Impact of social media on patient adherence

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Presentation at eyeforpharma Multi Channel Marketing Conference, London, November 7th, 2013

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Impact of social media on patient adherence

  1. 1. Non-adherence is the norm- Legalize it!
  2. 2. “Increasing the effectiveness of adherence interventions may have a far greater impact on the health of the population than any other improvement in specific medical treatments” Haynes RB. Interventions for helping patients to follow prescriptions for medications. Cochrane Database of Systematic Reviews, 2001, Issue 1.
  3. 3. Poor adherence to treatment of chronic diseases is a worldwide problem of striking magnitude 50% ... or lower depending on country “Adherence to long term therapy”, WHO 2003
  4. 4. Self-regulation: Grasshopper vs. ant Source: Self-regulation model, Leventhal et al. 1984
  5. 5. Beliefs drive behavior Causes Time Control/ Cure Identity Consequences Source: Illness perception model, J. Weinman et all 1995
  6. 6. Resisting medicines Concerns Overuse Necessity Harm
  7. 7. So does the Internet impact adherence?
  8. 8. We asked 200 patients in HealthUnlocked Lupus community how they felt about adherence
  9. 9. About 60% admitted to having missed doses
  10. 10. ...mostly because said because they forgot
  11. 11. ...few admitted because of side effects
  12. 12. Going deeper though some deeper motives emerged The drugs have lots of side effects and sometimes i just don’t want to take them...so I forget I stopped, because I wanted to know how I feel without med. Just felt completely fed up and couldn't be bothered. Medication doesn't really make me feel much better. Scared by the thought that this is my future and then find out that most people think it is an inevitable ...
  13. 13. Online engagement made patients feel better informed and consequently more confident
  14. 14. ...which in turn had an effect on their adherence
  15. 15. Internet creates mostly POSITIVE change Information It makes you think about the consequences of taking them when you read about some of the side effects that people suffer from. It made me question drug regime more. Motivation I was able to negotiate the change with my NHS Endo after a year on no meds. I now take in split doses. I am doing well. Skills That people tend to explain their experiences this has led me into trusting the meds a little bit more. Change It encouraged me to wait for the tablets to take effect. It's the support you get and the motivation and they understand what you are going through. It helps me stick with my meds despite the side effects reading what other people have to put up with. Gives me confidence to hear that people have the same experiences 15
  16. 16. Information + Motivation + Skill= Behavioral Change Info + Skill + Motivation = Change
  17. 17. How can Multi Channel Marketing help? Reinforcement Product necessity and safety Content Change Disease awareness Patient information and education Relapse prevention and recuperation Social Support Commitment Conversation Self Monitoring Tools Behavioral strategies Behavioral contracting Goal setting Feedback 17
  18. 18. Payors “get it”: Non-adherence comes at a cost Source: Medication Adherence Leads to Lower Healthcare Use and Costs Despite Increased Drug Spending, Health Affaires, 2011
  19. 19. Payors believe digital is part of the solution
  20. 20. Are we letting our patients down? Products lie to us. Food says "low carb" or "sugar-free," but isn't good for us. Nutritional information isn't always accurate, or has unrealistic serving sizes. Companies and gadgets lie. We're told something makes diabetes "easy" or "painless." Diabetes is never easy, and never painless.   My insulin pump is the best piece of technology I've ever had, but it sometimes lies to me too. Sometimes it says it's delivering fine, but the cannula is kinked so my sugars are suddenly in the 20s with no explanation? I never know. How much of the insulin did I actually get? Diaturgy blog
  21. 21. Are we expecting patients to behave according to unrealistic standards we made up in labs?
  22. 22. Non-adherence is the norm- Legalize it! Non-adherence is nothing new but our definition of adherence is old Need to transform adherence guidelines into real world health outcomes Patient empowerment is rising and the internet is the elevator
  23. 23. Patients need to be supported not blamed “Adherence to long term therapy”, WHO 2003
  24. 24. Self-Regulation-Experiment: social vs. hangover

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