Fast Track

• Adherence has always been one of the largest obstacles in healthcare
• Consider and understand the behaviours that lead to non-adherence to develop a good user experience
• Create messages that resonate by involving patients through digital technologies.

The key to good UX is understanding a user's habits and behaviours and creating interventions that fit around these behaviours to help him or her reach his or her goals. Replace 'user' with 'patient' and that last statement could equally be referencing adherence - one of the largest obstacles in healthcare for one simple reason: it's hard. Recovery programmes can be long and arduous; they require routine behaviours that are boring and unpleasant and they often provide little indication of progression or success. The pressure on so many areas of our lives is eased by thoughtful, user-centric design and we need to take the same approach to adherence.

A holistic view
There's rightly been a lot of noise about pharma's increased role in maintaining adherence and the need to go 'beyond the pill'. Our response must be more than lip service. Gone are the days when a hastily put together advice booklet was enough. Pharma is under the microscope more than ever; healthcare providers don't want expensive patented drugs that will drain their purses, they want effective and economical treatment systems. They want long-lasting improvements in quality of life for patients and that reduce the costly burden of care.

To achieve this we need to take a holistic view of patient pathways, supporting them and the stakeholders throughout this pathway. The quality of this support is paramount, in both its strategy and execution, and that's where the principles of UX come in. 

Information alone isn't enough. You can tell patients that something is good for them but that doesn't mean they'll do it. When they're isolated and alone, good advice that was given to them weeks ago can seem irrelevant. We need to provide motivation as well as information. We need to consider the behaviours that lead to non-adherence and help patients to change these behaviours.

Our daily lives are full of products that utilise principles of motivation to encourage positive changes in behaviour: from loyalty cards to LinkedIn profiles that rate the 'strength' of our online presence to encourage us to provide more information. One of the greatest exponents of such methods is Nike, who utilises a range of 'gamification' techniques in its training and fitness apps: badges and other indicators of progress, meaningful rewards, social engagement with other users, all wrapped-up in intuitive operating experiences.

Interaction can instil a deeper understanding 

Modern digital technologies have a number of properties that make them a particularly effective facilitator for behavioural change. Their pervading presence in everyday life has caused us to become very quick adopters of a wide range of principles and functions. 'Like' buttons, pinching and zooming hand gestures, and hash-tagging are now as engrained in our unthinking behavioural patterns as more traditional habits. The best way to encourage adherent behaviours is to link them to existing habits, and so by hosting interventions that encourage adherence within the network of deeply engrained digital behaviours, we increase the chance of their adoption.

Interactivity
The interactive power of many modern platforms allows us to actively involve participants causing messages to resonate with great strength. Interaction can instil a deeper understanding of the principles you're conveying, thus empowering patients to feel more confident about adopting them in everyday life. ClickHealth's Bronkie the Bronchiasaurus was a Nintendo video game designed to help children with asthma manage their condition (see video below). The game required players to complete asthma management tasks similar to those for humans.

The results were highly impressive. Children who played for as little as 30 minutes reported increased efficacy, significantly out-performing a test group who were shown an informative film instead of playing the game. What's more, the increase proved to be lasting, with the improved efficacy maintained long after the study session had occurred. The implication is that it was the interactive nature that was crucial; by actively engaging the children and allowing them to rehearse the behaviours, the game gave them the confidence to apply these practices in a real-life setting.

As more-or-less constant companions in our lives, mobile devices are in a unique position to encourage adherence among patients. This is in part due to their obvious convenience, but also their ability to store and detect data relating to a range of different factors (such as our location, the time of day, our schedule, who we're with etc) and utilise this data to offer timely prompts that influence our behaviour. The sheer quantity of personal data potentially available to mobile devices means that they can very easily 'get to know' a huge number of personal habits. When combined with methods of persuasion and interaction, this kind of 'digital empathy' offers some incredible potential to deliver timely disruptive behaviours that encourage adherence.

As Benjamin Franklin said: “Tell me and I forget. Teach me and I remember. Involve me and I learn.”

For more on this topic download UX: Pushing the right buttons from Havs Lynx' PMHub page