Self-administered treatments are often preferred by patients, if available, especially to avoid the challenges of organizing appointments, transport, time off work, childcare or other logistics associated with hospital or in-clinic administration.
Where treatment self-administration involves using a drug delivery device, such as an inhaler, syringe or autoinjector, many patients need added support to help overcome the common barriers that lead to suboptimal adherence and outcomes.
As a result of poor self-administration, patients may seem unresponsive to the medication and simply switched to a different treatment. They also risk their condition and symptoms worsening, and even hospitalization.
One study showed as few as 7% of participants used their metered dose inhaler correctly, and only 16% used an autoinjector correctly.1
In designing a personalized patient engagement solution that provides an optimal treatment initiation experience, Atlantis Health takes an evidence-based approach to define a behavioral strategy that targets modifiable factors related to medication adherence.
From our experience across a wide range of self-administered treatments delivered via devices, we have identified several common adherence-related barriers:
Low understanding and poor technique/skills to administer safely and correctly
Low self-confidence to adopt the new behavior
Health literacy limitations
Limited access to further training or support: the healthcare team may not have sufficient time or skills to ensure patients master their new device and feel confident to do it alone at home.
Pharmaceutical companies can help support a positive treatment initiation experience and lay a strong foundation for ongoing treatment adherence by acknowledging the individual’s needs and behavioral barriers, and providing personalized treatment initiation support that complements the efforts of the healthcare team.
40-80% of medical information provided by healthcare practitioners is forgotten immediately, and half that is remembered is incorrect.2
Treatment device and administration videos are a core element for newly prescribed patients; however one-on-one coaching from a nurse can provide a level of empathy and personalized engagement.
Our nurse teams providing one-to-one coaching are well-versed in patient-centered communication and motivational interviewing principles.
They also complete program-specific training to address each patient’s specific barriers with appropriate behavior change techniques, ensuring the patient is highly confident and competent to move forward with their medication routine over time.
Nurse-led coaching at treatment initiation, conducted in the patient's home or via video or voice call, includes:
Assessing each patient’s confidence and any treatment concerns, as well as other adherence-related barriers.
Advising and observing the patient, offering encouragement and feedback—and additional sessions if needed for the patient to master their treatment administration.
Providing appropriate strategies to overcome concerns, for example reducing anxiety through mindfulness or relaxation techniques.
Offering inbound call support for future questions or to talk through the steps again if needed.
It’s great that there are nurses who really take their time to show you everything, to explain everything, and to be there for any questions or concerns. In this day and age, everything is rushed, and doctors don’t always have the time to talk about everything. It feels really reassuring. —Rare disease program participant
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100% of patients confident and competent: Empowering people living with a rare disease
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Our behavioral science-based approach has been successfully applied in designing and delivering effective patient engagement solutions from disease awareness and activation, to long-term personalized self-management of chronic conditions across a wide range of treatments.
Beyond self-administered treatment support, we have helped prepare patients ahead of infusions or HCP-administered treatment—in standard care and in clinical trial settings.
Our experience extends to developing and delivering healthcare provider training and tools, as well as treatment access support, to help ensure a positive experience and outcomes across the patient journey.
References
1. Bonds, Rana S. et al. Misuse of medical devices: a persistent problem in self-management of asthma and allergic disease. Annals of Allergy, Asthma & Immunology, Volume 114, Issue 1, 74 - 76.e2
2. Kessels RP. Patients' memory for medical information. J R Soc Med. 2003 May;96(5):219-22. doi: 10.1177/014107680309600504. PMID: 12724430; PMCID: PMC539473.