1 / 38

Patient Information in an Era of Change

Patient Information in an Era of Change. Louis A. Morris, Ph.D. Senior Vice President PRR, Inc. Communications Change. Source from HCP to Manufacturer Channel from personal and print to mass customization internet Message from health education to marketing Audience

afya
Download Presentation

Patient Information in an Era of Change

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Patient Information in an Era of Change Louis A. Morris, Ph.D. Senior Vice President PRR, Inc.

  2. Communications Change • Source • from HCP to Manufacturer • Channel • from personal and print to mass customization • internet • Message • from health education to marketing • Audience • from dumb terminal to active decision maker

  3. Thesis • Redefinition of communications structure creates new opportunities • We need new thinking • marketing approach to patient education • Implications for Pharmacy • public health advocates • implementers of cultural change • who pays?

  4. Patient Info Sources: Traditional Face to Face Mass Media Help Seeking/ Reminder Ads Through HCPs Manufacturer Through HCPs Public Service Ads Independent

  5. Patient Info Sources: Modern Face to Face Mass Mass Media Customization 1-800 #s Registries Manufacturer DTCA HCPs - Start Kits Public Relations Database Marketing Infotisements Independent HCP/Com- mercial PSA/En- dorsemts HCPs

  6. Blending • Starter Kits - info packages • Disease/Drug Newsletters • Registries • Clinical Experience Trials • Direct mail • Ads in direct mail pubs • Ads in patient information at Pharmacy

  7. Blending on the Internet • Is it independent content or an ad? • What is the Source? • Search Engine Results? • Paid Linkages? • Future Increase in Internet Use • Multimedia Content • Faster Access, Smart Slaves, Always On less active search, more passive use

  8. Blending - Resch Questions • How important is source credibility in patient information? • How important is face-to-face? • Hi tech/Hi touch • How does this affect pharmacy? • Pharmacist rated highest in credibility • Pharmacists viewed as most accessible • Ability to take advantage?

  9. Why DTCA? HCPsMCOsPat’s Gatekeeper + + ++ Influencer +++ + ++ Therapy Selector +++ + + Buyer + + User + ++

  10. Message Evolution • User: • “Finish all your medicine, even if you feel better” • Gatekeeper: • “The doctor has treatment programs that can help” • Influencer: • “Easy to swallow”

  11. New Messages • User: Medication Compliance - Will there be a rebirth? • Barrier Assessment Tools • AARDEX (MEMS Monitor) as a feedback tool • Influencer: Quality of Life • FDA barriers • Implicit, “benefit-related” messages • symbolism

  12. Message / Audience Interaction: Patient Information Processing • Willingness and Ability to Learn • Motives - Message Involvement/Goals • Ability - Literacy/Self-efficacy • Opportunity - Task Constraints • Perceived and Actual Cognitive Load • Simplification • Signals

  13. Audience Tailoring - Stages • Smoking Cessation: • Precontemplation, Contemplation, Preparation, Action, Maintenance • Abstinence at 18 mo: • Single Brochure 11.0 • Individualized to Stage 18.5 • Interactive feedback 25.2 • Personalized (calls) 18.0 Velicer et al., 1993

  14. Information Search Clusters Factors Ambivalent Uncertain Risk Assertively Learners Patients Avoiders Self-Reliant n=140 n=132 n=200 n=153 Information Involvement .502 .069 -.275 -.160 Self-Care Orientation -.124 .575 -.483 .249 Regimen Barriers .170 1.056 -.563 -.365 Information Avoidance 1.167 -.603 -.327 -.121 Risk Aversion .239 .056 .302 -.664 Question- Asking .013 -.163 -.542 .838

  15. New Role for Pharmacy • Message Tailoring • New “diagnostic” tools? • Feedback Provider (Compliance Coach) • Computer records to measure refill compliance • Financial Barriers • Can this be provided through manufacturer • mass customization? - privacy favors Pharmacy • Pharmacist user fees?

  16. New Role for Pharmacy (2) • Location for services: • in pharmacy (face to face) • in central location (mass customization) • Activity • initiator or responder to patient requests • passive or active service implementation

  17. Health Education and Marketing • Health Education: • combination of interventions to change behavior (info transfer) • select by “what works” • focus on trials to establish efficacy • Marketing • facilitating equitable exchanges (2 way flow) • select by communications goal • focus on efficient resource use

  18. Marketing Perspective Health Behavior Change is more likely if: • people are involved with healthcare decisions • educate and empower patients • people actively plan how to comply • planning helps overcome barriers • health professionals teach and explain treatment • people do what MDs and RPhs tell them to do 3 Inverse Relationships

  19. Behavior Change Persuadable (weak messages) Low Involvement High Involvement

  20. Behavior Maintenance Ease of Adoption Thought/Planning

  21. Behavior Change Frequency/ Reach Complex Messages

  22. Marketing Insights • People Change Behavior • when it is easy • when they want to • when it serves their needs/interests • People Maintain Behavior • when they internalize beliefs/culturally driven • Population Interventions: Cost-effectiveness • Targeting/Relationships/Market tests

  23. When is 7% change successful? • Health Education • significantly better than control • depends on sample size • Marketing • major success • define in terms of $$ made, share of market, meeting projections

  24. Relationship Era Time Era Attitude 20’s Production A Good Product Sells Itself 50’s Sales Creative Advertising 80’s Marketing Find a Need and Fill it 90’s Relationship Long-term Relationships

  25. Pharmacy • Pharmacy as Cultural Change Agents • technology, cross-(sub)cultural, dramatic events • intercept strategies for nonsearchers • tailoring interventions • Take advantage of relationships • database marketing • How to make it pay?

  26. Why Pharmacy? • Credibility (Expertise and Trust) • Decision making - Framing • Accessibility • Close to the Consumer • understand people’s interest • Existing relationships • keep info private

  27. Segmentational Bases • Demographics- age, gender, literacy • Disease- severity, stage, timing • Geographies- location, Prizm characteristics • Psychographics- Customized AIOs, VALS • Volume- % consumed, concurrent therapy • Outcome- responders, compliers, QoL • Benefits Sought- motives for therapy, info

  28. Implications for Pharmacy • Credibility • Economics - little face-to-face • lost opportunity - OBRA ‘90 • New Switches • renewed call for 3rd class of drugs • Nutrition Supplements

  29. Historical Perspective “Let no physician teach the people about medicines or even tell them the names of the medicines, particularly the potent ones, such a purgatives, opiates, narcotics, abortifacients, emetics or any other which are particularly dangerous: for the people may be harmed by their improper use. This under penalty of forty shilliings” -Royal College of Physicians, 1555

  30. Why Advertise to Consumers? DTC Promotion MD Patient Manufacturer RPh

  31. Objectives • Why advertise to consumers? • How is consumer marketing different? • What role does FDA play? • What will be the ultimate effect of DTC?

  32. 8 FDA Concerns • Reminder/Institutional • Implied Claims • Disclosure Adequacy • Contextual Fair Balance • Limits on Effectiveness • Overall Fair Balance • Unsubstantiated Claims • Distractions “RID the CLOUD of DDMAC Response”

  33. DTC Considerations • Hot, Hot, Hot • FDA Guidance relaxes TV disclosures • $800 mil in 1997, $1.3 bil in 1998 • Multiple Media • TV, magazines, internet, professional distribution, direct mail, outdoor • Different Challenges and Still Learning • FDA Very Sensitivity to TV: 11 of 20 DTC ads had an FDA letter

  34. What Evidence Suggests: Hypotheses • DTC increases MD visits (Pravacol) • DTC increases patient requests for drugs • People want risks but info may be confusing • Physicians still don’t like it (fluid) • MCO hate DTC • Risk information may be problematic • may also detract from benefits • Additional disclosures may be problematic • information overload, supers have min impact

  35. What Evidence is Needed: Too Early to Form Hypotheses • How are TV claims interpreted? • Uses / risks / info availability • How prices/costs/liability will change? • Impact on consumer as influencer, user • Cumulative effects (trivialization) • What is a “positive/negative” outcome? • Eye of the beholder, consensus needed • Need research agenda

  36. Truthfulness, Balance, Disclosure • Roth: • 1/3 of ads lack fair balance (unclear what definition was used) • General Concerns • Multiple streams of info (see pictures, hear/see words, hear background)/ Limited take away (only 49% of supers are comprehended) • Explicit and Implicit Claims • Limited internal “context-availability” • Disclosure as a remedy?

  37. Future of DTC • More, More, More • Patient as central in future marketing • Marketing as part of drug development • Mixed Media • campaigns designed to “move through process” • Pharmacists as Implementers • passive or active role?

  38. Audience Evolution • Information Hungry Segment • Remains Stable for 2 Decades (about 12%) • Heterogeneous Elderly • Multiple Meds • Aging Boomers • More willing to question HCPs • Service Directed

More Related