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The patient frontier: Are we really patient-centric?

Policy and regulations may place the focus on patients, but Craig Mills from Frontera London asks if we are truly putting them first

One green umbrella amongst several white onesWho was it that said we live in interesting times?

There's a growing emphasis on patients but just how patient-centric are we?

Here's a perspective for you:

Quality standards have focused on evidence-based medicine for as long as we can remember with guidelines, policy and regulations forming the backbone. It's hard to argue that this has been anything other than sensible, intuitive; entrusting key management choices to those best educated to make clinical decisions.

How well is this working for patients?
New research from 2,500 patient groups informs us that patients want a different approach: one where decisions are based more on improving life quality (even if it means reduced life expectancy). Moreover, they want clinical decision makers to improve their communication and understanding skills. Consider what the public see...

Evidence-based approaches often position compliance as a secondary consideration when surely it has to be a major measure of treatment success when poor adherence and misdose limit clinical benefit. The cost to Europe of this is somewhere in the range of 195,000 lives and €125bn annually. The specific cost to pharma must be significant in that. Consider two basic examples:

1. Urinary incontinence affects women, on average, for seven years before they pursue treatment options with their GPs – neither side wanting to raise the 'water-works' discussion. By then, symptoms and an accommodated lifestyle have had chance to 'mature'. Should we be surprised then that treatment belief lasts a matter of months before the majority of patients stop?

Even when conditions affect core senses, the same challenge is encountered.

2. Glaucoma, responsible for approximately 15 per cent of blindness, has a dramatic reduction in adherence in the first year, despite drops being able to control crucial eye pressure.

So what's going wrong? Patients forget drugs; they misunderstand information; they worry about side effects and encounter problems: nothing surprising there. But if we were patient-centric, wouldn't we be investigating more, prioritising this as the dynamic component of the market? The consistent theme throughout the issues is communication, which brings us back to what patients said they wanted. 

Are we really listening?
Increased patient participation is inevitable. A recent study with 150 GPs and 488 patients found over one-third of patients had asked their doctor for an alternative treatment using information sourced elsewhere. In 69 per cent of instances, the doctor agreed. When you consider that 15-25 per cent of prescriptions are not even filled, the value of greater participation has to be of benefit to health, doesn't it?

The internet has arguably been responsible for creating a more informed patient. But when it comes to organisations understanding how patients now fit into their business planning, where are we?

Craig Mills, Frontera
The Author
Craig Mills is managing partner of Frontera London, an integrated creative agency, that's focused on patients and health consumers. Previously, Craig was managing director of McCann Healthcare.



20th April 2011

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