Relatorio global

Doctor - Patient Global Communication Performance Insights from the Worldwide Independent Network (WIN™) of Market Research Fall, 20111

Contents 1. Background & Research 3 2. Context and Methodology 4 3. Key Findings 6 4. Communication Assessment Tool 7 5. Medication Usage 102

1. Background & ResearchBackgroundWIN™, the Worldwide Independent Network of Market Research, the largestindependent organization of Market Research firms with members in 64countries, prepared this landmark review of physician-patient communication.ResearchPhysician-Patient communication critically influences the effectiveness ofmedical education initiatives, treatment decisions and patient compliance torecommended treatments.WIN™ conducted this ground-breaking study on physician-Patientcommunication throughout the world to provide the healthcare stakeholderswith a better understanding on how patients perceive communication skills oftheir doctor, how patients engage their physician, how treatment choices areinfluenced, the frequency and preferred modes of interaction and sources ofinfluential information.3

2. Context and Methodology Methodology and Geographical distribution: In total, the study was carried out in 39 countries. In each country, the most appropriate interviewing methodology was used given local conditions. Fieldwork dates: Fieldwork was conducted between July 19th 2011 and October 3rd 2011. Sample: The total size of the sample is 31 577 cases representative of 1 938 990 516 people. Sample in each country is probabilistic and was designed to represent the general adult population. General coverage of the sample is as follows: 75% national 25% urban Weighting: The data was weighted in two steps to obtain representation by country and worldwide. The data was first weighted to generate data representative of the general population for each country. A second weight, according to the size of the population surveyed, was then applied to obtain global and regional totals. The margin of error per country is between +/- 2.34% and 5.66%, 19 times out of 20. The table on the next page presents a summary of the methodology used in each country to conduct this survey. Each sample is representative of its country’s population in terms of socio-demographic variables. Sample sizes ensure accurate generalizations to the total population and allow a very precise interpretation of the results.4

2. Context and Methodology… Sample Population represented Margin of Country Firm Method Sample Total Population Sampling Method Age Weighting variables Fieldwork dates representation by sample error +/- MPG LLC (Marketing ProfessionalArmenia CATI 1003 7 953 438 Quota Sampling National 3 356 000 18+ Gender, Age Aug. 12-25 3.09% Group)Australia Colmar Brunton Online 910 20 000 000 Stratified National 18 200 000 18+ Gender, Age, Region Aug. 4-10 3.25% Gender, Age,Austria Gallup Austria Face to Face 532 8 400 000 Random quota sampling National 7 300 000 14+ Region,Employment, Jun. 20 - Aug. 3 4.25% IncomeBosnia Mareco Index Bosnia CATI 750 3 850 000 Multistage random sample National 2 950 000 15+ No Jul. 19 - Aug. 5 3.58%Brazil Ibope Inteligencia Face to Face 1410 190 000 000 Probabilistic National 141 248 576 16+ Gender Age, Employment Aug. 11-15 2.61% Gender, Age, Region, TypeBulgaria BBSS Face to Face 633 7 300 000 Random National 6 500 000 18+ Jul. 28-Aug,04 3.90% of settlement Gender, Age, Region,Canada Leger Marketing Online 1004 33 739 900 Random National 24 750 000 18+ Aug. 8-15 3.09% languageChile IBOPE Inteligencia Chile CATI 473 15 116 435 Random Urban 5 408 150 18-60 Gender, Age, Location Aug. 19- Sep. 5 4.51% Random Sampling with online PanelChina WisdomAsia Online 400 1 300 000 000 Urban 51 520 000 15+ No Aug. 11-17 4.90% (Shanghai, Beijing and Guangzhou)Colombia CNC (Centro Nacional de Consultoria) CATI 612 44 000 000 Two-stage design applied simple random sampling Urban 13 826 630 18-65 No Aug. 23-29 3.96%Czech Gender, Age, Region, Size of Mareco Ltd. Face to Face 1000 10 224 626 Random route sampling National 8 392 530 18+ Aug. 4-15 3.10%Republic CommunityDenmark DMA Research Online 510 5 600 000 Random National 4 200 000 18+ No Aug. 12-15 4.34%Finland Taloustutkimus Oy Online 522 5 385 000 Random Nationl 4 577 250 15+ Gender, Age, Region Aug. 12-19 4.29% Gender, Age, Region,France BVA Online 999 65 000 000 Quota Method National 50 700 000 18+ Aug. 1-4 3.10% OccupationGermany Produkt+Markt Online 1006 81 800 000 Random National 56 500 000 18-70 Gender, Age, Region Jul. 25-Aug. 2 3.09%Greece Centrum S.A CATI 300 10,961,758 Statified Urban 6,351,506 18-74 Region Jul. 18-Aug. 3 5.66%Hong Kong Consumer Search CATI 800 7 100 000 Random quota sampling National 6 130 300 15+ Gender, Age Jul. 30-Aug. 19 3.46%Iceland Capacent Online 717 320 000 Random from our Web-panel National 247 437 16+ Gender, Age, Region Aug. 10-18 3.66%India DataPrompt CATI 803 1 210 193 422 Random Urban 963 600 000 18+ No Jul. 23-Aug. 19 3.46% Random digital dial including both Gender, Age, Social classIreland Red C Research CATI 839 4 580 000 National 3 203 814 18+ Aug. 8-10 3.38% landline and mobile numbers and Regio. Gender, Age, Region, Size ofItaly Doxa CATI 882 60 300 000 Random National 50 000 000 18+ Jul. 21-24 3.30% Community, OccupationJapan NRC (Nippon Research Center ) Online 1000 126,475,664 Random National 99,604,610 18-79 No Aug. 11-15 3.10%Kenya Infinite Insight Face to Face 1003 38 610 097 Random National 26 254 865 18+ No Jul. 30-Aug. 8 3.09%Lebanon Reach CATI 1000 3 759 136 Random National 2 781 760 18+ No Aug. 1-30 4.38%Luthuania UAB RAIT Face to Face 703 3 200 000 Random Probilty Routine National 2 625 400 15-74 Gender, Age, Education Aug. 1-18 3.10% Gender, Age, Region size,Macedonia BRIMA Face to Face 820 2 052 722 Multi stage stratified random probability National 1 689 265 15+ Sept. 1-7 3.42% Nationality Gender, Age, Region, TypePakistan Gallup Pakistan Face to Face 1752 187 342 721 Stratified Probability Sampling National 88 000 000 18+ Aug. 7-13 3.70% of settlementPalestine PCPO Face to Face 992 4 170 000 Random National 1 876 500 18+ No Jul. 20-Aug. 15 2.34%Peru Datum Face to Face 918 27 412 157 probabilistic, multistage stratified allocation Urban 16 085 385 18-69 Gender, Region Aug. 5-8 3.11%Poland Mareco Face to Face 305 38 200 000 Stratified random Urban 5 100 000 15-65 No Jul. 28-Aug. 2 3.23%Romania TNS CSOP Face to Face 750 21 431 298 Stratified Probability Sampling National 18 190 003 18+ Gender, Age, Region Jul. 24-Aug. 1 5.61%Russia Romir Online 1180 143 000 000 Random Urban 69 000 000 18-44 Gender, Age, Region Aug. 5-9 3.58%Saudi Arabia PARC CATI 1155 27 000 000 Random Urban 13 000 000 15+ No Jul. 19 - Aug. 24 2.85% RandomSouth Africa TRS (Topline Research Solutions) Face to Face 400 49 320 000 Urban 33 819 800 18+ Gender, Age, Region Jul. 29-Aug. 10 2.88% (Johannesburg, Durban, Capetown )Korea Gallup Korea Online 500 49 773 145 Random Soft Quota National 40 359 211 18+ Gender, Age Aug. 9-18 4.90%Sweden CMA Research Online 1049 9 446 812 Statified National 7 250 000 15-75 No Aug. 9-13 3.03%Swizterland Isopublic Face to Face 343 7 870 134 Random-quota National 6 050 314 15-74 Gender, Age, Region Sept. 21-Oct. 3 5.29%Tunisia EMRHOD CATI 600 9 910 872 Stratified (governorates are strata) National 732 326 18+ No Aug. 22-27 4.00%USA TRiG Online 1002 313 232 044 Random National 234 265 000 18+ Gender, Age, Region, Race Aug. 8-12 3.10% 5

3. KEY FINDINGS Doctor-Patient Relationship Around the World 1. Communication effectiveness between doctors and patients is related to being compliant to taking prescribed medication exactly as the doctor directed. 2. Communication Assessment Tool (CAT™) showed the communication between doctor and patients is poor with a very low score of 22%. 3. Asian markets are amongst the lowest on communication effectiveness. 4. Directionally, comparing results from prior years, communication effectiveness between doctors and patients on a global level trended downward.6

5. Doctor Communication Assessment Tool Q. Thinking of your most recent visit, please rate the doctor’s communication with you. CAT (Comunnication 2011 2010 Assessment Tool) Attributes % % Talked in terms I could •Compared to last year, fewer citizens rated their doctor as understand 25 32 excellent this year in all of the 15 communication assessment How would you rate the care 24 30 provided by your doctor categories asked in the survey. Paid attention to me (looked at 24 32 me, listened carefully) •Only a quarter or less rate their doctor as excellent in all of the Treated me with respect 24 34 categories. Greeted me in a way that made 23 29 me feel comfortable •Only 18% of respondents felt their doctor encouraged them to Showed care and concern 23 30 ask question. Understood my main health 23 30 concerns Discussed next steps, including 22 29 •With only 25%, “talk in terms I could understand” this is the any follow-up plans attribute that received the rating of excellent most frequently. Gave me as much information as 22 30 I wanted Let me talk without interruptions 22 31 Showed interest in my ideas 22 29 about my health Key Finding: Spent the right amount of time with me 22 30 Checked to be sure I understood A quarter or less of citizens rate everything 21 27 their doctor as excellent in all Involved me in decisions as 19 25 much as I wanted of the categories. Encouraged me to ask questions 18 23 Total 22 29 *Global totals represent the averages of the top boxes scores in every surveyed country **In 2010, 23 countries participated in the survey. IN 2011, 39 countries participated in the survey of which only 15 were recurrences from 2010.7

5. CAT (Communication Assessment Tool) Q. Thinking of your most recent visit, please rate the doctor’s communication with you.Communication Assessment Tool Communication Assessment Tool (CAT)(CAT) 2011 2010 •Overall, the CAT score in the 39 surveyed Country % % Ireland 66 NAThe Communication Assessment Tool countries is at a low of 22. Armenia 66 NA Chile 59 NA(CAT), developed by Makoul et al, Macedonia 56 NAassesses patient perceptions of •The country with the highest CAT score is Bosnia 51 NAphysicians’ interpersonal and Australia 49 NAcommunication skills. Ireland with a score of 66. On the other USA 48 52 hand, Pakistan continues to record a low Lebanon Saudi Arabia 48 45 40 51The CAT is a 15-item survey that is easilyadministered in a paper-and-pencil CAT score with the lowest this year at 5 Canada 43 47 Sweden 37 NAformat, via the phone or Internet. The (Pakistan scored a 7 in 2010). Germany 36 NACAT asks respondents to rate different France 35 39dimensions of the communication and Switzerland 33 NAinterpersonal skills of the physician •Of the countries that participated in the Greece 32 NA Colombia 28 NAusing a 5-point rating scale (1=poor, survey for the past two years, Austria’s Iceland 27 302=fair, 3=good, 4=very good,5=excellent). Makoul et al found that CAT score most decreased (-19) while Italy South Africa Bulgaria 25 24 - NA 25scoring the CAT based on the (+10), Lebanon (+8), Korea (+7), China Brazil 23 30 Lithuania 23 NAproportion of items rated as excellent (+7) most increased. Russia 23 - 22was more meaningful than summarizing Tunisia 22 NAthe scores using means. Their Korea 22 15psychometric analysis of response Austria 21 40scales indicated that “a rating of Denmark 21 NA Italy 21 11‘excellent’ was akin to ‘yes’, while even‘very good’ was closer to ‘no’ than Key Finding: Czech Rep. Romania 20 20 NA NA‘yes.’” Data for the present study were Finland 19 NAanalyzed using the sum of the items On average, citizens India 16 - 17scored as excellent divided by the Kenya 15 NA throughout the world give Palestine 14 NAnumber of items answered.* their doctor a low CAT score. Hong Kong Poland 13 11 NA NA China 11 4*Source: Japan 10 - 11http://www.stfm.org/fmhub/fm2010/September/ Peru 6 NALinda567.pdf (2010) Pakistan 5 7 Total 22 29 8 **In 2010, 23 countries participated in the survey. IN 2011, 39 countries participated in the survey of which only 15 were recurrences from 2010.

5. Global Communication Assessment Tool (CAT) Summary Summer 2010 Doctor-Patient Relationship around the world High CAT scores Citizens in Armenia, Australia, Bosnia, Canada, Chile, Columbia, France, Germany, Greece, Ireland, Lebanon, Macedonia, Saudi Arabia, Sweden, Switzerland, and the USA are very satisfied with their communication with their doctors with CAT scores above average.Key Finding: Middle East 42 Low CAT scores Americas 38 Citizens in China, Hong Kong, India Japan, Kenya, Pakistan, Palestine, Peru, Poland and are the least satisfies with their doctor with Western Europe 31 below average CAT scores. Eastern Europe 23 Average CAT scores Africa 21 Respondents in Austria, Brazil, Bulgaria, Czech republic, Denmark, Finland, Iceland, Italy, Korea, Asia 16 Lithuania, Romania, Russia, South Africa and Tunisia have average CAT scores. Total 229 *The data for this graph is based on questions presented on slides 12. For the definitions of CAT (communication Assessment Tool) please refer to slide 12.

6. Medication Usage Q. Do you currently have a medication that was prescribed by the doctor with whom you most recently met?Q. How often would you say you have taken this prescription medication exactly according to the doctor’s direction? Most of the Only some of the Yes All the time time time/Rarely % % •39% of individuals currently have a medication that was % % China 80 43 55 3 prescribed by a doctor. Korea 68 36 54 10 USA 63 70 21 8 Australia 62 67 30 3 •Just over half (57%) of respondents take the medication Palestine 58 34 28 38 Canada 57 72 23 5 exactly according to the doctor’s directions and another Austria 57 68 32 1 South Africa 55 58 25 17 31% take the medication according to the doctor’s Bosnia 53 84 7 9 direction most of the time. France 53 73 23 3 Bulgaria 52 91 6 3 Colombia 52 70 15 14 Romania 50 75 18 7 •While Bulgarians are most likely to take prescription Denmark 50 79 18 3 medication exactly according to direction (91%), citizens Germany Sweden 50 49 64 75 32 18 3 6 Of those on of Peru and Czech Republic are the least likely to do so Czech Rep. 48 prescribed 44 26 29 Japan 48 medicaton, 55 42 3 with 29% who answered that they only some of the time Italy 48 taken 76 20 3 Poland 47 77 19 2 or rarely take the medication according to direction. Ireland 47 medication according to 78 13 9 Macedonia 47 doctors 85 10 4 Lithuania 46 direction 72 19 8 Hong Kong 44 41 43 14 Brazil 43 78 14 8 Tunisia 41 50 27 23 Switzerland 40 68 23 8 Key Finding: Iceland 39 61 34 6 Armenia 39 43 18 38 Just over half (57%) of citizens on Pakistan Lebanon 38 38 41 74 47 16 11 10 prescribed medication take it exactly Saudi Arabia 37 58 20 20 Finland 37 73 24 3 according to the doctor’s directions. Greece 35 68 7 25 Chile 35 65 21 13 Russia 32 50 42 7 Peru 31 53 18 29 India 26 44 34 22 Kenya 24 60 19 20 Total 39 57 31 12 10

Relatorio global

by Renato Okano on Nov 10, 2011

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