A leading multinational pharmaceutical company, here referred to as “PharmaCo.”
In the past it was assumed that patients would follow whatever course of treatment their physicians recommended. Today, it is well known that many patients do not comply with physician recommendations—often with negative consequences for their health. The quality of the doctor-patient relationship (the relationship’s “concordance properties”) helps to determine whether patients adhere to the treatments their doctors recommend. With this in mind, PharmaCo decided to invest in finding ways to improve doctor-patient communication and relationships. This investment had the potential to both enhance patient health outcomes (by increasing adherence with the full range of physician recommendations) and to advance PharmaCo’s own business objectives by increasing patient compliance and persistence in cases where the recommended course of treatment was pharmaceutical. The company engaged five academic experts on doctor-patient dynamics to develop a web-based protocol to help patients communicate effectively during medical appointments. PharmaCo then engaged Environics to measure the effectiveness of this protocol over the course of a year. PharmaCo wanted this research to have the potential to be published in peer-reviewed medical journals, so they turned to Environics for data collection and analysis that would meet the most rigourous standards.
Environics designed a research process that measured patients’ experiences during medical appointments, as well as their self-reported adherence to their physicians’ instructions following their appointments. Since this was essentially a clinical trial, Environics established and tracked two control groups in addition to the group exposed to the PharmaCo-commissioned web training. Because PharmaCo aimed for the findings of this study to be considered valid across a range of contexts, Environics also had to ensure that the sample of patients in each group fulfilled an unusual array of requirements. Patients in three countries were included in the study and a wide range of other characteristics were systematically accounted for, including demographic and psychographic factors and various disease states. Each patient’s experience unfolded in five stages. Respondents were:
(2) evaluated on their existing relationship with their doctor and their overall orientation to health;
(3) randomly assigned to an experimental condition (either the treatment group or a control group);
(4) introduced to the web-based training to prepare for their next physician visit; and
(5) assessed after their appointment on the quality of their interactions and on their post-appointment behaviours and perceptions.
A smaller sample of physicians—also carefully assembled—was also tracked over the course of the year in order to enable a gap analysis of physicians’ and patients’ perceptions of particular aspects of the doctor-patient relationship.
The study confirmed some of PharmaCo’s hypotheses about factors that might enhance doctor-patient concordance. Based on specific participant feedback, PharmaCo will be able to refine the web-based training protocol for future use. Because of the extensive and complex nature of the recruitment process, PharmaCo and Environics learned a great deal about the kinds of patients who are willing to participate in and adhere to a psychosocial project of this nature. PharmaCo is currently building on the insights from this project to develop a proven “concordance enhancement” tool it will be able to share with physicians and patients.