Unfortunately, some advertising for pharmaceutical products still falls short when it comes to fully informing patients about the appropriate uses for a product. I think this is better now than in years past, but there is still room for improvement by some advertisers and those that fall short need to improve. Of course, the FDA sometimes forces an “improvement” on some advertisers, but my experience has been that most marketers want to both comply with applicable regulations and create useful, effective and accurate messages. Many companies continue to invest heavily in improving the effectiveness of their patient communications even when they are well within the bounds of FDA regulations, because they want to communicate with their consumers in the most effective manner possible. This continued emphasis on effective communication about a sponsor’s product – including the best ways to present risk information and gain patient understanding, in addition to interest in the product, is likely one of the best ways to improve the situation you describe.

A second area in which sponsors/advertisers should focus to improve the patient’s knowledge is in emphasizing an integrated approach to their communications strategy that includes a variety of communications channels for both the patient and the professional audience (physicians, nurses and pharmacists, as well as other providers). Marketers who elect to utilize only “mass media” DTC advertising (TV and print) may be effective in gaining the consumer’s attention and generating interest in their product, but they may be offloading much of the responsibility for patient education to professionals, and creating the situation you describe. With only a modest shift in resources that still invests in these traditional outlets if desired, marketers can generate interest in their product while also providing consumers with additional methods of obtaining information. These can effectively augment the patient’s knowledge and lead to a much-improved physician-patient visit. Interactive and CRM programs come to mind, as do additional point-of-care communications such as the pharmacy.

An additional point that deserves attention is the role of the health care provider (the physician and hospital, in your example) in making sure the physician is properly informed. Increasingly, health care organizations are banning pharmaceutical company personnel from having contact with the health care providers that staff their facilities. While some controls over these interactions are likely necessary and prudent, I don’t believe it is wise for healthcare organizations to ban all contact and interaction. Pharmaceutical companies can play a useful role in educating both consumers and professionals, so long as the information they provide is accurate and balanced, and presented in a way that doesn’t inappropriately influence the information recipient (professional or consumer) or interfere with patient care. We hear much about the situations in which this is not the case, but industry can play an effective role in this area. I am hopeful that health care organizations will find ways to work with the pharmaceutical industry to establish policies and practices that foster useful exchanges of information rather than banning contact by their staff with the industry altogether.

Finally, it is worth noting that the situation you describe is that of a dialogue between the physician and patient, which can lead to both parties having a better understanding of the patient’s needs and potential treatments. Creating and encouraging that conversation is one of the most helpful things that can occur in the physician-patient relationship. Even in cases where the patient has an incomplete understanding of the product in question, it’s better to have their misconception corrected by their physician or pharmacist than have the patient continue on without that guidance. It can admittedly be annoying for the professional, but patient counseling “comes with the territory” and in my opinion a reasonable amount of this dialogue is an obligation of practicing in a modern society, with an audience of consumers that will continue to have access to multiple sources of information. If we are smart about how we conduct ourselves as an industry, we can do much to ensure that those conversations are well-informed and useful to all involved parties.

Managing multiple conditions and a variety of medications has become something that many patients face every day, and this will be even more common as our society grows older. But it’s not just the elderly that are affected. Early intervention into a variety of conditions can help prevent symptomless health problems like high LDL cholesterol or hypertension from progressing into more serious medical events such as a heart attack or stroke, but this means that even middle-aged, active and otherwise healthy people can be taking multiple medications for many years. The result is that this is becoming the normal situation when communicating with patients.

The first thing that patients taking multiple medications want to know is often, “Will these drugs play nice together?” Hopefully the patient’s physician has taken this into account, but often patients are cared for by a variety of providers who may not communicate with each other, much less the patient, about the various medications they are prescribing. This is where the patient’s pharmacist can play a vital role in care, both by checking for interactions but also in counseling the patient. For this reason, many experts believe patients are best served by having all their medications supplied through a single pharmacy provider (generally a single store or more commonly, any location within a single pharmacy chain), a view I also share. When that is the case, it opens up a wealth of options for communicating with a patient, and multiple medications can actually mean multiple opportunities for communication to occur. But this must be done with careful planning and with a long-term view, and as much as practical and possible, messages should be tailored to the needs of individual patients.

The role of pharmaceutical brand teams (the client) in patient communication is to support the patient’s therapy by working with health care providers and carefully selected solutions providers to deliver information that supports the patient’s care. These messages are different than traditional DTC in that the brand team isn’t trying to generate general awareness and initial interest across a wide consumer audience; instead, and if conducted appropriately, these messages support the patient’s treatment by providing and funding information that the patient might otherwise not receive. Goals often include keeping the patient adherent to a prescribed therapy or, in some situations, informing a patient about additional ways their condition might be managed (such as the availability of a CRM program, additional information sources, or even an additional medication that they might want to discuss with their physician). To best serve the needs of the patient taking more than one medication, keep these principles in mind:

• Create Relevance through Segmentation Every marketer knows that audience segmentation is important, but think about WHY: because it allows you to speak to individual audiences in unique ways and with unique messages that matter to them. Patients taking multiple medications create many unique, addressable audiences with specific information needs based on the specific combinations of medications they are taking. Technology allows many of these segments to be easily created and addressed (for example, patients taking statins alone compared to patients taking a statin, an anti-hypertensive, and a medication for diabetes) with unique messages that will resonate with the individual patient because they offer information that speaks to their unique situation.

• Walk With the Patient Patients taking multiple medications often start each of those medications at different times in their life, and most have at least some apprehension with each new drug added to their therapy. Again, technology allows us to know when a new drug is added to therapy, and what drugs the patient is already taking. Instead of delivering the same message to every patient regardless of how long they’ve been taking your product, think about addressing the concerns of a patient just starting therapy differently than those of a patient that has been on the product for many months or years. If you combine this element of time with the segmentation mentioned above, you can create messages that really address the concerns a patient is likely to be having at a given point in their therapy. And don’t just speak to patients in the first few months of therapy! Although patients just starting on a medication may have special needs and be at somewhat higher risk of discontinuing therapy, there is proven financial value to maintaining ongoing support for a patient taking your product, in addition to the value it can bring the patient in their treatment. I like to call this process of addressing patient needs no matter where they are in their therapy, “Walking with the patient.” It can pay incredible dividends to the patient, their health care providers, and the supporting brand.

• Adapt, Change and Grow with Patients Don’t think that you can just create a series of messages, hand them off to your promotions manager and solutions provider, and be done with it. You probably aren’t doing that with your DTC campaign or the messages you deliver to your physician audience, so why would it be any different for communicating with your patients? When something changes in the patient’s world, think about how your message to them needs to change. New audience segments are created every time a new product comes to market, and sometimes those changes are occurring outside your immediate therapeutic class. Anticipate the needs of your most important audience segments and tailor your messages to meet those information needs. One example that might surprise some brand teams is the economic concern created by the recent financial crisis and the effect this can have on patients taking multiple medications. I’ve noticed some thoughtful (and smart) brand teams stepping up communication about their copay assistance programs to these audiences, which is a great example of adapting to the needs of the patient in a way that both helps them and prevents the brand from losing a valuable, long-term revenue source if the patient lapses from therapy.

• Know and Respect Boundaries I’ve heard product managers complain that they can’t address the needs of their patients unless the patient signs up for their CRM program, or “opts in” to a special program. That’s just not correct. Technology allows for the creation of audience segments, message sequencing and timing, and other factors that address and customize programs for patients – even those taking multiple medications – using de-identified patient data. The patient’s identity can be known to only the health care provider (such as the pharmacy) for many effective programs, and brand teams should take advantage of these technologies. Patients should be invited to join well-designed CRM programs and similar offerings that may require the patient to share at last part of their personally identifiable information, but don’t think you must know this to offer effective programs that meet the needs of specific patient groups, or even specific patients.

Patients taking multiple medications, even for multiple conditions, do have more complex information needs than patients taking only a single medication. But pharmaceutical brand teams can effectively meet those needs in a variety of ways if they keep these points in mind, work with their solutions providers to plan and update their communications on an ongoing basis, and above all, keep the patient’s needs top of mind as they design and implement their communications programs.

It’s important to make sure materials are written at a reasonable reading level, but that’s just the beginning, and only one part of the solution. Appropriate reading levels help to make things understandable, but they don’t focus on actually engaging the patient, which is essential for changing behavior and creating “healthy habits.” For that, I believe you need to think about three additional elements: Attention, Relevance, and Relationship

Attention means just that – gaining the patient’s attention as they’re bombarded with messages and media. Advertisers are generally good at this but the techniques used in advertising aren’t always applicable to the patient education environment. Recent research we’ve conducted using actual patient education messages showed sometimes surprising results in this area. For example, we found that in some situations the typical “happy person picture” may do little to grab the patient’s attention, while simple but bold headlines – especially in the form of an intriguing question – often fared better. The context in which the message is delivered appears to have a great influence on this, and the take-away message is that you shouldn’t assume that what works for your DTC campaign will work for your patient education materials. The two can work hand-in-hand, but too many brand teams think in terms of one size fits all. It doesn’t.

Relevance, in my opinion, is the key driver for engagement in patient education. The more you can customize your materials to meet the needs of key segments of your audience, the better. The newly diagnosed patient has a different set of fears, concerns, and experiences than that same patient may have one year later, as they consider the additional therapy their physician has prescribed. Yet many companies try to deliver the same set of generalized, vaguely helpful advice to both groups. This is often done because it’s difficult and time-consuming to take materials through the medical, legal, and regulatory clearance processes our industry requires, but it can pay big dividends to brand teams and companies willing to invest just a little more time. My experience has shown that if you work with your MLR review board in advance, explaining the different needs of your core audience segments and how you plan to vary your core materials for each, this process will be much smoother. Help them understand your need for materials that “strike a chord” with the audience. Much of your content can be consistent across all pieces you develop, with the variations designed to achieve relevance highlighted for an easier review.

In addition to delivering information, establishing an ongoing relationship with the patient should be the goal of most patient education programs; the idea that we can “check the box” for patient communication by delivering a single brochure or enrolling the patient to receive a trinket and booklet in a CRM program is often both bad medicine and a poor investment decision. The goal should be to assist the patient by anticipating their likely needs, delivering information that answers their questions and informs their decisions, and showing that you value them as both customers and people. And like most relationships, this will probably require interaction through a number of channels. In-office, in-pharmacy, online, and the list goes on – the patient should feel that you want to engage them, have accurate and helpful information they can easily use, and actually care about their needs. That patient is much more likely to be engaged, adhere to their prescribed therapy, and enter into a patient-brand relationship that meets both their needs and those of the brand team.