The Best Teacher for Patient Adherence: The Weight Loss Industry

Posted on June 18, 2013 by Grace Soyao

Let’s admit it – the weight loss industry is a mammoth industry to reckon with, both in terms of revenues and absolute number of customers who are currently participating, tried it in the past, or with intentions to try it in their lifetimes. Market Data Enterprises estimated that the weight loss industry is estimated to be at $66 B in the United States alone in 2013. As an industry, it continues to attract market players with differentiated offerings, each armed with the latest studies that prove the programs’ effectiveness, which surprisingly attracts legions upon legions of advocates and followers. This is an enviable position that pharmaceutical marketers can learn from. So let’s tease out some of the parallels on adherence between the pharmaceutical and weight loss industries.

Ownership of treatment goals

ownership

First, there are end points and goals to accomplish. The difference is that for weight loss, it is specific, measurable and established by mostly by the customer. There is a sense of ownership at the onset. For most disease states, the goals, especially medical goals, are set by doctors and not necessarily by the patient. In managing primary or specialty diseases, the goals are mostly based on standards of care, immediately detaching the patient from the first important step – goal setting.

Clarity of treatment path

clarity

Second, in weight loss management, most programs present the weight loss path in explicit ways making adherence simpler and easier. For example, following the Low GI Diet, the message is simple: eat foods that have low Glycemic Index; promoters simply organize foods from low to high GI scores with specific suggestions on timing for consumption – a process that is easy for customers to understand and follow. In treating diseases, while physicians follow a standard of care and treatment algorithms, they are quickly translated to “scripts” with very limited opportunities for patients to comprehend the treatment approach hence leading to sub–optimal treatment adherence. Borrowing from Chip and Dan Heath’s bestseller Switch: How to Change Things When Change is Hard, the presence of the “rider” (can be the physician) that leads the elephant (may be the patient or caregiver) by creating a simple and clear path towards a goal can help to motivate positive changes in behaviour to optimize health outcomes. Change happens when we know our destination and why it matters to us.

Presence of a support system

support

Third, weight loss programs are designed around systems, integrating other streams that will increase opportunities for successful adherence to program or help manage expectations, e.g. coach, partners, apps, etc. In drug treatments, patients are generally left on their own once they leave physician clinics, armed with a prescription, a 10 minute download of information and an order to come back for follow up visits. Meantime, patients are left on their own rushing to get home to secure second opinion or advice from their “invisible” coaches and partners in the online world.

Grace Soyao
Founder & CEO

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Optimizing Efficient and Organized Patient Care through Patient Pathways

Posted on June 12, 2013 by Grace Soyao

On May 8th 2013, Self Care Catalysts hosted our very first Patient Advocacy Through Collaboration Round Table with nine Canadian patient organizations. We felt that in order to truly understand the patient journey across multiple therapeutic areas, there was a need to incorporate the perspectives of patient groups. Through this very successful round table discussion, we not only discovered the ways in which patients manage their care with the support of patient groups, but we also uncovered many gaps in the system that impede the achievement of better health outcomes.

One of the key findings from this round table discussion is that patients are often lost and uninformed in terms of how they should navigate their care pathway.

Oftentimes, illnesses and diseases are thrust upon patients without warning, and they are left confused and unsure about what their next steps are. There is no “orientation program” for patients afflicted with a new health problem. In the physician’s office, they are given information about their treatment, but they are not told what to do next: Are there patient support groups available? How do I get access to clinical trials? Where can I find others who share the same experience with me?

There is also no practical standard in terms of how HCPs disseminate information to patients. The quality of information that HCPs provide to patients is not part of a consistent standard of care. Many physicians do a great job in treating the illness, but not the patient who is often dehumanized in a clinical setting.

Therefore, there is a need for HCPs to collaborate with patient groups that can provide the support that patients need in a post-consult / post-hospitalization setting. In addition, having access to an information repository with clear care pathways can motivate patients to navigate their treatment because they will have clarity on what the next steps are and what needs to be done.

Grace Soyao
Founder & Chief Strategy Officer

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A New Normal: The Metastatic Breast Cancer Patient’s Story

Posted on May 23, 2013 by Grace Soyao

We are privileged at Self Care Catalysts to amplify the voice of patients. Our recent report on Metastatic Breast Cancer (MBC) in the United States, based on an exhaustive analysis of online conversations and in-depth one-and-a-half hour interviews with MBC patients with various receptor statuses, provided us with a thorough understanding of how women diagnosed with MBC go through decision-making processes that are driven by their unique sets of choices and conflicts. When Angelina Jolie revealed her decision to undergo double mastectomy, there was a vast range of conversations and responses; some hailed her action heroic and inspiring while others admonished her for taking a route that is less favoured by many women and physicians alike. Jolie wrestled with formidable decision conflicts, but how she eventually decided on her course of action was most likely driven by the values that truly matter to her – to live long and meaningfully with her children and family.

This is the story of Metastatic Breast Cancer patients in the United States:

A New Normal: The Metastatic Breast Cancer Patient’s Story

woman-iconThe patient’s journey begins with an unwanted gift. Betrayed by her own body and subjected to bearing a condition that promises to never go away, the patient is embarking a battle she must fight every day. The irony is lost on her. What she perceives to be the end is only the beginning of a longer journey.

Women diagnosed with Metastatic Breast Cancer are warriors of a struggle waged against their own bodies. Their journey begins with tragedy and progresses to developing a “new normal” suited to fit and accommodate their condition. Although a primary driver of her own condition, the patient requires an effectively integrated system of support throughout her journey. Aware of what their diagnosis entails, the battle against their condition is a struggle to prolong the inevitable. The primary objective is no longer simply a cure. In its place, patients seek to prolong their survival, to maintain a standard to their quality of life, and prevent the negative progression of their condition.

The initial stages of the patient journey prove to be among the hardest both emotionally and physically. Lacking in support and knowledge from public domains, the patient relies on their integrated system of support to mold the decisions she pursues in fighting her condition. After the stage of acceptance, the patient acknowledges her condition and what it could mean in the long run. She understands that “normalcy” no longer exists and it is her duty to create a “new normal” that is more accommodating for her. Addressing the struggle does not imply undergoing aggressive therapy, as is the case in Early Breast Cancer patients. Instead, the patient must strike a balance in concerns to what they are willing to sacrifice in terms of their quality of life in order to prolong the inevitable. Patients have described the experience as one of the “living dead”. In the initial stages of diagnosis and the beginnings of treatment, the patient requires a system of understanding to empathize and support her in coping with her condition, especially when lacking in optimism herself.

After passing the initial stages, the patient understands that the progression of her condition lies in her hands. Patients of Metastatic Breast Cancer often become experts of their condition in terms of treatment and experience. It is a method of empowerment and taking control of the condition. Taking their expertise, they expect to be treated as equals to physicians inside and outside of the doctor’s office. They apply their knowledge online by becoming advocates of their own cause to fellow patients. By this stage, patients are beginning to rebuild their inner selves, allowing them to increase their motivation to seek opportunities that will allow them to prolong their survival. Paradoxically, their initial pain is transformed into a positive outlet of appreciation and improvement.

Success is no longer measured in time, but instead in the currency of life’s milestones. Although interrupting one’s ability to pursue long-term goals and living in uncertainty, the women diagnosed with Metastatic Breast Cancer fight back in order to regain control of what they have lost in their lives. The journey of our patient is not one that is linear. These women are empowered by the prospect of winning the battle by living another day. The strength of these women must be recognized and supported by the medical community and public discussion by giving Metastatic Breast Cancer the visibility it needs. Without a cure, the only thing left to gain is time and these women fight for time against their bodies every day.

Grace Soyao
Founder & Chief Strategy Officer

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Self Care Catalysts’ Patient Advocacy through Collaboration Round Table

Posted on May 15, 2013 by Grace Soyao

IMG_0627At Self Care Catalysts, we pride ourselves on amplifying the voice of patients in their healthcare conversations. In the spirit of promoting true patient-centric care that is not just lip service, we organized our first Patient Advocacy through Collaboration Round Table on May 8th at the MaRS Discovery District. Nine patient organizations dedicated and united by the mandate of promoting patient-centred care gathered together to ideate on solutions that will drive improved health outcomes for patients.

Some of the attendees of this round table are:

  • CAMH, Centre for Addiction and Mental Health: David Wiljer (Senior Director, Transformational Education)
  • Canadian Digestive Health Foundation: Catherine Mulvale (Executive Director)
  • Colorectal Cancer Association of Canada
  • Leukemia & Lymphoma Society of Canada: Lucy Di Carlo (Community Outreach Manager, Ontario Region)
  • Myeloma Canada: Aldo Del Col (Co-founder & Executive Director)
  • Rethink Breast Cancer: Ashley Mac Isaac-Butler (Senior Advocacy Manager)
  • Thyroid Cancer Canada: Mary Floro-White (Executive Director)
  • Willow Breast Cancer Support Canada: Linda Kurjanczyk (Coordinator, Peer Support)

I facilitated this round table discussion in my role as Founder and Chief Strategy Officer at Self Care Catalysts. This event was highly successful, and much of the credit goes to the representatives from these various patient groups who were extremely passionate in discussing how to improve patient care. Together with Self Care Catalysts’ expertise in bridging the gap between patients and the healthcare industry, we were able to lead an active and fruitful discussion and propose actionable solutions to the most pressing issues in patient.

We believe that patient engagement should be more than just talk, which is why we continuously strive to understand patients’ needs and listen to their voice that is often unheard. We talk to real patients; we listen to their stories; we partner with patient advocacy organizations. This round table event is but one of many more to come. Through our research and collaboration, we aim to develop strategies and solutions that accurately reflect the complexities of patient needs for pharma and the healthcare industry. Only with a clear understanding of the end consumer—the patients—and their decision-making process can healthcare and treatment solutions lead to better patient health outcomes.

Grace Soyao
Founder & Chief Strategy Officer

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Motivation – Isn’t That All I Need To Change?

Posted on May 8, 2013 by Grace Soyao

A recent study at the University of Missouri in Columbia discovered that rather than considering our physical activity patterns to be genetic, it is the desire to be active or indolent (in other words, the motivation to exercise) that is inherited. However, the scientists also cautioned that the argument of pinning predisposition to physical motivation should not become the excuse of those who prefer being a couch potato. As noted by Dr. Booth from the study, “behavior remains a mix of innate tendencies and personal choice”. It is important to understand motivation as one of the behaviour changing parameters; however, it is not all.

In the best-selling book on behaviour change, Switch, Chip and Dan Heath employ a vivid metaphor about how the brain works based on two systems: the rational which is represented by the Rider, who needs to be directed; and the emotional which is represented by the Elephant, who needs to be motivated. It is argued that when these two systems are in alignment, rapid and effective changes in behaviour will naturally take place.

According to Oxford English Dictionary, motivation is defined as, “a reason or reasons for acting or behaving in a particular way”.  When it comes to health decisions, simply understanding the reason(s) of patients’ actions is not sufficient for Pharmaceutical companies. Most of the time, leverageable opportunities of Patient Influence lie in the demystifying the process of how patients, as well as their caregivers, are directed and motivated to make treatment decisions.  In this sense, a holistic framework that goes beyond the knowledge of genetic predispositions, motivation and personal preferences is needed so that influential touch points along the patient journey can be identified – both from the inside and the outside of the physician’s office.

Grace Soyao
Founder & Chief Strategy Officer

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Proud Donor To Important Causes

Posted on April 23, 2013 by Grace Soyao

Self Care Catalysts is pleased to announce that our donations to Colorectal Cancer Association of Canada and BCMets.org have been made. With a passion for patient advocacy at heart, Self Care Catalysts believes that patient communities are significant self-care enablers for not only patients but also caregivers along their journey of treatment management. By providing effective and interactive platforms that drive better patient support, organizations like Colorectal Cancer Association of Canada and BCMets.org truly live up to their visions of being patient-oriented.

A Google search on “patient support groups” gives you 114,000,000-results. This is a number that cannot be ignored when we reflect on what makes patient support groups important. Patient support groups provide tremendous emotional and practical assistance to patients and their care providers.  The functionality of the well-organized patient communities effectively equips patients and their families with information, knowledge, and confidence they need when making decisions for better health outcomes. Moreover, on a macro level, patient support groups fill in the gaps in the existing healthcare system by advocating for patients’ needs when facing physicians and pharmaceutical companies.

Self Care Catalysts will continue to be a proud supporter of these amazing patient organizations and a passionate agent in amplifying patient voices. At the same time, our mission further resides in driving better health outcomes for patients through helping them to make better treatment choices. To us, understanding patients is the core to everything in the healthcare system surrounding us today. 

Grace Soyao
Founder & Chief Strategy Officer

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Patient Navigators … New Stakeholders Making A Difference

Posted on April 10, 2013 by Grace Soyao

No one is ever ready for any illness diagnosis, even more so for the journey that lies ahead. A recent article on patient navigation as a new health field sheds a glimmer of hope to patients who often are lost in the sea of healthcare complexity. In all patient research that Self Care Catalysts has conducted, it was determined that there is an aspect of disease management that is sorely missing as patients enter an unknown world where a lot of moving parts and personalities could not even pinpoint the “entry or exit points”. Sad but true.

For example, in the case of Diabetes patients, they suddenly are thrust in the complexity of Self Care which demands that they change their day to day eating, socializing, working habits in addition to learning moment to moment blood glucose monitoring and administration of oral or insulin therapy.  Similarly, metastatic breast cancer patients, whether diagnosed for the first time or not, experience the same level of confusion around their treatment protocols. No one is an expert patient the first time they are exposed to the healthcare system.

Patient navigation is just what is needed to provide guidance and direction when patients are in the dark sorting through diagnostic and treatment management. Most importantly, Patient Navigators embody the “human connection” patients need when physicians miss out on patient expectations.

Patient Navigators who are clearly making a difference in patient lives can now fulfill the gaps that are missing in the patient circle of care. What is best is the side benefit they provide marketers when patient adherence improves as a result of one on one patient-patient navigator partnerships.

Grace Soyao
Founder & Chief Strategy Officer

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Patient Engagement Requires Physician Connection Too

Posted on April 1, 2013 by Grace Soyao

As patient power increases, physicians are challenged with how to manage the evolving patient behaviours. In a recent blog by Dr. Don Dizon, he commented on how every patient is different and people cope in very different ways. However, given the high-pressure health care environment that doctors work in, how do they find the balance between providing compassionate care that patients deserve and managing their own busy schedules? It is believed that a good patient–physician relationship will enable doctors and patients to connect emotionally. However, when patients are struggling at the bottom of their learning curve, being both psychologically and physically vulnerable, sheer provision of “medical services” from physicians is far from enough. Simply downloading expertise and knowledge could distance doctors from individual patients that are in need of comprehensive care, hence creating cracks in the patient-physician relationship.

Opportunities for Pharmaceutical Marketers are at hand around patient engagement through preparing patients for physician consults. For example, goal alignment can be established sooner if both parties are well informed of each other’s expectations. Most Pharmaceutical marketing programs are handed out after patients leave the physician’s offices however, missing the opportunities of helping patients and doctors even before the conversation in that room where most news is not good news.

Grace Soyao
Founder & Chief Strategy Officer

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Not All Health Apps Are Created Equal

Posted on March 27, 2013 by Grace Soyao

An article in the Healthcare section of Information Week, titled “When to Ignore That Mobile Health App” sheds light on some of the misguided benefits that health apps are purported to offer. In today’s age of digital consumerism with the widespread usage of mobile devices, there has been a app-development frenzy in the healthcare space – there already are more than 40,000 mobile health apps contributing to the $718 million global industry, according to Research2Guidance. However, it is wise to note that not all healthcare apps are created equal. In fact, many of these healthcare apps are not supported by clinical or patient research and are therefore misleading to consumers.

Healthcare professionals who utilize healthcare apps to aid in their practice need to be equally cautious before jumping on the bandwagon. They might end up getting wrong information or even convey the wrong information to their patients. Furthermore, not all mobile interfaces are optimized to view and display medical information.

How can consumers and physicians carefully choose which apps are the effective ones? The article suggests three criteria for evaluating the credibility of these apps: 1) Look for controlled clinical research that supports the app; 2) Demand physiological plausibility; 3) Don’t rely too heavily on anecdotal evidence.

In addition to those criteria, there is a fourth factor that will be instrumental in the success and effectiveness of healthcare apps that developers need to be cognizant of. Healthcare apps for patient consumers and physicians need to be developed based on a thorough understanding of patient decision-making and their experience. This will enable the apps to effectively serve the needs of their users, by understanding the various touchpoints throughout the patient decision making process that these apps will fit in to add value or solve the patient pain points or enhance a health goal.

A complete and granular understanding of the target consumer segment is imperative in developing any product. In this case, it would be wise for healthcare app developers to understand the consumers within the patients that they are serving.

Grace Soyao
Founder & Chief Strategy Officer
Self Care Catalysts Inc.

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A New Type of Influence: Patients on Physicians

Posted on March 17, 2013 by Grace Soyao

The power balance has tipped. Patients are increasingly influencing physicians and this trend will continue as patients band together with their peers, families and caregivers – all with rising strength and might. In a study on physician discomfort on patient influence, they argued that increased pressure from patients and their respective families and caregivers lead to physician discomfort and sometimes inappropriate care.

In our own studies at Self Care Catalysts, while we’re seeing this trend on patients advocating for their own treatment, they continue to expect their physicians to provide validation and more precise guidance.

So while patients are asserting their influence on their care, relationships with their physicians need to be sustained but with a new patient-physician dialogue framework that expects far bigger roles for patients, their families and their caregivers.

Grace Soyao
Founder & Chief Strategy Officer
Self Care Catalysts Inc.

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