Self-Management in Chronic Disease - Helping Patients Help Themselves

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One issue that keeps pharma and biotech marketers awake at night is treatment adherence.   Despite decades of innovation around better medications, smart devices and hi-tech educational tools, there is no direct path to ensuring that patients actually follow their prescribed treatment.

With an ever-increasing focus on chronic disease management, patients will take on even greater responsibility toself-manage their condition and treatment

How can we help support patients to stay on track?

A good place to start is to examine the “why” behind nonadherence. Health psychology frameworks tell us that any behavior, including medication adherence, is driven by a set of personal beliefs. Once we identify those beliefs, we can develop interventions designed to help change the beliefs that interfere with good self-management.

Looking through the lens of health psychology, we can identify 5 key ground rules for designing patient interventions:

1.       Personalization Wins Over Segmentation

Pharma is always looking to better understand their target patient population. One popular approach is through segmentation studies which look at a target population by group-level similarities including gender, age, disease severity and attitudinal measures. But, just because patients share demographic clinical traits or even have similar attitudinal qualities, that doesn't mean they have the same beliefs around their illness and treatment. 

Within one “segment,” patients can have completely different beliefs:

  • “I feel fine, and really don't need these pills”

  • “These pills are big – I'm going to only take half the dosage”

  • “I'm afraid of side effects – I filled the prescription but won't take them unless I get really sick”

Personalization looks at each patient as an individual with a unique set of beliefs – not just a fixed population segment.

2.       One size doesn't fit all

If a patient doesn't experience symptoms and is convinced she doesn't need the medication, will an educational outreach focused on side effects change her mind? If a person is afraid of side effects, will that fear be addressed by an app that tracks their progress in meeting treatment goals?

Successful patient interventions need to deliver the right message to the right person at the right time, and in a channel that is relevant to that individual. If a patient thinks the message is generic, he or she is likely to disengage or lose interest in the program.

3.       Education alone is not enough

Just because we know things are good for us doesn't mean we automatically change our behaviors.  Did you get 8 hours sleep last night?

Most nonadherent patients are choosing to not follow their prescribed treatmentEducation is important – but there also needs to be open communication that allows each patient to understand and address the particular beliefs driving their behaviors.

4.       Reminding isn't always the right answer

Since nonadherence is often intentional, reminders have limited potential for long-term improvement. Even among those who truly forget, once you take away reminders, they frequently lapse into old behaviors.

Sustained improvements in self-management require interventions that address fundamental changes in how an individual thinks about his/her condition, the prescribed treatment, and the impact of treatment on their prognosis. Once you change the beliefs, you can start to change behaviors.

5.       Patient-centricity Needs to Extend Beyond the Patient

Of course, it's important to keep the patient at the center of a support program.  It's also critical to recognize the patient's support team, including caregivers, family, pharmacists, doctors, nurses and dieticians.  In cases like Alzheimer's disease, caregivers need direct support to keep themselves healthy, so that they can fulfill their caregiving role.

But wait, there's more….

Medication adherence is just one component of optimal patient self-management.

While improved adherence is a primary goal for many patient support programs, an evidence-based approach can also be applied to address other relevant health-related behaviors, such as increasing physical activity and changing diet. 

For more insights on effective solutions for patient self-management, download our latest White Paper, “Self-Management in Chronic Illness
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