Adherence is one of the hottest topics in our industry today, largely because we’re becoming more aware of the fact that it’s one of the biggest stumbling blocks facing us. We know, for instance, that about a third of first-time prescriptions don’t get filled, and about 50% of patients don’t take medications exactly as prescribed.
There are multiple reasons for issues with adherence. Patients are skeptical. Or they believe the condition will resolve itself. Finances, worry about side effects, and focus on other life details all contribute to lack of compliance. The reasons can even differ by drug or condition for a single patient. This isn’t the fault of the patients, and we cannot ask physicians to take all the responsibility for addressing it. What we can do to help is rev up our marketing, as has been happening lately. New programs, campaigns and strategies are being developed all the time to encourage, remind, educate and incentivize patients at the point of care, so both patients and the industry benefit. After all, if they’re not taking it, we’re not selling it.
Here are a few general rules we’ve learned about helping practitioners, patients and pharma:
Five Basic Rules for Improving Adherence
1. You’re a patient—think like one. Don’t think like a marketer, think like a patient. We put out well-intended messages and believe that these will “convince” the patients they should take their prescribed remedy. But it doesn’t work that way. For instance, you may resist because you don’t want to be thought of as a “sick” person. In your complicated day, details (like taking your meds) may elude you. Does your physician have time to discuss the full prescribing information to you, or are you just told to “try this”? Do you sometimes think “missing a day or two can’t really hurt”? Or maybe you heard from a friend that they had a better result with a different medication. All of these and more can interfere with a proper course of treatment. We have to find messaging and marketing to overcome every kind of resistance.
2. You’re not a doctor, but you have to think like one anyway. Physicians have less time than ever to spend with patients. Getting a full 15 minutes with a patient means talking about the critical questions. But a doctor might not discover whether the lack of efficacy is due to the medication, the dose or just the fact that the patient missed 30% of their doses. This is why there’s so much focus on helping doctors with supplementary materials to help patients self-identify their own obstacles and to reinforce the rationale for taking the drug—personalized to the individual. Electronic and print documents, apps to use at work and at home, videos, and take-home reminders all can help meet the diverse needs of both new and long-term patients.
3. Let’s help the doctor-patient conversation. An important factor to remember is that you’re not replacing but assisting the doctor. It’s important to know, through market research, sales force feedback or other means, what healthcare professionals in your target demographic are saying to their patients, the degree of confidence in the drug that the prescriber conveys to the patient, and what kinds of help they would welcome for which kinds of patients. As the closest contact to the patient, they can provide valuable insights into what works and what doesn’t work.
4. Some patients are e-savvy, others aren’t. While we tend to place a lot of focus on digital communications and social media, there is still a large contingent of patients (especially in the senior population that sees doctors more often) who either don’t pay much attention to electronic devices or prefer to have their medical materials available in different or even multiple formats—including print. Also a factor is where the information comes from; anything directly from a trusted physician or pharmacist carries more weight.
5. Keep it simple, but repetitive. And the final, perhaps most important point: adherence is about sticking to it. That’s why the point-of-care definition has expanded to include communications at offices, at the pharmacy, and at home. We can’t yet predict which patients will respond to which medium or message, so we can get the most impact when we use multiple channels to reinforce a consistent message. Let’s talk to patients where they are, in the ways that they find useful and comfortable, and understand that, like us, they’re helped by frequent and friendly encounters that acknowledge that adherence can be a challenge but that relevant help is available.