Former Surgeon General C. Everett Koop said it best: “Drugs don’t work if people don’t take them.” Patient compliance, also known as patient adherence, is defined by the World Health Organization as “the extent to which a person’s behavior — taking medication, following a diet, and/or executing lifestyle changes — corresponds with agreed recommendations from a healthcare provider.” Noncompliance is a problem that crosses socioeconomic boundaries and can have serious consequences for patients.
As manufacturers of therapeutics, pharmaceutical companies have an obvious interest in patient compliance, and not only a financial one. A patient who is not compliant with antidiabetic therapy risks complications that ultimately will require serious intervention and chronic polypharmacy. A patient who did not anticipate the side effects of certain antidepressive therapies may take “drug holidays” or self-medicate with other drugs, with potentially disastrous consequences. Pharma companies therefore offer significant research- and education-related resources for improving patient compliance.
Representatives’ role
Many industry leaders agree that partnering with and motivating healthcare providers toward patient compliance are effective ways that pharmaceutical companies can contribute. Sales representatives are on the front lines, interacting with physicians every day. Representatives can play an important role in keeping patient compliance at the forefront of physicians’ minds, especially when doctors may overestimate their patients’ compliance with medication regimens. Sales representatives who recognize how patient compliance contributes to successful therapeutic intervention and disease management can engage physicians in a clinical dialogue that addresses compliance.
Know your company’s patient compliance tools and resources. Many pharmaceutical companies have created support resources, tools and self-management programs to help patients stay motivated and to help improve patient compliance with medication regimens. Be familiar with any support and educational resources your company may offer for patients, and help physicians, nurses and other healthcare practitioners become familiar with them too.
Anticipate — don’t avoid — patient compliance issues. Include patient compliance considerations in your clinical discussions with physicians. Don’t avoid bringing up potential patient compliance concerns with physicians for fear of making the product look “hard to use.” When you help healthcare practitioners anticipate potential compliance challenges, you will be seen as a partner in their patient care efforts. If you get feedback from physicians about patients not tolerating side effects related to your product or if you hear physicians voice concerns about patients’ ease of compliance with your product’s regimen, don’t become defensive. Let physicians know what resources may be available for patients, and ask what information or support you may provide to address these compliance issues.
Facilitate best practices among physicians. Keep your ears open and help facilitate best practices in patient compliance among physicians. One of your physicians may have an effective approach to managing patient expectations of the therapy and counseling patients to improve compliance. This information may prove helpful to other physicians in the community. You can be the conduit of these best practices.
Include nurses, physician assistants and pharmacists. Nurses, physician assistants and pharmacists are increasingly becoming patients’ primary points of contact for information following physician diagnoses, and sales representatives’ role in increasing awareness of patient compliance should also extend to these healthcare professionals. Nurses drive patient compliance by interacting with patients and asking about their perception of the treatment and satisfaction with the treatment. Nurses also directly educate patients on management of their conditions, answer patients’ questions about a therapy or side effects, and reassure patients who are fearful of their condition or of the treatment. Representatives can support nurses and healthcare staff by providing educational in-services and inviting their input.
Business studies have demonstrated that acquiring a new customer is more costly to companies than retaining an existing customer and that today’s companies must look at the “lifetime value” of a customer. We are moving from a predominantly “acute care” healthcare landscape to an increasingly “chronic care” landscape where patient compliance will continue to take center stage in the pursuit of successful disease management. A noncompliant patient presents a lose-lose-lose situation: a loss for pharmaceutical companies, for patients themselves and for healthcare.