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HealthEd and Amylin EXL Digital Pharma West 2011

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"Return On Education" presentation by HealthEd and Amylin Pharmaceuticals, EXL Digital Pharma West 2011, San Francisco. Presenters: Susan Eno Collins and Susan M. LaRue

"Return On Education" presentation by HealthEd and Amylin Pharmaceuticals, EXL Digital Pharma West 2011, San Francisco. Presenters: Susan Eno Collins and Susan M. LaRue

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  • 1. Return on Education™—Leveraging Patient Education to Improve Treatment Outcomes
    Susan LaRue, RD,CDE, Clinical Education Specialist, Medical Relations and Information, Amylin Pharmaceuticals, Inc
    Susan Eno Collins, RD, CHES, SVP, Health Education, HealthEd; Community Leader, SurroundHealth.net
  • 2. Give us the next 30 minutes and we will…
    Give you an introduction to Return on Education™—a framework you can use to develop effective programs
    Show you a case study where we incorporated the framework
    Share the positive results we got
    Hopefully, answer your questions
    6/21/2011
    2
  • 3. Return on EducationTM: Starts with a behavior-based approach for developing programs
    3
    Program
    Development and
    Refinement
    Post (After Program Launch)
    Pre (In Planning)
    During (In Development)
    Uncover Insights
    Choose Behavior Model
    Develop Objectives
    Capture and Analyze Results
    Launch
  • 4. Education Impact
    Desired Action
    And includes a Return on EducationTMframeworkfor evaluating the outcomes of the program
    6/21/2011
    4
    Program/Business Impact
    Customized based on program objectives
    Examples include
    Screening/diagnosis
    Talking with HCP
    Fill initial Rx
    Take Rx as prescribed
    Conversion
    Use of device
    Persuasion
    (“This is important to me”)
    +
    Clarity
    (“I understand and can apply what I am learning”)
    +
    Insight-driven content
    (“This relates to me and my life”)
    +
    Reaction to tactic/program
    (“This has been worth it. I have learned something new.”)
    Program
    Engagement
    Reach
    Frequency
    Business
    Length on therapy
    Increased sales
    Rep access
    Health Outcomes
    Symptom alleviation
    HEDIS measurement
    Function
    Clinical measures
  • 5. Case study: Effects of Patient Education Support Program on Pramlintide Adherence
  • 6. Acknowledgement
    6/21/2011
    6
    • This case study is based on the following publication:
    • 7. Lorenzi GM, LaRue SM, Collins SE. Effects of a patient support program on pramlintide adherence. Clin Diabetes. 2011;29(1):17-24.
    • 8. We wish to thank the lead author, Gayle Lorenzi, RN, CDE, University of California at San Diego, for her expertise and contributions
  • Pramlintide is taken as an adjunct to mealtime insulin
    Analog of the hormone amylin
    Hormone cosecreted with insulin by the beta cells in the pancreas
    Deficient in people with type 2 and type 1 diabetes
    Adjunct treatment for people with type 2 or type 1 diabetes who take mealtime insulin
    Injectable
    Taken prior to major meals
    A major meal is >30 grams of carbohydrate or > 250 calories
    Offers improved blood glucose control
    Fewer blood sugar swings throughout the day
    Added benefit of potential weight loss
    6/21/2011
    7
  • 9. The numbers shed light on the product’s challenges
    3
    Patients taking pramlintide at meal times may already be taking 4 shots of insulin a day
    Pramlintide becomes 3 additional shots to integrate into a daily routine
    50%1
    Adherence to medicines across multiple chronic conditions, including diabetes
    50% in 2 months2
    About 50% of patients starting pramlintide discontinued therapy within 2 months
    6/21/2011
    8
    Sources:
    1. World Health Organization: Adherence to long-term therapies: evidence for action. Geneva, World Health Organization, 2003.
    2. Data on file. San Diego, CA., Amylin Pharmaceuticals, Inc.
  • 10. Why did patients stop treatment? Their answers revealed a need
    6/21/2011
    9
    Lack of effectiveness (volunteered)
    Dosing regimen too complicated
    Did not lose weight
    Too expensive
    Side effects (volunteered)
    Additional injections required
    Potentially 57% of reasons for discontinuation can be addressed with
    additional education/realistic expectations
    Source:
    Adapted from Lorenzi GM, LaRue SM, Collins SE. Effects of a patient support program on pramlintide adherence. Clin Diabetes. 2011;29(1):17-24.
  • 11. To develop our program, we started with the Return on EducationTMapproach
    10
    Program
    Development and
    Refinement
    Post (After Program Launch)
    Pre (In Planning)
    During (In Development)
    Uncover Insights
    Choose Behavior Model
    Develop Objectives
    Capture and Analyze Results
    Launch
  • 12. Program objectives were based on behavior-change principles
    Set realistic expectations at the beginning of treatment
    Build problem-solving and communication skills
    Increase sense of self-efficacy (“I can do this”)
    6/21/2011
    11
  • 13. Trying to take a walk in patients’ shoes (uncovering insights)
    6/21/2011
    12
    Starting Pramlintide Therapy
    Maintaining Pramlintide Therapy
    • Healthcare provider knowledge
    • 14. Realistic expectations
    • 15. Hope for improvement
    • 16. Adjustment period/need for flexibility
    • 17. Insulin/appetite changes
    • 18. Weight loss
    • 19. Improved glucose levels, fewer fluctuations
    • 20. Improved AIC
    • 21. Perceived benefits of therapy
    • 22. Increased sense of control of diabetes
    • 23. Weight loss
    • 24. Less insulin
    Motivators
    Motivators
    • Additional injections
    • 25. Side effects
    • 26. Therapy disappointment
    • 27. Impact of changes on family dynamics
    • 28. Suboptimal dosing; fewer benefits realized
    • 29. Life demands
    • 30. Lack of healthcare provider support and education
    • 31. Frustration: different routine and considerations
    • 32. Unanticipated hyperglycemia
    • 33. Injection burden and treatment complexity
    • 34. Unexpected side effects
    Barriers
    Barriers
  • 35. Behavior models provide a blueprint for program design
    6/21/2011
    13
    Program designed using Social Cognitive Theory
  • 36. Designed for clarity by integrating health literacy principles
    6/21/2011
    14
    “I have challenges accessing, understanding, and using health information “
    “One out of 3 Americans have basic or below basic health literacy skills”
    Source:
    National Center for Education Statistics.  The Health Literacy of America’s Adults: Results from the 2003 National Assessment of Adult Literacy. (NCES 2006-483). http://nces.ed.gov/pubsearch/pubsinfo.asp?pubid=2006483.
  • 37. Applying the Return on EducationTMapproach to develop the program
    15
    Program
    Development and
    Refinement
    Post (After Program Launch)
    Pre (In Planning)
    During (In Development)
    Uncover Insights
    Choose Behavior Model
    Develop Objectives
    Capture and Analyze Results
    Launch
  • 38. Starting Pramlintide Therapy
    Maintaining Pramlintide Therapy
    Starting Pramlintide Therapy
    Maintaining Pramlintide Therapy
    • Healthcare provider knowledge
    • 39. Realistic expectations
    • 40. Hope for improvement
    • 41. Adjustment period/need for flexibility
    • 42. Insulin/appetite changes
    • 43. Weight loss
    • 44. Improved glucose levels, fewer fluctuations
    • 45. Improved AIC
    • 46. Perceived benefits of therapy
    • 47. Increased sense of control of diabetes
    • 48. Weight loss
    • 49. Less insulin
    In-officestarter kit with demo video
    Welcome kit with goal setting and wellness map
    Newsletter with expert
    and patient interviews
    Motivators
    Motivators
    Share Your Story
    Newsletters
    Feedback survey
    Co-pay card
    Co-pay card
    Outbound/inbound calls with nurses
    24/7 Information and education
    Outbound/Inbound calls with nurses
    24/7 Information and education
    Program design was mapped to insights…
    6/21/2011
    16
    • Additional injections
    • 50. Side effects
    • 51. Therapy disappointment
    • 52. Impact of changes on family dynamics
    • 53. Suboptimal dosing; fewer benefits realized
    • 54. Life demands
    • 55. Lack of health care provider support and education
    • 56. Frustration: different routine and considerations
    • 57. Unanticipated hyperglycemia
    • 58. Injection burden and treatment complexity
    • 59. Unexpected side effects
    Barriers
    Barriers
  • 60. To create a holistic, integrated experience
    6/21/2011
    17
    Starting Pramlintide Therapy
    Maintaining Pramlintide Therapy
    In-officestarter kit with demo video
    Welcome kit with goal setting and wellness map
    Newsletter with expert
    and patient interviews
    Share Your Story
    Newsletters
    Feedback survey
    Co-pay card
    Co-pay card
    Outbound/inbound calls with nurses
    24/7 Information and education
    Outbound/Inbound calls with nurses
    24/7 Information and education
  • 61. Outcomes of a Behaviorally Based Program
  • 62. Did the Return on EducationTMapproach work?
    19
    Program
    Development and
    Refinement
    Post (After Program Launch)
    Pre (In Planning)
    During (In Development)
    Uncover Insights
    Choose Behavior Model
    Develop Objectives
    Capture and Analyze Results
    Launch
  • 63. Education Impact
    Return on EducationTMframework guided the evaluation plan
    6/21/2011
    20
    Desired Action
    Program/Business Impact
    Persuasion
    Behavior Change Model Metrics
    Change in Knowledge
    Change in Attitudes
    Change in Skills
    +
    Clarity
    Clear by Design
    +
    Insight-driven content
    Tone
    Relevance
    Accuracy of Information
    +
    Reaction to tactic/program
    Satisfaction
    Appeal
    Usefulness
    Needs Met
    Impact
    Intended/Actual use of materials
    Customized based on program objectives
    Examples include
    Screening/diagnosis
    Talking with HCP
    Fill initial Rx
    Take Rx as prescribed
    Conversion
    Use of device
    Program
    Engagement
    Reach
    Frequency
    Enrollment
    Channel preference
    Site visits
    Business
    Length on therapy
    Increased sales
    Rep access
    Market expansion
    Health Outcomes
    Symptom alleviation
    HEDIS measurement
    Function
    Clinical measures
  • 64. Program was relevant
    75%: same or more vs. 11% less
    Q: Would you like to have more, less or about the same: Information about organizing my medicines
    6/21/2011
    21
    75% of respondents want the same or more level of information about organizing their medicines
    Source:
    Data on file. San Diego, CA., Amylin Pharmaceuticals, Inc.
  • 65. Program had high appeal
    71% of respondents want the same or more tools for talking with their HCP
    71%: same or more vs. 13% less
    Q: Would you like to have more, less or about the same: Tools for talking with my HCP
    Source:
    Data on file. San Diego, CA, Amylin Pharmaceuticals, Inc.
  • 66. Program was useful
    6/21/2011
    23
    Percentage of Patients
    The same/longer duration of calls
    The same/more frequent diabetes information
    The same/more frequent contact
    The same/more frequentnewsletters
    Patients Wanted:
    Source:
    Adapted from Lorenzi GM, LaRue SM, Collins SE. Effects of a patient support program on pramlintide adherence. Clin Diabetes. 2011;29(1):17-24.
  • 67. Prompted patients to talk with their HCPs
    Most respondents agree that the program helps them talk with their HCPs
    Q: The Support Program has helped me talk with my HCP about my pramlintide treatment
    Source:
    Data on file. San Diego, CA, Amylin Pharmaceuticals, Inc.
    24
  • 68. 6/21/2011
    25
    Percentage of Patients
    Patients Reported:
    High self-reported compliance and persistency
    On and continuing therapy the first 3 months
    Administration of maintenance dose
    Dosing 2 or 3 times daily
    Source:
    Adapted from Lorenzi GM, LaRue SM, Collins SE. Effects of a patient support program on pramlintide adherence. Clin Diabetes. 2011;29(1):17-24.
  • 69. Improvements were demonstrated
    6/21/2011
    26
    Patients in program were on pramlintide 50% longer relative to those not in program
    Source:
    Adapted from Lorenzi GM, LaRue SM, Collins SE. Effects of a patient support program on pramlintide adherence. Clin Diabetes. 2011;29(1):17-24.
  • 70. Program refinement based on analysis
  • 71. Using the Return on EducationTMapproach to refine
    ©2011 HealthEd Group, Inc.
    28
    Program
    Development and
    Refinement
    Post (After Program Launch)
    Pre (In Planning)
    During (In Development)
    Uncover Insights
    Choose Behavior Model
    Develop Objectives
    Capture and Analyze Results
    Launch
  • 72. Teachable moments shouldn’t be missed
    Web enrollments make up 50% of enrollees and often occur outside of business hours of call center.
    6/21/2011
    29
    Video-based FAQs feature call center nurse
    Video on BRAND.com creates continuity and familiarity
  • 73. Educational game developed to address confusion about Major Meals
    6/21/2011
    30
    Brand
    Brand
    Brand.
  • 74. One barrier and motivator still had to be addressed
    6/21/2011
    31
    Starting Pramlintide Therapy
    • Healthcare provider knowledge
    • 75. Realistic expectations
    • 76. Hope for improvement
    • 77. Adjustment period/need for flexibility
    • 78. Insulin/appetite changes
    • 79. Weight loss
    Motivators
    • Lack of healthcare provider support and education
    • 80. Frustration: different routine and considerations
    • 81. Unanticipated hyperglycemia
    • 82. Injection burden and treatment complexity
    • 83. Unexpected side effects
    Barriers
  • 84. A challenge and opportunity for you
  • 85. You can use the Return on EducationTMapproach to createa solution that promotes action and change
    33
    Program
    Development and
    Refinement
    Post (After Program Launch)
    Pre (In Planning)
    During (In Development)
    Uncover Insights
    Choose Behavior Model
    Develop Objectives
    Capture and Analyze Results
    Launch
  • 86. Education Impact
    Desired Action
    And evaluate your Return on EducationTM
    6/21/2011
    34
    Program/Business Impact
    Customized based on program objectives
    Examples include
    Screening/diagnosis
    Talking with HCP
    Fill initial Rx
    Take Rx as prescribed
    Conversion
    Use of device
    Persuasion
    +
    Clarity
    +
    Insight-driven content
    +
    Reaction to tactic/program
    Program
    Engagement
    Reach
    Frequency
    Business
    Length on therapy
    Increased sales
    Rep access
    Health Outcomes
    Symptom alleviation
    HEDIS measurement
    Function
    Clinical measures
  • 87. This is a complicated recipe
    6/21/2011
    35
  • 88. What patients have to manage day to day can also be complicated
    6/21/2011
    36
    “My Day”
  • 89. Retention ratesof different learning styles1
    Hands On
    90%
    Within just a few minutes of leaving the doctor’s office, patients may remember less than 50% of the critical information the doctor shared.2
    Discussion
    60%-70%
    Audiovisual
    40%-50%
    Seeing
    HearRead
    Digital solutions can help make learning more effective
    37
    10%-20%
    5%-15%
    HCP Office Visit
    1. Adapted from Edgar Dale’s “Cone of Experience.
    2. Davis TC, Williams MV, Marin E, Parker RM, Glass J. Health literacy and cancer communication. CA Cancer J Clin. 2002;52:134-149.
  • 90. Which can lead to positive health outcomes
    6/21/2011
    38
    “My Health”
  • 91. Thank you!
    Time for your questions
    6/21/2011
  • 92. To contact us
    Susan LaRue Susan.LaRue@amylin.com
    Susan Eno Collins s.collins@healthed.com
    To obtain a copy of this presentation, go to www.healthed.com
    6/21/2011
    40