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Does a lack of understanding of human behaviour affect healthcare?

Only by synthesising research across multiple disciplines can we truly understand how to effect patient behaviour change

Despite the multiple threads of research into human behaviour that embrace diverse academic disciplines, we’re still not achieving all we could in effecting patient behaviour change.
 

The difficulty seems to lie in pulling together the various strands of research and understanding of human behaviour, so that legislation and health care policies reflect the reality of how people behave rather than working mostly from statistical research data analysis.  

Assumption versus reality

A common assumption exists among policy makers that people, when they have all the relevant information, will carefully weigh up the pros and cons of a given choice.  Then, armed with the new information, and having carefully considered the costs and benefits, they will modify their behaviour favourably. Unfortunately, this doesn’t take into account natural human behaviour and the ways in which we often take mental shortcuts, operating on a rule of thumb basis.  

We tend to choose options that have worked for us in the past, or those that we see working for other people. If a specified change in behaviour is particularly challenging, we may go part way towards meeting it, which in terms of health outcomes may not be far enough. Sometimes taking mental or emotional shortcuts can have beneficial outcomes, but the practice can also work against our well-being.  

The assumption that patient behaviour change comes about through conscious, rational thought is often mistaken. Research by behavioural science has shown that subconscious thought has a great influence on the ways in which we behave. One cited example illustrates how packaging and tableware can influence the ways in which we perceive portion size. Wanting a full plate at mealtimes is neither conscious nor deliberate, and research has shown that people will often default to a smaller portion without feeling deprived if they use a smaller plate.
 

By recognising that many health decisions are environment based, and largely subconscious or automatic, patient behaviour change could be more effectively influenced, achieving improved health outcomes.  

A confusing healthcare message

Healthcare systems involve diverse, complex relationships:

  • Between patients and HCPs.
  • Between a patient and their family or the wider community.
  • Between HCPs.
  • Between payers.    
Together they make up the three main areas where a lack of behavioural understanding creates problems affecting patient behaviour change:

  • In healthcare provision.
  • In health policy making.
  • In general public health.    
Driven in large part by economics, health policy-making tends to repeat the same mistakes when creating health processes. Often, for instance, insufficient attention is given to preventive care. We put more effort into solving problems that are immediately obvious and present, rather than focusing on preventing potential problems in the future.  

Professional incentive structures that place the emphasis on treatment rather than prevention tend not to promote patient behaviour change. In the real world, this creates a somewhat double standard and may be sending out a confusing message to patients: on the one hand they must change their behaviour in order to achieve a better healthier future, but on the other hand there is little in the way of help until current unhealthy behaviour has done its damage.  

How pharma can help

The pharmaceutical industry is well placed to influence all areas of healthcare provision and make a valuable contribution through designing interventions that positively encourage patient behaviour change.  

With its unique access to research bodies across disciplines, to healthcare providers and key opinion leaders (KOLs), pharma can offer tremendous support and guidance in healthcare provision through creating joint working initiatives. 
 

By bringing to bear the current thinking and latest research into human behaviour, it would be possible to devise initiatives and interventions that truly address the obstacles that challenge patient behaviour change.


This article was originally published here: http://www.wearecouch.com/blog/patient-behaviour-change

27th April 2018

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