With an estimated 50% non-adherence in chronic conditions, segmenting patients based on their attitudes is critical to evolving adherence models.

1. Medical Advertising& Consultancy
Branding of Science
Science of Branding
www.brandcare.net

2. Non adherence
in Diabetics
An attitude and
behaviour study
2013 study
By Brandcare

3. Medicines don't
work
if people
don't take
them
And yet they are the
most neglected

4. Excuses take many forms!
Mehenga hai.
Bahut garam
padta hai
I didn't understand
the directions
I am feeling much
better. God bless the
doctor!
Mr. Sharma was
asked to stop
after a month
It’s not
available nearby
I forgot!
Buaji had Side
effects
I am so busy.
Chalta hai.
Hota hai.
I didn’t know
how long to take

5. Estimates of medication nonadherence rates
typically range from 30% to 60%,
when medication was to be taken over a long
period, compliance rates dropped
dramatically to approximately 50% for either
prevention or cure.
Meichenbaum D, Turk DC. Facilitating Treatment Adherence: A Practitioner's Guidebook. New York: Plenum Publishing Corp; 1987
Sackett DL, Snow JC. The magnitude of compliance and noncompliance. In: Haynes NRB, Taylor DW, Sackett DL, eds. Compliance in Healthcare. Baltimore: Johns Hopkins
University Press; 1979:11-22

6. Disease
Condition
Treatment
Demographics
Physician
Attitudes
Patient
Attitudes
The most impact able of these are

7. Hence Brandcare decided to study
non-adherence from attitude
perspective
We studied the attitudes of Indian
Patients and Physicians towards non-
adherence in Diabetes
Attitudes are
contagious

8. Non adherence
in Diabetics
An attitude and
behaviour study
2013 study
By Brandcare

9. Source:
1. WHO. 2003a. Adherence to long-term therapies: evidence for action. Geneva: World Health Organisation
WHO defines adherence as:
Defining non-adherence
The extent to which a person’s behavior – taking
medications, following a diet and/ or executing
lifestyle changes - corresponds with agreed
recommendations from a health care provider”

10. Non- adherence a difference in perspectives!
Physician believes that adherence
has improved over the past years
Past 5 years
24%47%
65%
Estimated non-
adherence
according to
patients
24%
Estimated non-
adherence
according to
physicians

11. Types of non-adherence and incidence
Short term
Long term
Medium term
50%
49%
0-1%
*Almost no patient reported permanent discontinuation of medicine without consulting
physician, hence assumed 0
Of the 64% non-adherent population,

12. According to the study the belief and behavior factors affecting non
adherence can be categorized into intentional and unintentional
*Represents views of “out of every 10 patients”. Total patient surveyed 120
Intentional
Unintentional
*Represents views of “out of every 10 patients”. Total patients surveyed: 120

13. The difference in Physician and Patient perspectives
Physician
Patient
Patient thinks his own efforts, understanding and
physician patient communications are most important
aspects affecting adherence
Physicians think patient’s own efforts put in,
understanding, affected degree impact adherence

14. Adherence in chronic
conditions is an
ACUTE
problem after all!
Belief and Behavioral factors have direct impact on
adherence, key adherence influencing factors identified are:
Understanding
(Knowledge of disease and condition )
Communication
(Interaction quality with physicians)
Affected
(Uncertainty / concern related
to disease / treatment)
Trust
(Faith on effect / safety of medications)
Effort
(Self-involvement to manage disease)

15. Patient respondent response recorded on the above five impacting factors were recorded on a
scale of 1 to 5. Response analysis helped us categorize patients into following six categories:
Patient Profiling

16. Disciplined
Patient Profiling
Very well organised and determined to achieve their goals. All their
efforts are driven in a similar direction, may that be eating, work or any
other schedule to be followed. They like to do things well in time and
have fixed patterns for a day. They have an inner calm and an outer
resolve. They are honest, controlled and cannot be easily wavered in
their decisions.
Eager, confident and proactive in managing
Disease, overall health

17. Disciplined
Patient Profiling
30% 70%
% of total sample % adherent

18. Confident
Patient Profiling
He has faith in himself in all his endeavors. He tries doing things on
time but whatever he does, he is filled with a deep sense of inner trust.
He is open about possibilities and aspirations to be pursued. He’s
aware of his overall state of well being and feels confident about
himself. He is aware of his thoughts and feelings and is committed to
his own purpose.
Eager and knowledgeable but have low trust in physician and
medications. They think they know best.

19. Confident
15% 50%
% of total sample % adherence

20. Worried
Patient Profiling
She is non-assertive in most of her daily regimen too and withdraws
from a lot of situations. If she gets too concerned about a certain thing,
then she can’t concentrate on the task at hand. She is also reluctant
to communicate the concern and tends to get distracted from important
matters.
Knowledgeable, concerned about diseases but
prefer lifestyle changes over medication

21. Worried
15% 40%
% of total sample % adherence

22. Confused
Patient Profiling
He is a person who is indecisive by nature, and might even come across
feeling of disorientation in a certain situation, getting away from it. It is
difficult for him to trust someone and is therefore detached and
disengaged at times. He is also quite judgmental about all possibilities.
Confused about disease, doctor’s advice and recommendations.
Lacks trust in medication and concern for health is negligible

23. 10% 40%
% of total sample % adherence
Confused

24. Laid back
Patient Profiling
He is mostly relaxed by nature and takes things lightly. He is an easy
going person who tends to go with the flow. He enjoys life to the fullest
and believes living in the moment. He is not affected soon by
situations.
They are afraid of the consequences but are too lazy to
act and are generally careless about their health

25. 15% 30%
% of total sample % adherence
Laid back

26. Doubter
Patient Profiling
He is a kind of person who is very perception led and is hesitant in
various situations that he comes across. May that be studying, work or
life; his tendency to doubt doesn’t leave him. Is generally surrounded
by low sense of faith on people around him and takes him quite some
time to build the same. He might have different or even absurd views in
different situations.
Their knowledge on disease, treatment is confounded.
They make their regimen to suit their schedule and do
not follow advice.

27. 15% 0%
% of total sample % adherence
Doubter

28. Patient adherence is a complex fallout of attitudes and behaviour. Solutions to
counter non-adherence should consider this. A one size fits all approach may not
work.
customisation may be the key to
improving overall adherence!

29. Customised modules and tools through
screening, diagnoses and treatment steps
can be developed

30. ..towards better chronic care together
Call us to create better
patient adherence
programs for you