Adherence Arena: Time to shake things up in compliance
Traditional adherence tactics not
working well enough? Try some creativity
As
a recently practicing surgeon myself, I can vouch for the fact that physicians
care deeply about medication adherence.
The
physician's perspective, expressed in the most positive light, is this: Physicians want to help people, and it's
difficult to help if treatment recommendations aren't followed.
Or,
expressed in a more cynical light: It's annoying for physicians to see their
hard work "go to waste" when a patient is non-adherent.
A
recent Consumer Reports survey of 660 primary care physicians found that
treatment non-adherence (medication or other) is the number one complaint that
physicians have regarding their patients. I'm not surprised.
At
HealthPrize, we decided to do our own assessment of what physicians think.
We
conducted a 100-physician survey, asking them about adherence issues in
general, and introduced them to HealthPrize.
As
background, at HealthPrize we've developed an interactive online and mobile
adherence platform that combines rewards with education and reminders, all based
on gaming dynamics and behavioral economics.
It's
designed to maximize engagement and, specifically, to attract patients as
widely as possible, including those who actually need an adherence solution.
Oftentimes,
only the already engaged and motivated (and adherent) patients sign up for
adherence programs.
The
physicians in our survey felt that, on average, 59% of their diabetic patients are
adherent to their medications (to their physician's satisfaction).
Take
into account that adherence is often overestimated, and the actual number is
likely lower than that.
Then,
88% answered that, in the treatment of diabetes, they agree or strongly agree
that there are drugs to choose from that are comparable in all important ways.
When
asked about which factors might sway their prescribing decisions among similar medications,
rebates (73%), rep support (66%), and patient education support and materials
(61%) were considered important (rated as a 5, 6, or 7 on a 1 - 7 rating scale
of importance).
In
comparison, the availability of the HealthPrize program fared better than all
of the above, with 77% of physicians assigning it an "importance" rating of 5,
6, or 7.
Product-related
websites didn't fare too well, at 37%, and manufacturer reputation even less,
with 25% of physicians assigning it a 5, 6, or 7 in terms of importance.
Finally,
we posed a thought experiment in which a head-to-head comparison between two
competing diabetes drugs was set up, one with HealthPrize and one without.
We
then posed the opposite scenario, making HealthPrize available to patients on
the other drug.
Reported
physician prescribing preferences flip-flopped between the two drugs by over
thirty percentage points, in favor of the HealthPrize-assigned brand.
What
does all this mean?
Physicians
are dying for some creativity out there!
The
traditional tactics are nice, and safe, but they're not working well
enough. We need to shake things
up.
Katrina
S. Firlik, MD, is co-founder and chief medical officer of HealthPrize
Technologies, LLC (http://www.healthprize.com/).
Prior to HealthPrize, she was a practicing neurosurgeon in Connecticut. She is
also the author of Another Day in the
Frontal Lobe: A Brain Surgeon Exposes Life on the Inside.