationship with their HCP
• Most receptive to new treatments
• Refer to psoriasis information the most frequently
• 57% have moderate psoriasis; 32% severe
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Profile: Actively engaged
Actively engaged
16%
• 40% use prescription medicine and 40% use
non-prescription medicine
• Have the most positive relationship with their HCP
• Tend to trust their HCP the most
• Tend to have a good level of satisfaction of topicals
• The most adherent segment (54%)
• 56% have moderate psoriasis; 33% mild
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PROFILING YOUR PATIENTS
Interactive session
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Dr Yi Zhao
Table 10
Professor Xibao Zhang
Table 9
Dr Niranjan Ariyasinghe
Tables 3 & 4
Dr Masatoshi Abe
Table 6
Dr Anwar Al Hammadi
Table 5
Your facilitators
Professor Min Zheng
Tables 7 & 8
Professor Sameer Zimmo*
Tables 1 & 2
*Global faculty member
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Answer key questions about your patient to assist in profiling
• Burden of disease
• Engagement with treatment
Help meSelf-manager Actively engagedWhy me?
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Questions about burden of disease
Psoriasis disease impact
Psoriasis stops you from doing everyday tasks…
You feel unhappy about your skin…
Your psoriasis affects your relationships with people…
Your psoriasis affects your sleep patterns…
Your psoriasis affects your confidence…
Your psoriasis stops you from socialising, going out or playing sports…
Your psoriasis flares…
Your psoriasis is itchy…
OVERALL your psoriasis affects your quality of life…
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Questions about engagement with treatment
Patient’s engagement with treatment
Your treatment makes a difference to your skin
You like your treatments
You follow the treatment regime recommended to you by your HCP
Your lifestyle doesn’t interfere with your regime
Treatment really works for your psoriasis
You understand how using your treatment helps you
You like going to see your doctor/nurse/HCP
You have time to use your treatments
OVERALL you are satisfied and engaged with your treatment plan
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Plot where your patient ‘scores’ on the two axes
Plot your scores on the graphs provided and try to identify which patient group or ‘profile’ best fits the description of your patient
Agree
Burden of disease
Engaged with treatment
Agree a bit
Disagree a bit
Disagree
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Plot where your patient ‘scores’ on the two axes
Plot your scores on the graphs provided and try to identify which patient group or ‘profile’ best fits the description of your patient
Agree
Burden of disease
Engaged with treatment
Agree a bit
Disagree a bit
Disagree
Self-manager
Why me Help me!
Actively engaged
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Plot where your patient ‘scores’ on the two axes
For example, this patient is highly engaged with treatment, with occasional disease burden…
Agree
Burden of disease
Engaged with treatment
Agree a bit
Disagree a bit
Disagree
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Self-manager
Plot where your patient ‘scores’ on the two axes
…it is likely that they are in the ‘self-manager’ category
Agree
Burden of disease
Engaged with treatment
Agree a bit
Disagree a bit
Disagree
Why me Help me!
Actively engaged
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Plot where your patient ‘scores’ on the two axes
Plot your scores on the graphs provided and try to identify which patient group or ‘profile’ best fits the description of your patient
Agree
Burden of disease
Engaged with treatment
Agree a bit
Disagree a bit
Disagree
Self-manager
Why me Help me!
Actively engaged
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Timing
• 40 mins to work through the case study and profile the patient as a group
• 15 mins discussion within your group• How you might adapt your consultation for this patient
• What information would you provide this patient
• 15 mins feedback/discussion with the wider group
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We identified different means to increase the segments’ satisfaction with prescription topical efficacy
Self-managers require…
• Focused treatments with short-term results
• Treatments that live up to their fear of side
effects (especially their reluctance towards
steroids)
• Products specialised in reducing visibility
Actively engaged require…
• Further improved products (regarding
efficacy and burden of treatment)
• A sustainable treatment
•Informed about new treatments
LOW DISEASE IMPACT HIGH DISEASE IMPACT
Why me? require…
• Effective and low burden medical
treatments
• A better and less confusing understanding
of psoriasis
• An environment that understands and
cares about their psoriasis
Help me require…
• Conviction that products have real
medical value
• A systemised treatment regimen
• Clearer instructions and increased care
• New hope, quick wins