Signs of Success: The Positive Outcomes of Patient Centricity
Patient centricity creates self-propagating benefits that positively affect patients, physicians, and everyone else in the industry.
Patient centricity is no longer just a buzzword. Professor Andrew Miles, Senior Vice President & Secretary General, European Society for Person Centered Healthcare, shares that there is a growing body of empirical evidence that patient-centric initiatives improve drug adherence and health outcomes for patients, boost job satisfaction in clinicians, secure profitability for pharmaceutical companies, and help concretize the value that payers have been itching for. In his upcoming presentation at eyeforpharma’s Patient Summit Europe in October, Miles will discuss in detail how positive outcomes are spreading across the entire health industry through a patient-centric approach.
Increased treatment adherence and health outcomes
Increased adherence leads to improved health outcomes for a community. It results in decreased levels of illness and prevents the exacerbation of long-term conditions, which in turn, reduces frequency of hospitalization, length of hospital stays, and the likelihood of secondary care consultations. Miles emphasizes that in involving patients in designing their own treatment, physicians can help drive adherence.
Historically, industry has made efforts to take the patient seriously. “People started as early as the latter parts of the 1970s to talk about patient-focused, client-centered and user-oriented care,” shares Miles. These terms, however, involved patients having to build around how doctors and hospitals worked and what pharma wanted, which often reduced the patient down to a number or a statistical component. “A patient is a person and not a biological machine,” says Miles.
However, the current term ‘patient centricity’ provides definitional clarity as to what should happen – industry building itself around the patient.
When asked whether patient-centric approaches increase adherence, Miles responds with a resounding, “Yes, they do. The empirical evidence shows they do.” The evidence he speaks of is both quantitative and qualitative. More and more organizations are conducting adherence initiatives such as pill counting. Based on patient surveys and interviews, many patients also report seeing a difference in the performance of physicians, who now ask patients how they feel and explain what their options are.
According to Miles, “This relationship-based model of care between physician and patient is a shared decision-making approach,” which is a stark contrast from the traditional paternalistic approach where the physician instructed what the patient needed. Today, quality clinical practice involves marrying objective clinical observations with the subjective experience of the patient. “If the doctor has built up a relationship of equality and trust with the patient, then it becomes a different story.”
Increased job satisfaction among clinicians
When clinicians begin to see the improvements resulting from patient centricity - clinically and in terms of quality of life for patients - this feeds into a sense of a job well done for physicians and healthcare professionals. When the satisfaction of patients goes up, so does that of doctors.
Miles highlights the significance of patient centricity’s ability to improve the job satisfaction levels of doctors. “There has been a loss of the human side of medicine,” he reports. Since the discovery of the early drugs such as penicillin in the last century, progress in biomedical and technological advancements has been massive, but has had an unintended consequence. “As medicine has become more and more scientific and technologically advanced, it has become less and less humanistic, caring and compassionate,” says Miles. There has been a risk that physicians are being reduced to serving as technicians in applied science, rather than being providers of a broader, more inclusive form of care, in other words, consummate professionals. Furthermore, patients have taken notice of the reduced level and nature of care they have been receiving. “Patient advocacy groups have been built up based on these observations,” adds Miles.
Building a relationship-based connection between physicians and patients gives doctors the opportunity to bring back the humanistic nature of their role. Additionally, Miles explains that there is evidence suggesting that person-centered relationships help protect against burnout, which is a common condition experienced by healthcare professionals. Fulfilling their role by increasing adherence and patient outcomes for their patients helps reduce the chances of burnout. Miles explains, “If patients start seeing you less because they’ve started to get better, then you’re not going to be so busy and so tired!”
Profitability based on health economy assessment
Patient centricity is a virtuous circle where the value chain of healthcare is reinforced through a feedback loop, and advantages across the circle begin to self-propagate, greatly benefitting the entire industry. The prescription level and performance of a drug are maximized by patient-centric efforts, which is a profitable situation for pharma and valuable to payers, providers and commissioners.
As Miles explains, a drug maker cannot recover research and development costs and turn a profit if patients say they do not know enough about a drug, if they are having difficulty taking it, or if their physician is unable to provide enough information to convince them that it is the right drug for them, etc. Additionally, if patients are unhappy with a drug, they will tell other patients. If physicians aren’t satisfied with a treatment, they will share their opinion with their colleagues. “Again, it all goes back to adherence,” reminds Miles.
We can measure these [adherence, exacerbation of symptoms, hospital admission, etc.] easily. We can know if changes occur as a consequence of the patient-centric approach.
From a health economist’s perspective, evidence about patient adherence and the performance of a drug in terms of efficacy and security in the real world market is the golden ticket to profitability and savings. The company that delivers the most effective drug comes out as the clear winner. “We can measure these [adherence, exacerbation of symptoms, hospital admission, etc.] easily. We can know if changes occur as a consequence of the patient-centric approach,” highlights Miles.
Physicians leading the achievement of a ‘sweet spot’
The ‘sweet spot’ of patient centricity is where the needs of industry (to maximize profit and power to investment) and patients (symptom management, functional recovery, having a trusted physician, etc.) intersect. “That is the holy grail,” describes Miles, who estimates that 95% of physicians still don’t deliver patient-centric services at the level and caliber that patients deserve that would constitute as the sweet spot. He notes that some physicians even still fail to do the simple things like greeting the patient as they enter a room or maintaining eye contact with them, but there's hugely more to the patient-centric approach than this, he adds.
The clinician must take the lead in creating the therapeutic relationship. According to Miles, two things must happen so that physicians can create the mutually beneficial intersection between business and patient:
• First, physicians must be intellectually convinced of the benefits of placing the patient at the heart of their practice, which can be achieved once they are educated on the empirical evidence about patient centricity and its multiple benefits.
• Second, pharma has a direct role to play in facilitating such education and in assisting the development of the clinical tools necessary to make true patient centricity a reality.
Professor Miles reveals that there are still those in the industry who have apprehensions about involving the patient too much, especially in designing clinical trials. He reminds us that without the perspective of patients, pharmaceuticals will always be perceived as pill-making, commercially-driven entities. Pharma will never be able to rebuild trust and its reputation. With patient centricity, everyone works around the patient and the concomitant positive outcomes cascade to patients, physicians, care providers, health economies, payers and commissioners.
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