OPINION7 July 2016

Thinking outside the medicine box

Healthcare Opinion UK

In recent years, pharma has begun to focus more acutely on the patient. Incite’s Dr Pamela Walker explains how patient research can best be implemented. 

Many companies now place the patient at the heart of their marketing initiatives. There is investment in understanding broad patient perspectives and needs, as well as gathering deeper insight into their day to day experiences.

That said, compared to health care provider (HCP) market research, patient research often has less clear business objectives and path-for-action execution.  In an increasingly competitive marketplace, adding value and improving patient outcomes means maximising patient insight.

Before kicking off research which involves significant investment of both time and money, it is critical to define a clear business objective. Patient insight is critical for motivating marketing and sales teams and so internally focussed objectives are just as relevant as external ones.  

Patient insight can be implemented to further both internal and external initiatives, depending on the core business objective:

  • External initiatives: these include a whole host of support initiatives for both the patients but also carers, family and friends; at-home support via local/ regional/ national programmes (in some markets these are already in place and pharma can partner on a regional level); packaging optimisations.
  • Internal initiatives: using patient collateral to show benefits of the product (can also be done externally as part of detailing to HCPs) but internally this is critical to motivating marketing and sales teams and well as humanising the condition at hand.

Securing the deepest patient insight is not a streamlined process. It calls for a level of flexibility not always needed in HCP research as well as consideration of multiple perspectives to get the complete picture. Everything from recruitment to logistics to moderation needs to be carefully orchestrated to be as sensitive as possible to the participants’ needs.  To do this effectively, we need to work both harder and smarter.

Working harder

Working harder means we need to approach data collection from a variety of angles across a variety of respondents and through a variety of touchpoints. For example, face-to-face structured conversations lend themselves well to exploring key points in a patient’s journey e.g., diagnosis.

However, it is equally valuable to make a cup of tea together and discuss the day to day; to observe the treatment regimen in situ (at home or in hospital); to observe day-to-day activities that may or may not be impacted by the patient’s condition –transportation, housework, work, hobbies.

For some of these activities interviewers can tag along, for others a video or paper diary is the appropriate medium and for others online forums are best. Interviewers also need to go the extra mile in terms of flexibility and sensitivity. Some top tips for moderators include:

  • Be flexible around timings – adapt on the spot to the length of the discussion based on the patient’s abilities; it is important not to over tax the patient; have breaks if required and talk about other topics.
  • Take it slow – allow time for introductions and spend time getting to know each other.
  • Keep things simple – use friendly, clear and simple language, allow the patient and carer to do the talking and the moderator the listening; make sure questioning is easy to understand and allows time for reflection.
  • Give the patient control – allow space and time for tangents and let the patient lead the conversation; this lead to  more meaningful discussion that can bring to the fore deeper issues critical to the patient.
  • Involve the carer – friends and family can offer a third party perspective that is invaluable; they can step in and fill gaps the patients may not be able to articulate; they can help the patients recall experiences and challenge the patient if they underplay the impact of the disease or give a muted account of their journey.

Working smarter

Planning the ‘ideal’ methodology is a great place to start, but having contingency plans for many eventualities is key. Preparedness to adapt the methodology at a moment’s notice to suit the needs of the patient is necessary (e.g., using paper diaries instead of video diaries, changing the type of interview conducted, allowing the carer to complete the task on the patient’s behalf if they are not up to it themselves).

Think carefully about stimuli. Read any stimulus through the patient’s eyes. For example, any hypothetical product profiles must be presented using non-medical, patient-friendly language. In the same vein, discussion of available or pipeline products needs to be approached with caution. We cannot raise hopes or over promise.

When it comes to analysis, piecing together the viewpoints of different individuals, data from different touchpoints and in different formats requires a bespoke framework. This can be developed prior to the analysis and based on some key guiding principles borrowed from qualitative social research studies.

Namely, an adapted version of the Framework Method has proved very useful (originally developed by Ritchie and Spencer at the Qualitative Research Unit, National Centre for Social Research in the United Kingdom in the late 1980s). Having a framework based on core themes, delineated within a matrix, helps organise what can be disparate insight and allow for careful comparison across participants.

What’s next?

Once insight is gathered, collated and carefully analysed there are a whole host of applications. At a basic level, the use of ethnographic insight can highlight gaps in support via the simple capture of day-to-day routines. Support gaps may not only be evident for patients, often carers and family have a large role in managing a condition for patients, yet support for them is lacking.

Adherence is not a new issue and especially for oral treatments can be challenging. When treatment regimens are tricky, adherence is often highlighted as an area needing further support. There are so many clever blister packs and administration tools nowadays, however, there could be a simple tweak to a product that could greatly improve patient adherence and outcomes.

Dr Pamela Walker is director and head of health at Incite

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