april 24 th , 2014
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APRIL 24 TH , 2014. PATIENTS WITH MULTIPLE MORBIDITIES:. Refocusing the Communications Lens on a DTC “ Blind Spot ”. A Condition-Centric Paradigm. DIABETES. Diabetes. High Cholesterol. Flip the lens to a patient-centric view, that takes multi-morbidity as a fundamental axis of analysis. - PowerPoint PPT PresentationTRANSCRIPT
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PATIENTS WITH MULTIPLE MORBIDITIES:
Refocusing the Communications Lens on a DTC “Blind Spot”
A P R I L 2 4 T H , 2 0 1 4
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A Condition-Centric Paradigm DIABETES
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Flip the lens to a patient-centric view,that takes multi-morbidity as a fundamental axis of analysis
Diabetes
HeartDisease
Hypertension
OA
Depression
HighCholesterol
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Over 65s
• 12% US population in 2000 20% by 2030
• Healthcare costs will account for 25% of US economy by 2037
• 50% are living with 2+ chronic health conditions
Sources: U.S. Census, Congressional Budget Office, CDC
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Hypotheses:
≠
Need to address them in very different ways, to connect with and motivate them via effective marketing strategies.
Diabetes
HeartDisease
Hypertension
OA
Depression
HighCholesterol
Diabetes
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• Unmet needs from the healthcare community and pharmaceutical companies
• Relationships with HCPs
• Treatment attitudes and behaviors including compliance and adherence
• Receptivity and response to DTC communications.
Implications for their…
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1. Thought leader interviews with academic physicians
2. Psychologically oriented focus groups
3. Art hypnosis groups
4. Survey (n=2,000 Type II diabetes patients)
• Diabetes Only
• Diabetes +1 other Condition
• Diabetes + 2-3 other Conditions
• Diabetes + 4-5 other Conditions
• Diabetes + 6 or more other Conditions
Methodology – Type II Diabetes Test Case
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• All diagnosed with Type II Diabetes
• 9 out of 10 diagnosed with at least
one additional condition
• Average # diagnosed health conditions = 4.1
MOST COMMON CO-MORBIDITIES
• High Cholesterol
• Hypertension/High Blood Pressure
• Obesity
• Sleep Apnea
• Osteoarthritis
• Depression
• Heart Disease
• Asthma
• Neuropathy
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NUMBER OF CONDITIONS
COMPLIANCE & ADHERENCE
NUMBER OFCONDITIONS
COMPLIANCE& ADHERENCE
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Diabetes Only Diabetes +1 Diabetes +2-3 Diabetes +4-5 Diabetes +6 or more
65
51 49 50
40
% of Patients Compliant with Rx Directions
Just adding one additional condition on top of diabetes impacts compliance dramatically
Diabetes Only
Diabetes +1
Diabetes +2-3
Diabetes +4-5
Diabetes +6 or More
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% of Diagnosed Conditions Being Treated
And, as more conditions are diagnosed, patients begin to prioritize which ones they’ll treat
Diabetes Only
Diabetes +1 Diabetes +2-3
Diabetes +4-5
Diabetes +6 or more
90
80
7470
66
Diabetes Only
Diabetes +1
Diabetes +2-3
Diabetes +4-5
Diabetes +6 or More
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Hours per Month Attending to Conditions
Nearly one full workday a week
Diabetes Only
Diabetes +1 Diabetes +2-3
Diabetes +4-5
Diabetes +6 or more
10.5 10.912.7
19.1
22.9
Diabetes Only
Diabetes +1
Diabetes +2-3
Diabetes +4-5
Diabetes +6 or More
“I get angry and I just want to explode. So many drugs you have to handle, and doctors
you need to see.”
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I went to the drug store to pick up high blood pressure medication, $146 for 30 days. I finally said no I'm not taking it.
All of the different meds are expensive. I have had to prioritize drugs. Sometimes that even means missing meals.
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“Diabetes restricts my lifestyle”
Diabetes Only Diabetes +1 Condition
51 AGREE%26 AGREE
%
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Diabetes +6 or moreDiabetes +4-5Diabetes +2-3Diabetes +1
69%
49%
37%
27%
45%
30%
26%
20%
38%
30%
24%22%
It limits my social life and activities
It causes insomnia and difficulty sleeping
It hinders my sex life and intimacy
% Reporting Practical Impact of
Multi-Morbid Conditions on their Lives
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% Reporting Emotional Impact of
Multi-Morbid Conditions on their Lives
Diabetes +6 or moreDiabetes +4-5Diabetes +2-3Diabetes +1
56%
44%
32%
24%
42%
31%
18%23%
42%33%
17%15%
32%
29%
18%16%
26%23%
14%9%
35%
19%
9%5%
29%
20%
9%12%
It creates uncertainty or unpredictability in my life
It impacts my relationships
It undermines my identity and how I see myself
It has a social stigma attached to it
It makes me feel guilty, like it was my fault
It hinders my ability to care for others who need me
It makes me feel isolated
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If it came to life as an animal, diabetes would be…
“Keep having to think about it”
“Irritating”“Nagging”
“Annoying”
“Distracting”
DIABETES-ONLY:
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If it came to life as an animal, diabetes would be…
“Terrifies me”
“Threatening”
“Lethal”
“Sinister”
“Deadly”
DIABETES + 6
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“Diabetes impacts my self-image”
Diabetes +6 Conditions
63 AGREE%
Diabetes Only
28 AGREE%
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Social self impacted
Sexual self impacted
“I want to feel like a whole person, a full man, I've always been able to protect and defend myself
and family and now with these ailments, I'm concerned about that.”
“My libido is not nearly what it once was, and it does affect my manhood. It bothers the hell out of me.”
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“Everything is being ripped apart. I'm ready to lose it. I'm at the breaking point.
Fear and anger at the same time. I feel like screaming at the top of my lungs from the highest mountain.
It's heart breaking. I feel like I’m beyond help.
I'm stressed, I feel like any moment I'm going to explode emotionally. I'm not taking any more pills.
I felt as though it was going to be a hard road. It was too overwhelming, it was so long. And there was really nothing at the end of the road.
I feel like I have failed at health.
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+ 6 or more+ 4 - 5+ 2 - 3+1
49%
40%
21%
16%
47%
35%
26%
18%
32%
28%
14%
8%
33%
22%
15%
10%
33%
22%
14%
8%
32%
20%
15%
10%
29%
19%16%
11%
Weighed down
Loss of control
Vulnerable and helpless
“Less than” – not a whole person
Imprisoned
Broken
Failed at health
% Reporting Emotional Impact of
Multi-Morbid Conditions on their Lives
Diabetes +1
Diabetes +2-3
Diabetes +4-5
Diabetes +6 or More
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“I have been entirely open in sharing how it has impacted me emotionally”
Diabetes +6 Conditions
27 AGREE%
Diabetes Only
54 AGREE%
“Nobody knows what is going on.”
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“Strength”
“Mindfulness”
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“Awareness”
“Focus”
“In control”
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“Not Giving Up”
“Hopeful”
“Courage”
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“Lost”
“Life washed away”
“No safe place”
“Overwhelmed”
“Hopeless”
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“Sadness”
“Disintegrating”
“Lost the life force”
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“Lonely”
“In need”
“No anchor”
“Welcoming the relief of death”
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DIABETES ONLY DIABETES +4
Draw how you see yourself, living with diabetes/diabetes and your other conditions
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Degree to Which Ads Make Them Feel Understood
The more conditions they live with, the less understood they feel by advertisers
Diabetes Only Diabetes +1 Diabetes +2-3 Diabetes +4-5 Diabetes +6 or more
76
61
54 5451
Diabetes Only
Diabetes +1
Diabetes +2-3
Diabetes +4-5
Diabetes +6 or More
“If I heard messages about people living with multiple conditions I’d feel less alone.”
“The ads aren’t talking to me - they have no idea what it is like for me.”
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DIABETES
Diabetes
HeartDisease
Hypertension
OA
Depression
HighCholesterol
DIABETES
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THANK YOU!