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The Heart of the Matter 9: Context is King

McCann Complete Medical outlines why multichannel communications - anchored in strong clinical data from journal publications - must not only be transparent, they must also provide a clear clinical context for local HCPs.
The Heart of the Matter 9: Context is KingMcCann Complete Medical outlines why multichannel communications - anchored in strong clinical data from journal publications - must not only be transparent, they must also provide a clear clinical context for local HCPs.

The drive for greater transparency in medical publications is changing the dynamic of healthcare communications.
Flagship policy in both Europe and the US is mandating the full disclosure of clinical trial data, while international regulations now dictate data sharing, including anonymised individual-patient data, across all interventional clinical trials. The implications for pharma have been signifi cant.

Emphasis is increasingly shifting towards getting full datasets into the public domain, as well as focusing on the publication of curated information to support clinical decision-making. Consequently, the evidence-base is ballooning. In an already data-rich environment, the volume and depth of accessible information has massively grown, further clouding the decision-making process for HCPs.

The transparency agenda has spawned an ever-increasing expansion of the ʻgrey literatureʼ. This literature includes (but isnʼt limited to) clinical trial registries, regulatory agency archives, technical documents from government agencies, study results, protocols and abstracts of paper/poster presentations from meetings and congresses. Itʼs easily accessible. And itʼs growing.

Itʼs therefore no surprise that healthcare professionals, like consumers, are getting fat on information. As busy clinicians become further burdened by the burgeoning amount of information at their disposal, it is ever more important for pharma companies to ensure their data communications tell clear, robust clinical stories that enable physicians to rapidly assimilate the clinical context for their patients.

Publications are a natural starting point for this crucial information. As the backbone of communications for the pharmaceutical industry, journal articles have long been the central pillar of scientifi c exchange with HCPs. But, far from being an endpoint, theyʼre only the beginning of what is now a multichannel communications journey. As the combination of digital innovation and data transparency transforms stakeholder engagement, companies are increasingly seeking new ways to cut through the noise to help physicians contextualise clinical data at the local level.

The journal to the centre
The escalation of accessible data may have stolen attention from the traditional journal article but, paradoxically, it has also reinforced its value. “The journal article remains the most effective means of communicating scientifi c data to a healthcare professional,” says Leslie Citrome, Editor-in-Chief, International Journal of Clinical Practice. “Clinicians want up-to-date information that they can use in the day-to-day management of patients. A good journal article will give them that. Of course, journal articles are also valuable for researchers - though they have very different needs. Whereas a researcher might want details, data, tables and reference points, a clinician wants to know the bottom line: is the intervention going to work? Is it going to be easy to implement and worthwhile using? Rather than simply being the presentation of research data, a journal article is curated content, designed to help HCPs with everyday clinical practice.”

“As we know, the transparency of data is critical - and the emergence of the grey literature as a reliable source of robust and in-depth uncurated information will play an important part in attempts to achieve it,” says Les. “However, while this content may be hugely valuable to researchers, it is of very little practical use to physicians on the front lines. Moreover, with documentation running into thousands of pages, clinicians simply donʼt have the time to look at it. Thatʼs why journal articles, that provide timely, relevant and easy-to-digest clinical information, remain the crown jewels of data communications.”

To maximise the opportunity, therefore, publications professionals and brand teams must do all they can to ensure that journal publication, and all the other activities that are built on the data within it, provides clarity around the clinical context.

Clinical study v clinical practice
The value of publications in the communication of scientifi c data is indisputable. But this is only the beginning of the discussion. “Journal articles are the cornerstone of all communication around the safety and effi cacy of a product and the gold standard of communicating clinical trial data,” says Jane Nunn, Head of Operations, Complete HealthVizion. “Since the real-world population for a product will naturally differ from the trial setting, journal articles can sometimes fall short of providing the local contextualisation of data that HCPs need. Itʼs here where alternative means of communication can play a valuable role. These could be as varied as digital education programmes, post-hoc analyses, national meetings or peer-to-peer learning. Although these approaches are still anchored in the original trial data, they can help overcome the inherent limitations of ʻclinical study versus clinical practiceʼ, and present data in ways that are more relevant to the clinical practice of individual stakeholders.”

So where do you begin? The answer is to start with a detailed understanding of customer demographics, knowledge-bases, behaviours and needs - and to develop communications strategies that refl ect it. The rapid proliferation of media and evolving reading habits is dictating a move beyond the default use of traditional channels. “The non-stop demands of patient care mean that most HCPs arenʼt trawling through publications or reviewing new literature on a daily basis. They donʼt have time,” says Jane. “Their source of information are varied, ranging from collated sources, congresses and meetings, to peer discussions and, in some cases, professional social networks. Effective communication is therefore dependent upon understanding HCP personae - and adopting a multichannel approach that fl exes to suit individual needs, attitudes, contexts and prior clinical experience. That understanding is the baseline for effective engagement - and itʼs the reason why focusing on publication as the beginning of the communications journey is so important.”

All the worldʼs a stage
The demographics of pharmaʼs customer-base are fl uctuating. Nowadays, all the worldʼs a stage. The rapid expansion of clinical trials into emerging and developing markets refl ects the globalisation of medical research. However, with global studies set up to unearth both common trends and local variation, the dissemination of data that emerges from clinical trials should be similarly nuanced. Yet this is rarely the case.

“Historically, publications planning in pharma has focused activity at the global level,” says Sarah Feeny, Head of External Affairs and Service Development, Complete Medical Communications. “As such, journal articles are typically rooted in data from global studies. But what happens on the ground in individual markets doesnʼt always refl ect what happened in the clinical trial. For example, a global study may publish the results of an oncology product that has been trialled in combination with a chemotherapy backbone that differs from one used in real-world practice in an individual country. Translating global evidence back down to a country level is vital - but is seldom achieved through a journal article. As a result, articles can lack the appropriate contextualisation, fail to refl ect clinical practice and, more often than not, lack much of the context needed for HCPs to truly understand the role of the product in their day-to-day practices.”

Lost in translation
Similarly, a high majority of journals are published in English. This is a non-sequitur. “When the industry conducts globally-led activities, companies need to acknowledge that theyʼre likely to reach a tiny proportion of prescribers,” says Sarah. “The majority of prescribers outside North America, the UK and Australasia will not be looking for information in English. Fundamentally, since a large percentage of these customers donʼt read international journals or attend international congresses, any over-reliance on traditional journals as the major vehicle for communication means pharma risks failing to connect with a large chunk of the audience.”

The opportunities to engage, however, are not unfamiliar. “The industry is long accustomed to podium and poster presentations at global congresses. But we sometimes forget that there are also national meetings that are well-attended by local thought leaders, where data are presented in their own language,” says Jackie Marchington, Director of Global Operations, Caudex. “Unfortunately, too often the gap between global publications planners and local affi liates means we miss a huge opportunity to have local investigators present data in their local language - and to contextualise it in line with clinical practice on the ground. Likewise, in some cases, there can be opportunities to conduct subanalyses of data. For example, a trial may have suffi cient

participants from Latin America to enable analysis specific to that subgroup. This can help create more relevant and compelling data thatʼs aligned with local clinical practice.”

So how do you reach these crucial local stakeholders? The answer is a collective responsibility. “Success is contingent upon greater collaboration between global medical teams and affi liate personnel, to bridge the gap between global publications and local clinical practice,” says Sarah. “The sole reason for communicating research information is to ensure that its consumption allows prescribers to enhance clinical practice and patient care. We must therefore work hard to ensure that information is accessible and aligns with cliniciansʼ needs. The most proactive companies are empowering local affi liates to think about the data sets that are held at the global level - and encouraging them to use those data sets to develop resources that resonate with local clinical practice.”

Think global, think local
In a global marketplace with complex local dynamics and cultural nuances, striking the right balance is challenging. Thatʼs why the most effective approach is to work with a strategic partner that can provide expertise across the full gamut of medical communications, regulatory support, strategy development and multichannel stakeholder engagement.

As the volume of information available to HCPs continues to swell, the importance of driving excellence in medical communications will similarly grow. The publication will remain the cornerstone of scientifi c exchange and is crucial in establishing a clear, robust clinical story. But the most successful companies will be those where communications strategies take appropriate consideration of local clinical implications and demonstrate an understanding of how publications can be used as part of a wider, multichannel journey. After all, context is King.


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21st February 2017

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