Adherence Is a Dirty Word

Adherence Picture BlogInstant gratification is not fast enough.

That’s the short answer to what derails (or drives) patient engagement. It’s simple really—you’re asking someone to change their routine, visit the doctor, spend their money, change their lifestyle—for something that doesn’t necessarily have a recognizable payoff tomorrow.

We design programs, apps, and all kinds of resources to “encourage adherence,” but they may only add to this burden. So what, exactly, is that burden?

Try it yourself.

That’s what patient educator and advocate Catherine Price (@catherine_price) has folks do. Dubbed the Tic Tac Challenge, participants use Tic Tacs as placebo pills, to see what it REALLY takes to remember to take your meds.

I organized a small Ogilvy Payer “Adherence Challenge” among my Payer, Creative and Shared Service colleagues, with the help of our fabulous summer interns. In the true spirit of a new prescription, each person got a script (with varying dosing regimens) which was filled at the “intern pharmacy.” Some scripts even had a prior authorization (PA) hurdle, which required a trip to our Director of Operations to answer SOX questions, to mimic the health plan benefits investigations and appeals process.

So how did we do?

Well. I didn’t even fill my script. The PA hurdle I landed with proved too great a barrier in my schedule.

Others’ success ranged from “almost compliant except for one travel day” to sporadic compliance, and some reported back compliance—but only on workdays when it fit into a routine. Variations on time of day, taking with food, or polypharmacy had a noticeable impact on the adherence burden. While some had routines or other reminders to help them along, no one was 100% compliant. With so much going on in our lives, it’s no wonder it’s easy to forget.

 

What’s the answer?

Well, there is no single solution. Merely knowing that “you have to” is not enough. There needs to be a reason you WANT to take a pill every day. Health needs to be integrated into life, not an add-on to it. HCPs need to speak the language of their patients— à la shared decision-making—to truly engage patients toward the benefit that adherence gives them in their life. Technology, while helpful, cannot solve everything for the unmotivated patient (hit that snooze button again!). Far-off benefits are strongly outweighed by what the patient needs/wants/feels right now.

For us, this is just something to keep in mind as we design apps, resources and CRM programs. Simple, integrated, and aligned with the patient’s goals is the mantra I will be marching forward with. A patient cannot just be adherent (a supporter or follower). Instead, a patient must be an enthusiast—active in his or her health interests.

 

These insights came from my attendance at the Patient Adherence & Access Summit this past June. If you would like the full write-up from the summit, just shoot me an email and I’ll happily send it over!

claire.pisano@ogilvy.com

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