Meeting summary by Carol Kasik

[You can see Prof. Parhar’s slide presentation here.]

Non-adherence or poor compliance is not new and has always been difficult to manage, yet it is a growing concern among healthcare professionals and the pharmaceutical industry. So why haven’t we done anything yet? ... And why are we still talking about this when products have been promoted for years?

Jas Parhar, Professor of Healthcare Marketing, Rotman School of Management, U of T

Pharmaceutical companies have been concentrating their efforts in two areas:
getting to new patients and retaining existing patients (adherence to treatment). Professor Parhar questions the way pharmaceutical products have been promoted and brings our attention to the “patient.” Are we targeting the end-user (i.e. patients) the right way; do we fully understand their needs?

Several factors have to be considered when trying to understand patients. First, patients can be separated in two different compliance groups:

Unintentional non-compliance
These patients don't understand the appropriate use of medicines; they take them at the wrong time or the wrong dose; they don't understand the instructions or they simply forget. This can be managed by counseling patients since they are motivated, yet they need assistance. This is where compliance aids such as dosettes and prescription refill reminder phone calls are helpful.

Intentional non-compliance
These patients choose not to comply with a medical regimen, reflected in unfilled prescriptions or filled prescriptions not taken, or where patients refuse treatment. This is more difficult to solve because it is rooted in patients’ beliefs and attitudes.

Table 1: Six Patient Types. (Click for larger view)

Secondly, we need to consider that all patients are not the same. Attitudes vary towards their medication and healthcare providers. This has direct impact on how much they comply with their prescribed treatment (both pharmacological and non-pharmacological). In addition to this, Behaviour affects the compliance to their treatment, their relationships with their healthcare providers, and the value they seek from them.

The complexity continues since we now have to look at six different patient types: skeptical, confused, resigned, concerned, confident and proactive.

Professor Parhar has four recommendations for enhancing adherence:

#1.Think in New Ways to develop deep patient insights

There is an immediate need to find a new way to think when marketing pharmaceutical products, thus a new paradigm shift. This will allow getting into a mindset to start looking at things from patient eyes, developing empathy and developing deeper insights. The shift needs to be done at four levels:
1. Move from Product to Customer Solution
2. Move from Promotion to Communications
3. Move from Price to Costs
4. Move from Place to Convenience

#2. Consider pharmacists - they are an important part of your marketing mix

With their busy practice, physicians don’t have the time to properly council patients, so the need to find an alternative route is needed. Pharmacists can now offer council to patients through MedsCheck. This unique program helps patients understand the benefit of taking their medication regimen and how it can make a difference in their lives. This is a one-to-one patient-consultation (~30 minutes) once a year, to assist them with complying with their prescription medications, drug interaction and other over-the-counter medication they may be taking.

#3: Help pharmacists help you

Facilitating the MedsCheck process can help significantly improve revenue & patient outcomes.

#4: Encourage Physicians to Prescribe MedsCheck

MedsCheck has the possibility to include other healthcare professionals (physicians, nurses) for a continuum of patient care. With patient consent, they may request a copy of the patient's Personal Medication Record or MedsCheck Medication Review form that the pharmacy provides to the patient. This allows them to compare it to the current patient chart information or to utilize it for medication reconciliation. The MedsCheck form can also be used for hospital admission planning.

The bottom line is that improving patient compliance can save lives and reduce health care costs. Through customized patient strategies the paradigm shift can be started.

About the Author:
Carol Kasik is head of Strategic Marketing at Researchology. She can be reached at carol@researchology.ca