Global Immunology Patient Study: Patient motivators to support treatment engagement
Evidence for Change Series: Immunology in Focus
Autoimmune therapies have evolved to include self-administered options and this trend toward patient-managed treatment regimens is expected to continue. Despite these significant advances in managing immunological conditions, treatment engagement remains a key consideration for patients navigating chronic autoimmune conditions.
Self-administered treatments offer patients greater flexibility and independence, but with self-administration, understanding the key motivators for treatment adherence becomes crucial. This is because self-administration of treatment often removes the patient from traditional healthcare support structures, so immunology care teams and patients require innovative solutions to maintain optimal adherence to autoimmune therapies.
Evidence for Change Series: Immunology in Focus
Autoimmune therapies have evolved to include self-administered options and this trend toward patient-managed treatment regimens is expected to continue. Despite these significant advances in managing immunological conditions, treatment engagement remains a key consideration for patients navigating chronic autoimmune conditions.
Self-administered treatments offer patients greater flexibility and independence, but with self-administration, understanding the key motivators for treatment adherence becomes crucial. This is because self-administration of treatment often removes the patient from traditional healthcare support structures, so immunology care teams and patients require innovative solutions to maintain optimal adherence to autoimmune therapies.
Optimizing Immunology Patient Support
Our findings reveal new and current insights into what motivates people living with autoimmune conditions to take their treatment as prescribed. They demonstrate the need to provide targeted and personalized patient support for those with autoimmune conditions.
As part of immunology patient support programs, interventions are required that specifically leverage the individual's key motivations for adherence. Optimizing immunology patient support programs this way will enable and empower those living with autoimmune conditions to Change for Good
To learn more about how our findings can be leveraged in your patient engagement strategy, contact our Global Head of Behavioral Science and Lead Researcher—Dr Kate Perry—for a 30-minute online discussion: Click Here to contact Kate and request a meeting and receive a free copy of our study report.
Read about our expertise & behavioral science insights.
Introduction
At Atlantis Health, we are committed to incorporating the patient voice into our solutions to improve patient outcomes, including optimizing treatment adherence. As part of that commitment, we conduct primary research to gain a deeper understanding of the patient experience.
This year, as part of our Evidence for Change research series, we surveyed 152 individuals living with autoimmune conditions across the globe to gain insights into their experiences throughout the patient journey, including what motivates engagement with prescribed medication.
Methodology
- Participants were recruited from a reputable global online panel frequently used in Behavioral Science research.
- Eligible participants were aged 18 or older, residing in the US, Europe, or Asia Pacific, and living with an autoimmune disease and currently prescribed long-term medication.
- The survey covered demographic and clinical factors, challenges and support throughout the patient journey, as well as treatment experiences and adherence.
- We used an observational mixed-methods design, incorporating psychometrically validated questionnaires and open-ended questions to explore patient experiences in detail.
Sample Characteristics
Age:
- Most participants (57%) were aged between 35-64 years, with a third (33%) aged between 25-34 years.
Gender:
- Nearly three-quarters of participants are women (n=107).
Diagnosis:
- The sample included people living with a wide range of autoimmune diseases, encompassing both common and rare conditions.
- These conditions affect various systems of the body, including the endocrine (e.g., Hashimoto's thyroiditis), digestive (e.g., Crohn’s disease), musculoskeletal (e.g., rheumatoid arthritis), neurological (e.g., multiple sclerosis) and dermatological (e.g., psoriasis) systems.
Treatment:
- Most participants were prescribed at-home treatments (n=136; 89%), with the majority taking oral medication (n=96; 63%) once a day (n=80; 53%).
Patient Reported Treatment Motivators
Adopting a positive psychology approach that focuses on strengths and facilitators of behavior (as opposed to challenges and barriers), participants were asked:
“Name two things that motivate you to take your main autoimmune condition medication as prescribed (for example – this could be something you do or have, or something you think, say, or feel)”
This question seeks to uncover the motivational factors that support an individual’s commitment to following their prescribed regimen.
Motivators are Personal, yet Shared
Our thematic analysis of these responses uncovered several key themes regarding what motivates them to adhere to their medication. These include:
- Symptom management, particularly in relation to pain, fatigue, energy levels, and sleep
- Prevention of worsening symptoms, disease progression, complications, hospitalization, and/or death
- A desire to improve health, feel better, and maintain overall well-being
- The need to feel normal and remain engaged in everyday activities, roles, and responsibilities
- The use of external reminder systems and the importance of establishing and maintaining routines for medication adherence.
Categorizing Motivators
Based on the themes identified, the Approach-Avoidance-Assertion Model1 provides a practical way to categorize the motivators, offering a useful lens for designing interventions that align with patients’ natural drivers for adherence.
Approach Motivators
- Approach motivators reflect a desire to achieve positive outcomes.
- This includes experiencing symptom improvement, wanting to feel better, wanting to be healthy and wanting to be alive.
- About half of patient motivators were classified as approach motivators.
Avoidance Motivators
- Avoidance motivators reflect a desire to avoid adverse or negative consequences.
- This includes reducing or eliminating symptoms, preventing complications or hospitalizations and reducing risk of death.
- About one-third of patient motivators were classified as avoidance motivators.
Assertion Motivators
- Assertion motivators reflect a desire to maintain control, independence and identity.
- This includes engaging in everyday activities and adopting roles and responsibilities, such as being a parent, partner and patient. It also includes active engagement with routines and a sense of accomplishment.
- About 20% of patient motivators were classified as assertion motivators.
Interventions to Enhance Motivation
By adopting a positive psychology approach and understanding the different motivators—approach, avoidance, and assertion—we can design interventions that align with patients' core reasons for adherence.
This approach helps identify the most relevant Behavior Change Techniques (BCTs) tailored to each type of motivator.
For instance, techniques like Goal Setting and Self-Monitoring are effective for both approach and avoidance motivators, while Valued Self-Identity and Prompts/Cues are better suited for assertion motivators.
By aligning motivators with appropriate BCTs, interventions become more personally meaningful, which enhances patient engagement, boosts effectiveness, and supports sustained adherence over time.
References
- Michaelson, M. M., & Esch, T. (2021). Motivation and reward mechanisms in health behavior change processes. Brain Research, 1757, 147309. https://doi.org/10.1016/j.brainres.2021.147309