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Patient Centricity: Identifying the attitudes and expectations of patients and doctors

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Preamble

Patient centricity is a broad term with respect to a pharmaceutical organization (The term pharmaco is widely accepted for pharma companies). Patient centricity covers the entire spectrum of a pharmaco including F&D, R&D, marketing, medical affairs, supply chain, finance and HRD.

The history of healthcare has always been linear – between the patient, the doctor and the pharmaco.

The patient-doctor relation was exclusive; like between a student and teacher, unquestioning and trusting. The patient was not overly concerned about what was prescribed and would dutifully follow the instructions.

Similar was the relationship between the doctor and pharmaco.

The end consumer, the one who generates revenues for a pharmaco – the patient – was seldom included.

Therefore, one rarely saw any relationship between the patient and the pharmaco, nor any diligence from the pharmaco towards building that relation.

The changing times have brought in a higher sense of responsibility amongst pharmaco’s. Simultaneously with the advent of newer complex and pricier therapies, the need to connect with the patient became imminent.

Objective of the Study

The objective of this study, jointly conducted by Jamia University, New Delhi and PharmaState Academy, was to understand the expectations which doctors and patients have from pharmaco’s.

This interim report was released during South and Southeast Asia e-Summit on Patient Centricity on 11th April 2021.

The outcome is full of new insights. Although this is the only the first phase of a study to cover over 5000 patients and 2000 doctors, it opens new vistas. You may soon see a seismic wave; Pharmaco’s will have to find out innovative ways to serve patients and also help doctors to serve patients.

Arm 1: Patient Satisfaction – Gaps and Expectations

655 patients from India, Bangladesh and Philippines were included in this study.

60% had chronic diseases: diabetes, hypertension, dyslipidemia, thyroid disorders, PCOS, arthritis, and a few more. This indicates the increasing burden not just on the patient but on the economy of the country. (Fig 1)

Fig. 1

Over half the patients reported co-morbidity. This indicates higher risk, escalated cost of treatment, and the need to manage complications in patients.

Let’s now dwell on the findings around the satisfaction levels of patients about their doctor’s.

An overwhelming majority of patients reported satisfaction on the parameters of attention, care and amount of time spent by their doctor. Although that’s a healthy sign, one patient in five did not feel satisfied with their doctor. When extrapolated to the universe, this is grave. (Fig. 2)

Fig. 2

When patients were asked whether their doctors spent enough time to explain the prescription, the dissatisfaction score was 42%.This is almost in consonance with the HBR findings in the article “Understanding Unhappy Patients Makes Hospitals Better for Everyone(1) (Fig. 3)

Fig. 3

These high scores of patient dissatisfaction is indicative of grave issues affecting South and Southeast Asia. One reason could be the abysmal doctor-patient ratio. This puts tremendous physical and emotional stress on doctors.

The critical factor of the overburdened doctors who are not able to find time for counselling can have significant consequences on patient outcome as well as the health of the patient.

For instance, discontinuation of antibiotic therapy midway, can result in antibiotic resistance. Similarly, poor adherence in chronic diseases like diabetes may lead to devastating retinal retinopathy.

These have long-term effects on society like increased financial burden and loss of productivity. This is an opportunity for pharmaco’s to become patient centered.

“The diabetic who knows the most, lives the longest.” -Elliot P Joslin.

This profound statement represents the central pillar for managing chronic disease. Todays hyperconnected world is leading to curiosity for information. It is important that patients soak in it from the right sources.

Patients are more than willing to open up their problems with ‘patients like me’, though some may not align with patient advocacy groups if not recommended by the doctor. (Fig 4). And one of the reasons why patients consider peer support as vital is because every condition has its own unique problems which only ‘patients like me’ can answer them. Patients may work really closely with their doctor to manage their problems, but there are some questions only other patients can help. Such a support group can be powerful platform for patients who desire to seek peer support during difficult times in their life. 

Fig. 4

This is one opportunity for the pharmaco’s to build CRM in their strategies.

When asked whether patients would accept help from pharmaco sponsored Patient Advocacy Groups, 63% either said no or ‘may be’. This is possibly because of the reputation the pharmaco’s have; some perceived, some real. One of the major levers identified in the study which can help adoption of patient programs initiated by a pharmaco, is their doctor’s recommendation.

Fig. 5

This study has more interesting revelations. Pharmaco’s must take cognizance!


Arm 2: Doctor Satisfaction – Gaps and Expectations

The second arm of the ongoing research is understanding doctors’ difficulties while treating patients and their mindset towards pharmaco’s  

218 doctors responded. These included private practitioners, hospital doctors and doctors who practiced privately and were also attached to hospitals. (Fig 6)

Fig. 6

The number of years of practiced ranged from fresh graduates to 35 years of practice as shown in Fig. 7

Fig 7

More interesting data has shown up.

Over 80% expressed satisfaction in time and attention they gave to patient – specifically about explaining the dosage regimen (Fig. 8).

Fig. 8

This also means that one doctor in five accepted their inability to explain the dosage regimen to the patient because of lack of time. This again becomes significant when extrapolated to the universe. 

The cohort comprised of doctors from various specialties and experience, indicating that this is a common issue. Could it be linked to the patient overload because of the abysmal doctor-patient ratio? More research is needed.

One thing which has emerged very strongly is doctors believe that pharmaco’s can play an active role in supporting them for counselling patients for dosages, side effects and importance of adherence. A significant majority also believe that pharma needs to have a patient centric approach. (Fig 9)

Fig. 9

However there seems to be uncertainty in 53% of the doctor’s to accept pharmaco supported patient advocacy groups. (Fig 10)

Fig. 10

Doctors were concerned around privacy. Over 65% of doctors believed that such programs have a potential to violate the sacrosanct confidential relationship with their patient.

This clearly indicates that pharmaco’s need to refurbish their image and rebuild the trust. The doctor beliefs and concerns must be addressed by pharmaco’s. Only then patient program driven by pharmaco’s can succeed.

The most heartening part is when asked whether pharmaco’s should adopt a patient-centric approach in their medico-marketing promotion, an overwhelming majority responded in the affirmative. (Fig. 11)

Fig. 11

Conclusion

The interim report of the ongoing study suggests that pharmaco’s have a great opportunity to adopt patient centricity in all fields.  Pharmaco’s should build up trust so both patients and doctors can accept the support from them.

Both the critical stakeholders show a favorable outlook towards pharmaco’s. However the trust levels show significant concerns from both the groups and pharmaco’s must address that.

Additional research to identify other aspects like medium of connect, language comfort, and frequency of touch points can strengthen designing patient support programs acceptable by all.

Pharmaco’s need to work diligently to build meaningful programs which can be attractive for all stakeholders. IPA, OPPI and IDMA should be proactive to build trust with patients and doctors.

And finally, adopting patient centricity is inevitable.

Watch Survey Result

The interim results were presented at Pharma Brand Management: South & South Asia Summit – 2021 by Mr. Bhavesh Vyas.

Acknowledgements

We are thankful to Jamia Hamdard University for providing support in data collection & to Mr. Bhavesh Vyas for for data analysis & its presentation on Pharma Brand Management: South & South Asia Summit – 2021 (Theme: Patient Centricity). We would also like to thanks Mr. Suraj Gupta for providing his assistance in data compilation.

Financial disclosure: No financial aids have been taken from any organization or institute for this study.

References:

Guney S, Childers Z and Lee TH. Understanding Unhappy Patients Makes Hospitals Better for Everyone. Harvard Business Review, Available-on:https://hbr.org/2021/04/understanding-unhappy-patients-makes-hospitals-better-for-everyone?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+harvardbusiness+%28HBR.org%29 (Accessed on 6th April 2021)

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