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How can pharma better engage and empower patients who are socially disadvantaged?

Knowledge to the people! Power to the people!

Cat Barnett and Jo HewittOur health is a lived experience every day. It goes beyond the walls of clinics and hospitals, and our interactions with healthcare professionals/providers. It is impacted by where and how we live, learn, work and socialise. If we understand our health and our ill-health better and make our own informed decisions, evidence and experience tells us we should be healthier and live longer, as well as cost society less.

So far so good. Unsurprisingly, a broad ‘movement’ emerged on the back of this understanding that has advanced putting patients first. Labelled ‘patient engagement’ it now encompasses anything and everything from patient involvement in healthcare design, planning and delivery of services to social media strategies and monitoring vital signs using wearable technology. Today, we are seeing partnerships between pharmaceutical companies and third parties. Amazon, for example, is using Alexa’s voice-activated technology for patient self-management of chronic diseases, such as managing diary appointments with doctors and providing medication reminders.

As technologies advance at an astonishing pace, so too will opportunities to empower patients and improve outcomes. Some commentators argue it’s a matter of time before patients are designing treatment approaches for themselves with their physicians. While many of us are excited about the prospect of body sensors predicting and advising on aspects of our health and disease management in the future, there’s a whole slew of society that is being left behind.

Evidence shows that in general the lower people’s socio-economic position is, the worse their health is - those who are the most socio-economically disadvantaged are twice as likely to have a long-term health condition than those who are the least disadvantaged. There is a clear social gradient in health that runs from the top to the bottom of the socio-economic spectrum and this gradient directly correlates with the cost to society, including healthcare costs.

We also see that access to technologies corresponds to the social gradient - only 47% of the world are online, with digital skills and access varying wildly across regions. Those lacking the skills/access are more likely to be older, have disabilities and lower income and education. There is a direct correlation between digital exclusion, wider social disadvantage and health inequalities.

Can pharma do more to better engage patients most impacted by health inequalities?

We know that patient engagement is only as effective as a patient’s knowledge, understanding, skills, ability and willingness to participate in his/her own care, in addition to the healthcare provision of a resource or intervention that enables that participation. For those who are socially disadvantaged, Professor Michael Marmot’s work at University College London’s Institute of Health Equity shows how social injustice leads to health inequalities, and that education is key to people getting control over their lives, but the very act of social injustice limits such education and disempowers.

Pharma has long been the driver of health education campaigns, either themselves or in partnership with patient associations. However, these have often taken a broad approach. To engage the socially disadvantaged, we cannot assume a ‘one-size-fits-all’ approach. It is imperative that pharma thinks differently and supports patients through a combination of universal (population-wide) and targeted interventions which reflect the disadvantage and hence, the level of need.

Pharma invests heavily in understanding patients and it is through this research that a targeted approach should be based. Indeed, for certain patients, Alexa may play her role, yet we need to identify whether others are being left behind. Take the recent Know Your Lemons campaign, which is built around striking imagery and aims to educate women on the signs of breast cancer. It was built upon the insight that adult illiteracy is one of the key barriers to understanding information about breast cancer. Many campaigns use text, partly due to sensitivities and censorship around using images of breasts, so the campaign sought to find an alternative route which could be easily understood by all women. Simple, yet effective and understandable and accessible for all types of patients.

There is constant talk of the rich getting richer and the poor getting poorer. Closing this gap could save billions in healthcare costs, but there is not one quick fix and not one single approach. Reducing health inequalities is a matter of social inclusion, fairness and social justice. Yes, health technology can play a role. However, until it is easily accessible, not only in terms of cost, but through ease of use, understanding and applicability, its full value will be a fraction of what it could be. So yes, pharma must work with new health technologies to engage and educate, but not to the detriment of a targeted approach that will not only help the individual, but the healthcare system as a whole.

Cat Barnett and Jo Hewitt are both directors at HAVAS Just::

In association with

Havas Just

7th June 2017

From: Healthcare



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