Utilizing patient experience research to identify reasons for nonadherence
In the US, over half of patients taking prescription medication are nonadherent. To understand more about why this huge number of people are not taking their medication, Relative Insight conducted patient experience research to find out.
We compared the discussion around nonadherence between healthcare practitioners (HCPs) and patients in online conversations on the topic. To ensure that all the analysis identified all medical linguistic features correctly, we used our specialist healthcare text analysis tool – Relative Medical – to discern insights from these conversations.
Relative Insight Medical‘s specialized healthcare processing pipeline interprets topics within a medical context. For example, the word ‘draw’ would be categorized under ‘art’ in a topic analysis in a generalist text analytics tool. In Relative Insight Medical, this would be correctly categorized as a medical procedure.
Using this specialist platform, our research identified key recommendations on how to improve patient experience.
Mental Capacity – ∞
Healthcare professionals are infinitely more likely than patients to cite lack of mental capacity to follow advice or make decisions as a reason for nonadherence.
Example comment: “Her capacity to consent to levothyroxine is impaired by a mental disorder”
Recommendation: HCPs should consider thinking about the mental capacity of their patients when designing treatment plans, incorporating steps to overcome potential barriers to adherence, such as involving family members.
Advice – 2.0x
HCPs are twice as likely to identify treatment instructions as ‘advice’ rather than ‘instructions’ and as such don’t always view nonadherence as a failure of patient failure. There is an understanding between this peer group that their advice will not always be followed.
Example comment: “I doubt whether poor control among my patient population can be attributed to excessively close adherence to dietetic advice”
Recommendation: Our patient experience research suggests HCPs should position treatment plans as instructions to be followed closely by their patients, not as advice or a suggestion.
Gap between theory and practice – 5.5x
HCPs are more likely to discuss treatment in academic terms, and are 5.5x more likely to discuss gaps between medical trials and practice.
Example comment: “Recommendations to provide shorter prescriptions are not substantiated by the current evidence base”
Recommendation: HCPs should focus on reducing complexity for their patients. Instructions need to be easily understood by patients and their families to increase chances of adherence. This recommendation applies to all those considering how to improve patient experience in healthcare.
Side-effects – 7.0x
Patients are seven times more likely than healthcare professionals to cite side-effects – both physical and mental – as the reason for nonadherence. When considering how to improve the patient experience, HCPs must consider whether side-effects
Example comment: “I started having bad side-effects after the 13th tablet so I stopped”
Recommendation: Potential side-effects should be clearly explained to patients and weighed against the benefits of taking medication.
Good attempts – 8.5x
Patients are nearly nine times more likely to talk about ‘attempting’ to follow a treatment plan prescribed to them, before giving up for lack of results or overwhelming side effects.
Example comment: “I have just stopped taking champix after 3 weeks after starting to get very depressed”
Recommendation: HCPs should clearly communicate expected timeframes for realising the benefits from the treatment plan to patients.
My body – 38.5x
Patients attribute stopping treatment because they feel that their bodies are telling them to do so, and are 38.5x more likely than HCPs to mention their own body in relation to nonadherence.
“I can barely get out of bed, and all day my body feels like I just ran a 26 mile marathon. All day, every day, my body feels physically ravaged”
Recommendation: Patients should be fully educated about the impacts a drug is likely to have on their body. Support groups with other patients may also be beneficial.
How specialized text analytics powers patient experience research
Through consumer insight analysis using Relative Insight Medical, we can shed light on some of the common factors affecting adherence and help HCPs overcome these challenges to improve patient care. This patient experience research uncovered insights that highlighted the following recommendations:
- HCPs should better manage expectations of patients when providing treatment plans. This includes discussing, not only the benefits but also the expected side-effects and time-frame for seeing results.
- Engaging with family members can help overcome barriers to adherence, particularly for patients who may suffer from some mental incapacitation.
- HCPs should leverage their expertise to provide clear, honest and assertive instructions for their patients, including the potential consequences of nonadherence. Treatment plans should be put forward as ‘instructions’ rather than ‘advice’.
