Transforming patient care with precise HCP behavior and insights

Transforming patient care with precise HCP behavior and insights

By Andi Weiss, Inizio Evoke Drive

At the start of my career in marketing and public health, I felt ready to address the challenges associated with helping patients overcome barriers to achieving more optimal health outcomes. I had decades of research at my fingertips, and I was well versed in applying behavioral models that could be used as the foundation for patient-focused initiatives.

I quickly realized that patients aren’t the only people facing barriers – healthcare providers were experiencing their own set of obstacles. Because patients are often so heavily reliant on their doctors, and patient success is frequently contingent on provider decision-making, it was clear we were facing a new and even bigger challenge: How do we, as marketers, promote pharma brands in a way that changes HCPs’ approach to patient management AND drives optimal patient outcomes?

As experts in human health behavior, we know real-world behavior is often driven by factors that are not easily articulated, and in many cases require more than a surface-level evaluation of the target audience. While widely used, typical HCP segmentations based on generalized insights often lack the nuance required to truly drive action. It’s not to say that there aren’t skeptics out there or early adopters; there absolutely are. However, leveraging these types of factors to drive change will miss the mark. To ensure the right behavioral strategy is in place to support providers and ultimately drive positive patient outcomes, it’s critical to first identify the key behavioral drivers and barriers at play.

At Inizio Evoke, we are often presented with commercial challenges, such as low adoption of a drug, poor adherence rates, and introduction of novel and unfamiliar MOAs. To truly understand the root of the issue, we need to dig deeper to understand both the patient and HCP challenges in each case.

Provider barriers that we have uncovered with clients and designed solutions around include:

• Entrenched provider beliefs and behaviors that prevent adoption of new-to-market medications (e.g., lack of comfort adopting new treatments, belief it may take too much time and effort to integrate new options into practice).
• Limited use of products due to a (often unconscious) biased view of the appropriate patient type or lack of clarity on the ideal patient (e.g., perceptions that certain types of patients will be unwilling or unable to use specific kinds of treatments due to complexity of dosing or administration, perceived cost and/or access limitations for patients).
• Suboptimal communication with patients that limits acceptance of a drug or leads to discontinuation (e.g., playing up the risks when presenting a treatment option versus helping patients also understand the benefits, lack of attention given to setting accurate expectations regarding side effects to be expected at the start of therapy).

Creating behavior change among providers that addresses the nuances uncovered in our research will not happen through information dissemination alone. HCP decision-making doesn’t take place during a sales detail focused only on product information; it takes place during interaction with a patient. What we’ve often found is that barriers like those listed above negatively influence provider decision-making and the patient is ultimately affected. Even the best product-focused detail aid will be ineffective when it comes to overcoming HCP behavioral barriers at play.

With this in mind, we conducted primary research with a unique methodology designed to reflect the real-world environment in which patients and physicians interact. The study included 341 primary care physicians and specialists across four disease states: type 2 diabetes, migraine, inflammatory bowel disease, and asthma.

We approached this study seeking to identify insights and strategies that can be applied to the real world. We wanted to uncover the deeper, real-world factors that are most likely to drive physicians to make one choice over another and to determine whether these factors vary across disease states and specialties. We were curious whether there are deeper human insights that we could uncover that could provide the key to being able to effectively change provider behavior and successfully deliver on pharma client goals.

We started by examining decades of published behavioral science research to identify potential drivers of physician decision-making and behavior across chronic disease states. Specifically, we chose to focus on factors that can be changed through evidence-based communication strategies.

The results of the study were interesting. What we found was that, among providers, both higher self-efficacy (i.e., feeling confident in one’s ability to make the best treatment choices to benefit patients) and higher perceived control (i.e., a belief about how one’s decisions and actions influence patient outcomes) predict greater likelihood of physicians prescribing medication. These findings provided us with the types of behavioral insights that could be used to define more actionable HCP insights.

In many chronic diseases, the burden of management largely falls on the shoulders of the patient. The choices patients make every day such as what to eat, whether to exercise, and how to manage symptoms are in their hands, which may make HCPs feel they have limited ability to influence outcomes. But with these insights, we can alter how providers view situations like this, supporting them in playing a role in the management of patients using a pharma brand – even when patients are required to take on the bulk of self-management responsibilities.

Physician self-efficacy and perceived control can be increased through skill-building initiatives that integrate with pharma communications efforts. Brand messages can be enhanced with a more practical context that drives uptake and influences outcomes among physicians and extended care teams. 

When physicians see the positive impact that their behavior change efforts have on patients, their self-efficacy and perceived control over outcomes will increase. And when this happens, an increase in prescribing will also occur.

Since this study was completed, the landscape has also rapidly evolved. We are seeing advances in medicine, expansion regarding information availability for both patients and providers, and an increase in patient advocacy initiatives.

All of these changes have gotten us thinking: How might we need to evolve our thinking around driving physician behavior change given the advancements we are seeing in the medical field?

Key questions we continue to ask ourselves as we partner with clients include:

• How might additional pressures from payers and health systems change these behavioral factors?
• In what ways do advances in personalized medicine and sophisticated therapies alter the behavioral drivers and barriers for HCPs? Do these drivers manifest differently in practice as a result?
• With the ability to more accurately deliver on next-best-action, how can modern technology help make behavior change more personal for providers?
• How can we measure the impact of interventions designed to change HCP behavior on patient outcomes and adjust strategies accordingly?
• How can we better integrate real-world environmental factors into behavioral research to reflect the actual decision-making process of HCPs?

We have realized that the core drivers of provider behavior that we uncovered are still present. People are still people, and the same things that may limit or support behavior are not going to drastically change over time. However, as interactions and information exchange in health care have evolved, additional behavioral drivers and barriers may be added to the mix, requiring new and innovative ways to drive HCP behavior. 

Andi Weiss is VP, behavioral services at Inizio Evoke Drive.