Participatory medicine is an emerging healthcare movement that champions patient preference and values as equal to medical expertise. Following participatory medicine processes means that everyone involved in a healthcare decision brings something to the table – and the results are a shared decision-making process where informed patients walk away with treatment decisions they are happy with. Although a movement still gathering momentum, greater patient involvement in healthcare is here to stay and the biopharmaceutical industry has the opportunity to embrace this change and find ways to act as a facilitator of shared decision-making.
The question of how to ensure both patients and doctors are equally empowered and facilitated to participate in treatment discussions is not an easy one. Healthcare systems are in need of external support to speed-up best practice adoption, with biopharma ideally placed to assist. Facilitating the adoption of shared decision-making should be a proactive focus of industry, as it provides wins for both individual companies and patients alike. If patients are more engaged in their treatment decisions, then they can consider what matters to them in approaching treatment – whether that be administration method, dosing frequency or the likelihood of associated risks. The ability to play a role in choosing a treatment path that reflects their personal priorities is then ultimately reflected in adherence.
Communications are of paramount importance in driving targeted behaviour change in patients and healthcare professionals in support of shared decision-making. First, three questions need to be asked: Are individuals motivated to undertake shared decision-making, does the environment they find themselves in facilitate this and do they have the ability to participate? In looking at each of these questions in turn, biopharma’s role in promoting shared decision-making becomes clear:
Motivation: Fully adopting shared decision-making involves individuals wanting to participate in the process. UK-based research has identified that many physicians believe that patients don’t want to make treatment decisions, despite what patients say. Often a lack of patient empowerment limits their motivation to be involved. Limited empowerment can be a specific issue for older patients, who have grown up with a ‘paternalistic’ healthcare system, where what the doctor says goes. Their reluctance to take more of an active role in care discussions can come from a fear of taking up too much of the doctor’s time or not being perceived as a ‘good patient’ for asking too many questions. It is therefore vital to use communications to achieve patient empowerment and tell the participatory medicine value story, highlighting what all parties involved get out of the process. This communication activity should focus on providing routine health information in formats that resonate with patients and help them to think about what they want to get out of their doctors’ appointments and what information they should be offering in return.
Opportunity: The environment that patients find themselves in has a direct impact on their ability to take part in participatory medicine. While developing attitudes and understanding are essential in facilitating a favourable environment, the skills of the doctors in being able to engage patients in this decision-making process are also vitally important. Research has indicated that physicians’ attitudes towards shared decision-making is the greatest influence on patients’ intentions to engage with the process. Biopharma can play a key role in providing training for physicians that coaches them on optimal patient communication practice. These skills will allow them to get the best out of their patients and, when coupled with meaningful tools, engage patients to play an active role in their own healthcare.
Ability: Provision of practical tools are essential in ensuring that both patients and healthcare professionals are physically and psychologically able to undertake shared decision-making. Research has identified that physicians want tools that help them to facilitate shared processes, and evaluation of specific tools has shown them to be effective in increasing patient satisfaction, involvement and adherence. Such tools, including patient decision aids, play an important role both prior to and during appointments. In providing digestible information on specific conditions, treatments and adherence best practice, patients are more informed about the decisions they face and the specific lifestyle factors that have an impact on these decisions.
Time and resource have been identified as major hurdles for healthcare systems in developing and maintaining tools, providing biopharma with an obvious opportunity.
Communications hold the key in promoting shared decision-making and participatory medicine, and biopharma, with the right expertise and resources, is ideally placed to provide the solutions.
Caroline Howley is an account director at GCI Health