005: How To Communicate With Patients More Effectively

In a previous article we had established that the key reasons for early drop-out have to do with misconceptions and wrong expectations. And that when we communicate information with patients, we clearly are not hitting the target. If we want to understand how we can make communication with patients more effective, we first need to understand what information is and what it can do. Information is data that is (1) accurate and timely, (2) specific and organized for a purpose, (3) presented within a context that gives it meaning and relevance, and (4) can lead to an increase in understanding and decrease in uncertainty. This is exactly what the Informed Consent process is all about.

Information is valuable because it can affect behavior, a decision, or an outcome. In other words; if we don’t meet all four criteria data does not transform into information and therefore has no value. All of us form an expectation of things to come based on the data we gather and receive. If that data turns out not meet the above criteria for information, then we risk making the wrong decisions and ultimately being disappointed about the outcome.

We also need to consider the way and form data is communicated. And communication is only effective if it:

• Leaves no questions in the mind of the audience
• Is concise
• Take the audience into consideration
• Is clear, specific and simple
• Shows respect for the audience
• Is repeated and confirmed by feedback

I believe we can all agree that the information we share during the Informed Consent process meets all the above requirements if we take trial participants as a group. However, each patient has his personal reasons to drop out and we should align the way we convey information to each patient individually. In practice this is not feasible because of the workload of site personnel. During site visit there is simply not enough time to gauge every patient’s individual need and capability and align the information and support we should provide. But with very limited extra effort our behavioral based Adherence Risk Management solution and services can help reach this goal to a large extend.

ARM is based on the Subjective Health Experienced Health behavioral model, developed at the Nyenrode Business University, The Netherlands by Prof Sjaak Bloem[1]. It enables healthcare providers to better align products and services to the actual needs of a patient at a specific point in time. It has been successfully put into practice and fine-tuned for oncology, hematology, infectious diseases, diabetes and pulmonary diseases. At PACE Clinical we use SHE to better align adherence supporting interactions to the actual needs and wants of an individual patient. With SHE adherence risk management takes a holistic approach focused on prevention instead of firefighting.

[1] Bloem, J.G. & Stalpers, J.F.G. (2012). Subjective experienced health as a driver of healthcare behaviour. Nyenrode research papers series no 12-01 (9 July). Nyenrode Business University, The Netherlands

(In 2018, a previous version of this article has been published on the Link2Trials website)