Bridging the Gap Between Doctor & Patient

Physicians – on average – spend 15-20 minutes with a patient for a typical office visit[1]. While 15-20 minutes may be sufficient for a general health checkup, for people dealing with a chronic condition (or multiple conditions) this time can seem limited.

Now imagine that you, yourself, are sitting in your doctor’s office and you have just been diagnosed with a chronic condition. The doctor was running 5 minutes late, and after some introductions and the information about your diagnosis, you now have 10 minutes left of your appointment. What is your doctor telling you about your condition – which, until 5 minutes ago, you may have never heard about? What do you want to know?

BuzzBack has been hard at work developing a methodology that gives us both the patient and physician perspectives on these issues, highlighting specific areas where there are gaps that may be able to be addressed by other stakeholders (e.g., pharmaceutical companies, health insurance companies, etc.).

For instance, our research found that when talking to COPD patients, while PCPs and Pulmonologists tend to focus a lot on treatment options, symptoms, and the origin of the condition when diagnosing a patient, there is less of a focus on overall health, which patients indicate being the top thing that they wish their HCP had spoken about when they had been diagnosed.

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Check back here for more information about our upcoming webinar, where we’ll be presenting our research findings on Patient-Physician Communication Gaps. 


[1] http://www.ajmc.com/journals/issue/2014/2014-vol20-n10/the-duration-of-office-visits-in-the-united-states-1993-to-2010; http://khn.org/news/15-minute-doctor-visits/

Doctor Patient Communication Gaps

Hysteria or Validated Concern? You Be the Judge.

As of October 19, 2016, there were 4,016 cases of Zika in the continental US. Of these cases, 137 were acquired in the US, and the remaining 3,878 cases were acquired in other countries[1].  Despite the low prevalence, Zika has gained wide media coverage across the US and is seen as a significant threat to many.

Here at BuzzBack, we were interested to find out what residents in the US and Brazil understood with regards to symptoms, transmission and prevention of Zika. According to our study, when asked to select the most severe among a list of outbreaks/pandemics, Zika was a close second to HIV/AIDS, selected by 20% (HIV/AIDS was selected by 24%). This may be surprising, given that HIV/AIDS impacts millions of people in the US[2].

Brazil, on the other hand, has faced far more Zika cases than in the US – over 90,000 new cases reported from January to April 2016 alone[3].  When asked to identify the most severe outbreak/pandemic, 24% listed Zika as their top concern (similar to that of the US) – whereas 44% indicate HIV/AIDS as the most severe.

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Data collected from PAHO & WHO: http://www.paho.org/hq/index.php?option=com_content&view=article&id=12390&Itemid=42090&lang=en

While it is not surprising that Zika is particularly top of mind and viewed as relevant at the moment, what is surprising is that (1) the concern in the US appears to be comparable to that of HIV/AIDS – despite having FAR less of an impact and (2) the general concern in the US appears to be comparable to that of Brazil – despite vast prevalence.

By utilizing BuzzBack’s eCollage (a non-lexical, indirect format to reveal personal feelings, using images as metaphors to reduce dependency on rational thoughts), the drivers of concern in the US are identified. The key source of fear in the US is the unknown. Individuals know there is a lot of information on Zika, but they are unsure of what is true or false. They worry about how much the virus will spread, and fear they will not see it coming or would not know they’re infected until it is too late. Not understanding the disease fuels fear – Are there clear signs of infection? Can it be stopped? Is there a cure?

Does Zika warrant this grave concern?  Or is this more of a reflection of people in the US being impacted by heavy media coverage?  Will the media ultimately help give individuals a greater understanding of what Zika is all about? Are there certain organizations (e.g. CDC, WHO) who can help clarify concerns about Zika? Only time will tell…

If this topic interests you, head over to watch our latest webinar which features more insights from our Zika study.


[1] http://www.cdc.gov/zika/geo/united-states.html

[2] In 2014, 44,073 people were newly diagnosed with HIV infection in the United States; in 2012, 1,218,400 people were reported living in the US with HIV; and in 2013 there were an estimated 12,963 HIV/AIDS-related deaths. http://www.cdc.gov/hiv/statistics/overview/ataglance.html

[3] http://www.rte.ie/news/2016/0427/784704-brazil-zika/

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Patient Perspective is Unimportant Here

That’s what some people will still tell you in the healthcare industry in America. “Patients can’t tell you anything important”. Too many times, we encounter people who think the patient perspective can be obtained through someone else. “Doctors tell the patient story well,” they’ll say. Or, “We already know what patients need”. My favorite is this one: “The patient perspective doesn’t really matter here because they don’t have any say in product choice or usage.” It’s always left me silent when I hear this from folks in marketing, or physicians or executives. Do you care what the patient feels? How they perceive their illness, their body, in this context? In these cases, it seems like everyone knows what the patient wants, except the patient. Countless people have brought patient perspectives to the forefront in the past fifteen years, so it’s surprising to encounter this underlying bias.

In the research work that I do, the patient voice and the patient’s imagination are the most important focus for me. I know a lot of people agree, but I find that sometimes even the best intentioned people only go halfway in their efforts to let the patient represent their own point of view. Recently I came across an article in the Huffington Post about people who suffer from migraines. Several of them provided a brief metaphoric description of how they experience their symptoms (e.g., “It leaves my brain feeling like a wrung out washrag.” Or, “It feels like I’m pushing my head against a pallet of bricks.”). My reaction was really positive – here’s a national media outlet giving voice to sufferers of a neurological disorder.

DOWNLOAD NOW!   'Mapping the Patient Journey' White Paper

Along with the narrative descriptions, pictures illustrate these same symptoms (e.g., a face in agony with a washcloth being twisted over it). Something was off with the pictures – they all looked similar and they were way too polished. In fact, a HuffPost artist had created the pictures, rather than the patients themselves. “What a shame,” I thought. “There would be so much rich insight offered by getting them to draw their own self-portraits.”

At BuzzBack, we often ask patients to create pictures or collages about some experience they’ve had, or in response to an idea we present (an ad, a package, a description of a drug, etc.). Then we ask them to tell a story about their picture. We’ll do this across as many people as seems reasonable. Sometimes it’s 1,000 patients, and sometimes a lot fewer. For sufferers of rare diseases, we’ll do it with the ones we can gather – maybe 25 or 30. We do it in the US, and in many other countries too.

At one point we started asking doctors and other healthcare professionals to engage in this free form, creative work based in imagery. Surprisingly, the professionals do it willingly and energetically, and we now do just as much work with them as with patients. Talk about a group that needs a creative outlet to vent their issues: doctors must be the most frustrated profession in America. In a 2014 survey of physicians, 81% said they were over-extended, and 29% would choose a different career if they could go back. Within this framework, they love to create pictures and tell us stories, too.

Sometimes, we’ll ask doctors to depict a patient with “disease X”. At the same time, we’ll ask patients with the condition to describe their doctor, or themselves, or some other aspect of the disease and its treatment. Then we tie the two perspectives – two sets of images and stories – together. What do they have in common? Where are there discrepancies?

As one might imagine, we get a rich visual collection tied in with a strong narrative assemblage. It’s the patient story and the doctor story together. For clients, it’s crucial for coming to a better understanding of the disease their drug treats. We find unmet needs, the extent of the struggle, the concerns and issues that doctors and patients both have. It all comes from personal experience, and personal perspective. It’s unfiltered and extremely rich. And we don’t draw the pictures for the patients, we let them do it themselves.

To find out more about how we do what we do, download our Patient Journey white paper now.

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Humanizing the Patient-to-Medicine Connection

One of the challenges facing the healthcare sector at large is patient adherence. It’s a topic of continuing importance and increasing interest.With on average 50% of patients not taking their medication as prescribed (and 33% never even filling their prescription in the first place), there’s much work to be done in understanding how to drive compliance.

We recently explored the impact of emotions when it comes to adherence, co-presenting our new study with Merck at the Pharma MR conference. We found that diving deep into patient feelings about their experience provides clues to how to positively influence their behavior and affect better outcomes. For example, in this study, we explored how they feel about managing their condition and their feelings about their physician relationship.

But what about the roles other individuals play in the complex puzzle? For example, what is the role of the pharmacist? Recent industry data shows the pharmacist holds an influential position. For example, a 2013 study by the National Community Pharmacist Association identified patient connectedness with their pharmacist as the leading predictor of adherence.

This pharmacy/pharmacist connection was the focus of a Wall Street Journal article that caught our eye here at BuzzBack earlier this month. It featured CVS CEO, Larry Merlo, who focuses on this exact issue: the need to humanize the patient-to-medicine connection with a clearer understanding of emotions. He sees the role of CVS as one to “help people on their path to better health.” Mr. Merlo believes that one of the ways CVS can truly make a difference is in making sure people take the medications they are prescribed.

CVS has made improving adherence a central goal, looking to improve it as much as 15% over the next two years by working on the pharmacy-patient relationship, and not just the administration of the drug. Mr. Merlo sees the pharmacist as integral to the equation: “CVS figures a one-on-one conversation with a pharmacist is two to three times more effective than any other method to change patient behavior – in a way, the human element that often goes missing in the U.S. health-care debate.”

At BuzzBack, we are excited to be part of the debate. Through innovative tools and creative expression techniques, we help consumers find the language to articulate the obstacles that need to be removed on their road to better health. And we uncover more effective ways that pharma companies can prepare physicians and pharmacists to communicate and lead patients on their adherence journey. In fact, we’ll be conducting an upcoming webinar presenting the results of our study around this important topic. Click to attend the webinar on Wednesday, March 4th or Thursday, March 5th.

patient taking medicine

Oh, I See Now! – Using Visual Communication to Improve Adherence

The high level of nonadherence across all therapeutic categories is a hot topic, and becoming hotter.  It’s a question of enormous cost on one hand (to patients, insurers, CMS, hospitals, families…) and a serious question of lost revenue for the pharmaceutical companies. The team at BuzzBack has been working on nonadherence related issues for a number of years, and we utilize our tools to interpret how patients with a given disease understand and feel about what, exactly, they are going through.

In that light, a recent article in the New England Journal of Medicine by Lisa Rosenbaum, M.D. caught my attention. Dr. Rosenbaum, who writes on medicine for many publications and is a cardiologist at the University of Pennsylvania, explores how patient feelings impact adherence to medication for cardiovascular disease. The author cites a study that suggests that “one way to address medication avoidance is to better communicate the benefits of a drug. Although such communication is essential, so is the understanding of what beliefs contribute to avoidance of cardiovascular medications in the first place.” What’s exciting about that statement is that an increasing number of pharma companies are working with firms like us to dig deep into the “why” behind patient nonadherence. In fact, BuzzBack is currently working on a study (which we will present at the Pharmaceutical Market Research Conference on February 5) in which patients express feelings about their relationships with their doctor, their disease, and their therapeutic regimen, using visual imagery as well as direct questions. We are looking into how strongly positive and negative emotions can influence adherence, and whether it is related to usage of alternative medicine.

In her article, Dr. Rosenbaum recalls conversations with patients about why they abandon their regimens. She observes how some patients cite an interest in “natural” solutions. Patients see their prescriptions as “chemicals” to avoid – the drugs intrude upon the natural state of things. Other negative feelings and associations that reduce adherence include suspicion, shame, failure, aversion, fear of risk, and loss of control. Patients also say that today’s advanced medicine and its apparent speed of effect makes adherence seem less important (paraphrased as “I feel so much better leaving the hospital than when I came in – I don’t need to take the drugs anymore”). Related to that idea, patients who begin to feel better once on their own often become nonadherent. This is especially true for asymptomatic patients who lack concrete evidence of their improvement.

The article advocates what we often find when studying adherence. Pharma companies need to better articulate the purpose of their drugs to patients. They need to explain how both the obvious and unseen changes are both important. The article confirms what we have worked on for many years: visual metaphors and the visual delivery of this information can improve compliance. Dr. Rosenbaum writes about how patients on clopidogrel frequently explain why they take their medicine and what the benefit is to them. These patients use visual language (from Plavix ads) to paint the “here’s why I do it” picture: “It keeps my blood flowing. “It keeps the pipes from clogging.” The distinct visual lexicon creates a compelling mental image that seems to encourage adherence. Other research over the past 30 years has confirmed that visual imagery helps patients understand their disease better and adhere better to treatment. Rosenbaum proposes creating visual communications that make an emotional and personal patient-to-prescription connection that literally illustrates the purpose and benefits of the treatment. This begs the question: what visual metaphors can help companies outside Dr. Rosenbaum’s cardiology realm? How can visual and latent emotional insights improve diabetes adherence? Adherence with asthma therapy? What pictures should be included in communications that will ultimately improve and even save patient lives?

Dr. Rosenbaum’s conclusion echoes the spirit of BuzzBack’s mission when working with healthcare companies:

“Although we tend to view nonadherence as patients’ failure to know what’s good for them, learning about people’s feelings about medications has made me recognize that my ideas of good and bad were defined solely in my terms. What I’ve learned is that if I felt what they feel, I’d understand why they don’t.”

When innovating insights for pharma, we are driven to get at the why so we can influence better outcomes – often uncovering the visual language that will resonate profoundly with patients. As an insights professional, I often find those projects the most meaningful and memorable because they do the most good.

If you’re interested in learning more about BuzzBack’s own study on adherence, get in touch with us below.

man taking pills

How Pharma Companies are Innovating With Packaging

I don’t know too many pharmaceutical companies who are not concerned about compliance. There is a constant discussion and search on how to ensure patients take their medicine or get their shots. How many of us get flu shots? For those of us who have suffered from the flu and never want to experience that again, taking the flu shot should be easy. They have made it easier and easier to get your flu vaccine – doctor’s office, health department clinic, schools, and even pharmacies.

Interesting enough, this article I read today indicates that fewer than half of all Americans who should get the flu shot actually get one. Is a person’s time the culprit or are there that many Americans who hate shots? The article also discusses a new type of vaccine in development that is patch-based and there are talks of it being sent via mail to be self-administered. The patch is covered in “50 tiny needles that barely penetrate the skin” and test volunteers reported the patch to be less painful than the flu shot.

It is  not just consumer companies looking for innovative packaging or names, but pharmaceutical companies are innovating new ways to ensure we take our medicine as well. If you want to truly differentiate yourself from your competitors, using the same research approach that everyone else is using is counter-intuitive. Market research and insight professionals have the ability to be the voice of change for their companies. Deciding to break out from the pack will fuel the innovation process. So go ahead, dare to be different.

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A New Spokesperson for COPD?

In case you missed it, the man most notably recognized for his tag line, “Live Long and Prosper” came out as being diagnosed with COPD (chronic obstructive pulmonary disease) just a week and a half ago. Leonard Nimoy who played Spock in the original Star Trek series is one of only a few celebrities to announce they’ve fallen ill with COPD. With his upfront approach and recent interview, the beloved actor is fast becoming the newest spokesperson to shed light on the 3rd leading cause of death in the U.S. (and the 5th leading cause of death in the U.K.).

A few days later, a U.K. study was released that found doctors are missing opportunities to diagnose COPD earlier. The retrospective study of almost 39,000 patients showed that “5 years before diagnosis, 85% of patients had visited their GP or a secondary care clinic at least once with lower respiratory symptoms.”

The World Health Organization predicts “that COPD will become the third leading cause of death worldwide by 2030.” With COPD on the rise, it’s quite obvious that the world needs to not only shine a light on this under-diagnosed disease for patients but for physicians as well. The timing of Leonard Nimoy’s recent admission along with the findings from this new study might help do just that.

At BuzzBack, we too were interested in understanding COPD better from a physician and patient perspective, so we decided to take a different approach that was highly effective in eliciting honest responses from both doctors and patients in a pre-established ‘safe-space’. Respondents participated in two BuzzBack Hive sessions over a one week period; they posted comments based on tasks and were encouraged to interact with other participants in the group. Interestingly, we learned that although current recommended and reported treatments involve few lifestyle modifications, patients’ advice to other COPD sufferers is almost strictly related to daily routine. Patients strongly suggest sufferers stop smoking, exercise, eat healthily, take medications, and establish consistency in doctor visits; this appears to be aspirational as many admit they struggle to follow their own advice.

For his part, Mr. Nimoy appears to be taking an upfront, positive approach to dealing with his diagnosis and much like the patients from our study is dishing out his own advice, albeit via twitter. Since his spotlight is a lot brighter than most suffering with COPD, maybe, just maybe the world will take notice.

To learn more about our COPD Study, like what doctors and patients said about new treatments,  send us an email.

 

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