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Why health psychology is the answer to tackling adherence

Atlantis Healthcare Clare MoloneyAtlantis Healthcare is a global expert in the strategic design, development and delivery of innovative, outcome-driven patient support solutions. Here Clare Moloney, Clinical Strategy Director at Atlantis Healthcare, discusses the topic of adherence and why pharma must look to health psychology to encourage behaviour change.

What are the factors that cause non-adherence?
There are numerous reasons behind non-adherence and these vary depending on the situation and the individual. The Capability, Opportunity and Motivation (COM-B) model aims to explain human behaviour in terms of the range of mechanisms that may be involved in behaviour change, and a recent paper, published in The European Health Psychologist and co-authored by some of my colleagues here at Atlantis Healthcare, discusses the application of COM-B to medication adherence.

  • Capabilities - things that are intrinsic to a person which can be psychological (for example understanding of the disease and treatment, memory and planning) or physical (for example adapting to lifestyle changes and dexterity)
  • Opportunities - things that are external to a person and can be physical (for example cost, access to medicines, complexity of treatment regimen and relationship with their healthcare professional team) or social (for example stigma associated with the disease, religious and cultural beliefs)
  • Motivators - those things that energise and direct behaviour which can be reflective (for example the perception of the illness and beliefs about the treatment as well as expectations around outcomes) or automatic (for example stimuli or cues to take action and mood state).

A person's adherence to treatment may be affected by one, some or all of these factors to varying degrees and so any programme which looks at influencing adherence should be tailored to address those factors that most influence that individual's behaviour.

Why should pharma look to health psychology?
Since drugs don't work in patients who don't take them, more must be done to model patient behaviour and support the real-world challenges of patients. The pharma industry is committed to encouraging adherence and supporting patients to self-manage, with a view to enhancing overall outcomes for their patients. At Atlantis Healthcare we work with a number of pharmaceutical companies to really understand the beliefs that drive certain behaviours and put in place personalised programmes which affect behaviour change.

In one recent programme that we developed on behalf of AstraZeneca, we assessed the reasons for low adherence in patients with acute coronary syndrome (ACS) who had been prescribed Oral Antiplatelet Therapy (OAP), a treatment that has been shown to reduce the risk of death or non-fatal heart attack. We looked at the underlying problems related to non-adherence in this patient population to identify common beliefs associated with non-adherence. Based on this, we developed a screening questionnaire that patients completed upon enrolment into the programme that would allow us to tailor the support programme for each individual, based on each person's own belief profile. Research at the end of the programme showed an improvement in adherence whereby 80% of patients never forgot to take their medication as prescribed, compared to 52% of patients missing or changing the way they take their prescribed medicine in the general population of patients prescribed OAP.

A multichannel approach to patient support is critical

How helpful are healthcare tools, devices and digital technologies?
Today, people have a number of healthcare tools, devices and digital technologies at their fingertips to help them better self-manage their health - from tools promoting overt actions such as moving more and eating better to reminding them to take medication. A multichannel approach to patient support is critical in order to resonate with different target populations and patient preference. With digital technology at the core it is possible to deliver personalised support tailored to each patient's needs. In this way, we can target covert behaviours, such as beliefs, thoughts and feelings, to ensure that truly patient-centred support delivers meaningful and sustained outcomes. Integrating other health technologies can offer integration of the system with a patient's health data to drive further customisation and support patient engagement.

How does the Atlantis Healthcare offering differ from that of other providers? 
The Atlantis Healthcare approach seeks to support and drive change through our unique ability to marry academically robust behaviour change evidence and methodologies with engaging user experience design and commercial expertise.

Atlantis' proprietary self-management framework incorporates insights from behavioural science, in particular health psychology and user-experience design to create support solutions that are engaging, commercially relevant and effective in driving behaviour change. This means that we are able to create solutions that meet the needs of all stakeholders: patients, healthcare professionals and pharma. Through this approach we are able to shift the boundaries of what effective patient support looks like in a 'real-world setting' and provide confidence to our pharma clients that there are lots of opportunities to help their patients, in a broad range of ways.

Clare Moloney is clinical strategy director at Atlantis Healthcare

In association with Atlantis Healthcare

2nd December 2016

From: Marketing

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