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APRIL 24 TH , 2014. PATIENTS WITH MULTIPLE MORBIDITIES:. Refocusing the Communications Lens on a DTC “ Blind Spot ”. A Condition-Centric Paradigm. DIABETES. Diabetes. High Cholesterol. Flip the lens to a patient-centric view, that takes multi-morbidity as a fundamental axis of analysis.
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APRIL 24TH, 2014 PATIENTS WITH MULTIPLE MORBIDITIES: Refocusing the Communications Lens on a DTC “Blind Spot”
A Condition-Centric Paradigm DIABETES
Diabetes High Cholesterol Flip the lens to a patient-centric view, that takes multi-morbidity as a fundamental axis of analysis Heart Disease Depression Hypertension OA
Over 65s • 12% US population in 2000 20% by 2030 • Healthcare costs will account for 25% of US economy by 2037 • 50% are living with 2+ chronic health conditions Sources: U.S. Census, Congressional Budget Office, CDC
Hypotheses: Diabetes ≠ High Cholesterol Heart Disease Diabetes Depression Hypertension OA Need to address them in very different ways, to connect with and motivate them via effective marketing strategies.
Implications for their… • Unmet needs from the healthcare community and pharmaceutical companies • Relationships with HCPs • Treatment attitudes and behaviors including compliance and adherence • Receptivity and response to DTC communications.
Methodology – Type II Diabetes Test Case • Thought leader interviews with academic physicians • Psychologically oriented focus groups • Art hypnosis groups • Survey (n=2,000 Type II diabetes patients) • Diabetes Only • Diabetes +1 other Condition • Diabetes + 2-3 other Conditions • Diabetes + 4-5 other Conditions • Diabetes + 6 or more other Conditions
MOST COMMON • CO-MORBIDITIES • High Cholesterol • Hypertension/High Blood Pressure • Obesity • Sleep Apnea • Osteoarthritis • Depression • Heart Disease • Asthma • Neuropathy • All diagnosed with Type II Diabetes • 9 out of 10 diagnosed with at least one additional condition • Average # diagnosed health conditions = 4.1
NUMBER OF CONDITIONS NUMBER OF CONDITIONS COMPLIANCE & ADHERENCE COMPLIANCE & ADHERENCE
Just adding one additional condition on top of diabetes impacts compliance dramatically % of Patients Compliant with Rx Directions Diabetes Only Diabetes +1 Diabetes +2-3 Diabetes +4-5 Diabetes +6 or More
And, as more conditions are diagnosed, patients begin to prioritize which ones they’ll treat % of Diagnosed Conditions Being Treated Diabetes Only Diabetes +1 Diabetes +2-3 Diabetes +4-5 Diabetes +6 or More
Nearly one full workday a week Hours per Month Attending to Conditions “I get angry and I just want to explode. So many drugs you have to handle, and doctors you need to see.” Diabetes Only Diabetes +1 Diabetes +2-3 Diabetes +4-5 Diabetes +6 or More
I went to the drug store to pick up high blood pressure medication, $146 for 30 days. I finally said no I'm not taking it. All of the different meds are expensive. I have had to prioritize drugs. Sometimes that even means missing meals.
“Diabetes restricts my lifestyle” Diabetes Only Diabetes +1 Condition 51 26 % % AGREE AGREE
% Reporting Practical Impact ofMulti-Morbid Conditions on their Lives
% Reporting Emotional Impact of Multi-Morbid Conditions on their Lives
If it came to life as an animal, diabetes would be… DIABETES-ONLY: “Nagging” “Irritating” “Annoying” “Keep having to think about it” “Distracting”
If it came to life as an animal, diabetes would be… DIABETES + 6 “Threatening” “Lethal” “Terrifies me” “Sinister” “Deadly”
“Diabetes impacts my self-image” Diabetes Only Diabetes +6 Conditions 63 28 % % AGREE AGREE
“I want to feel like a whole person, a full man, I've always been able to protect and defend myself and family and now with these ailments, I'm concerned about that.” “My libido is not nearly what it once was, and it does affect my manhood. It bothers the hell out of me.” Social self impacted Sexual self impacted
I'm stressed, I feel like any moment I'm going to explode emotionally. I'm not taking any more pills. Everything is being ripped apart. I'm ready to lose it. I'm at the breaking point. “ Fear and anger at the same time. I feel like screaming at the top of my lungs from the highest mountain. I felt as though it was going to be a hard road. It was too overwhelming, it was so long. And there was really nothing at the end of the road. It's heart breaking. I feel like I’m beyond help. I feel like I have failed at health.
% Reporting Emotional Impact of Multi-Morbid Conditions on their Lives Diabetes +1 Diabetes +2-3 Diabetes +4-5 Diabetes +6 or More
“I have been entirely open in sharing how it has impacted me emotionally” Diabetes Only Diabetes +6 Conditions 27 54 % % AGREE AGREE “Nobody knows what is going on.”
“Strength” “Mindfulness”
“Awareness” “Focus” “In control”
“Not Giving Up” “Hopeful” “Courage”
“Lost” “Life washed away” “No safe place” “Overwhelmed” “Hopeless”
“Sadness” “Disintegrating” “Lost the life force”
“Lonely” “In need” “No anchor” “Welcoming the relief of death”
DIABETES ONLY DIABETES +4 Draw how you see yourself, living with diabetes/diabetes and your other conditions
The more conditions they live with, the less understood they feel by advertisers Degree to Which Ads Make Them Feel Understood “The ads aren’t talking to me - they have no idea what it is like for me.” “If I heard messages about people living with multiple conditions I’d feel less alone.” Diabetes Only Diabetes +1 Diabetes +2-3 Diabetes +4-5 Diabetes +6 or More
Diabetes High Cholesterol Heart Disease DIABETES DIABETES Depression Hypertension OA