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Thinking outside the medicine box

Understanding broad patient perspectives and needs, and gathering deeper insight into patients’ day-to-day experiences

Thinking outside the medicine box

In recent years, pharma has begun to focus more acutely on the patient. Many companies now place the patient at the heart of their marketing initiatives. There is investment in understanding broad patient perspectives and needs, as well as gathering deeper insight into patients' day-to-day experiences. That said, compared to healthcare professional (HCP) market research, patient research often has less clear business objectives and paths for action execution. In an increasingly competitive marketplace, adding value and improving patient outcomes means maximising patient insight.

Open for business
Before kicking off research that involves significant investment of both time and money, it is critical to define a clear business objective. This may seem like a no-brainer, but can be much trickier to articulate than for more commercially focused HCP work. Certainly when it comes to the patient arena it isn't all about the numbers. Patient insight is absolutely critical for motivating marketing and sales teams to optimise their work, and therefore internally focused objectives are just as relevant as external ones.

Patient insight can be implemented to further both internal and external initiatives, depending on the core business objective:

  • External initiatives: these include a whole host of support initiatives for both the patients and carers, family and friends; at-home support via local/regional/national programmes (in some markets these are already in place and pharma can partner with them on a regional level); packaging optimisations
  • Internal initiatives: using patient collateral to show the benefits of the product (this can also be done externally as part of detailing to HCPs but internally this is critical to motivating marketing and sales teams as well as humanising the condition at hand).

Kicking off research
Securing the deepest patient insight is not a streamlined process. It calls for a level of flexibility not always needed in HCP research, as well as consideration of multiple perspectives in order to pull together a complete picture. Everything from recruitment to logistics to moderation needs to be carefully orchestrated to be as sensitive as possible to the participants' needs and to capture the full spectrum of information needed. To do this effectively, we need to work both harder and smarter.

When it comes to the patient arena, it isn't all about the numbers. Patient insight is absolutely critical for motivating marketing and sales teams

Working harder
Working harder means we need to approach data collection from a variety of angles across a variety of respondents and through a variety of touch points. For example, face-to-face structured conversations lend themselves well to exploring key points in a patient's journey, for example, diagnosis. However, it is equally valuable to make a cup of tea together and discuss the daily routine; to observe the treatment regimen in situ (be it at home or in hospital); to observe daily activities that may or may not be impacted by the patient's condition, for example, transportation, work, housework and recreational activities. For some of these activities interviewers can tag along, for others a video or paper diary is the appropriate medium, and for others online forums are an appropriate venue. The point is that multiple prongs are necessary to paint a complete picture of the needs and gaps in the daily needs of both the patients and the carers.

Interviewers also need to go the extra mile in terms of flexibility and sensitivity. Some top tips for moderators include:

  • Being flexible around timings - adapting on the spot to the length of the discussion based on the patient's abilities; it is important not to overtax the patient; have breaks if required and talk about other topics
  • Taking it slow - allow time for introductions and spend time getting to know each other; make a cup of tea and have a general chat before focusing on the key issue
  • Keeping things simple and easy - use friendly, clear and simple language, allow the patient and carer to do the talking and the moderator the listening; make sure questions are easy to understand and allows time for reflection
  • Giving the patient control - allow space and time for tangents and let the patient lead the conversation; this facilitates a richer, more meaningful discussion that can bring to the fore deeper issues that are vital to the patient 
  • Involving the carer - friends and family can offer a third party perspective that is invaluable; they can step in and fill gaps the patients may not be able to articulate; they can help the patients recall experiences and challenge the patients if they underplay the impact of the disease or give a muted account of their journey. 

Working smarter
Planning the 'ideal' methodology is a great place to start, but having contingency plans for many eventualities is key. Being prepared to adapt the methodology at a moment's notice to suit the needs of the patient is necessary (eg, using paper diaries instead of video diaries, changing the type of interview conducted, allowing carers to complete tasks on the patients' behalf if they are not up to it themselves). Be considerate: a highly involved, time-consuming or effortful approach may not be appropriate.

Think carefully about stimuli. Read any stimulus through the patient's eyes. For example, any hypothetical product profiles must be presented using non-medical, patient-friendly language. In the same vein, discussion of available or pipeline products needs to be approached with caution. We cannot raise hopes, over promise, or cause doubts about current treatments.

When it comes to analysis, piecing together the viewpoints of different individuals, data from different touchpoints and in different formats requires a bespoke framework. This can be developed prior to the analysis and can be based on some key guiding principles borrowed from qualitative social research studies. Namely, an adapted version of the Framework Method has proved very useful (originally developed by Ritchie and Spencer at the Qualitative Research Unit, National Centre for Social Research in the United Kingdom in the late 1980s). Having a framework based on core themes, delineated within a matrix, helps organise what on the face of it can be disparate insight and also allows for careful comparison across participants. This systematic and robust method is vital to generating effective recommendations routed in deep insight.

What's next?
Once insight is gathered, collated and carefully analysed there are a whole host of applications. At a basic level, the use of ethnographic insight can highlight gaps in support via the simple capture of daily routines. Across patients and carers a clear picture can be painted. Support gaps may not only be evident for patients, often carers and family play a large role in managing a patient's condition, yet support for them is lacking.

Adherence is not a new issue and especially for oral treatments this can be challenging. When treatment regimens are tricky, adherence is often highlighted as an area needing further support. There are so many clever blister packs and administration tools nowadays, yet a simple tweak to a product could greatly improve patient adherence and outcomes. Based on the patient/carer insight, it will be clear what element of the regimen needs tweaking - is it the time of day that is the challenge? Is it the number, shape or size of the pills? Do the patients have carers or other support to help them?

Ultimately, careful thought and planning are key ingredients to optimising any research but even more so with patients. Following the top tips outlined above will drive deeper insight, leading to meaningful actions that can deliver tangible outputs to marketing teams.

Article by
Dr Pamela Walker

is director and head of health at Incite

22nd December 2016

Article by
Dr Pamela Walker

is director and head of health at Incite

22nd December 2016

From: Marketing



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