Transcript Geospatial Tools in Social and Administrative Pharmacy

2013 National Consumer Survey
on the Medication Experience
Jon C. Schommer, Ph.D.
[email protected]
University of Minnesota, College of Pharmacy
Background
• Over 500 million times per day in the United
States, individuals make the decision to-take or
not-to-take a prescription medication.
• Eighty percent of the way chronic diseases are
prevented and managed is with medications.
• A person’s regular interaction with medications is
not only a frequently and consistently occurring
health care event, it also interfaces with almost
all other aspects of his or her health care.
Study Assumption
Individuals enter and exit various components of
the health-care system and they shift between
their preferred identity as a person and their
sometimes necessary identify as a patient.
The “medication experience” can be a unifying
and coordinating concept to bridge this
dichotomy.
The Medication Experience
• The personal approach to the use of
medications.
• It is shaped by traditions, religion, culture life
experiences, and what has been learned from
others.
• It influences expectations, concerns,
understanding, involvement, confidence,
trust, decisions, and behaviors.
The Medication Experience
The Medication Experience
The Medication Experience
The Medication Experience
The Medication Experience
The Medication Experience
The Medication Experience
The Medication Experience
The Medication Experience
The Medication Experience
The Medication Experience
The Medication Experience
The Challenge
• Patients vary widely in their make-up, their
preferences, and their needs.
• Patients have different abilities, motivations,
and social support systems.
• The challenge, then, is to meet the needs of
each individual.
2013 NCSME: Study Objective
• Identify and describe consumer segments
based on:
– Health care consumer type
– Medication beliefs
– Patient activation
– Information seeking
– Nature of interactions with health professionals
for decision-making
2013 NCSME: Methods
• Cross-sectional, descriptive mailed survey.
• Random sample of 1,000 adult individuals residing in
the United States.
• 136 were undeliverable and 93 signified that the
person to whom the survey was addressed was not
able to participate in the study.
• Of the remaining 771 surveys, 218 (28%) responded.
Average Population Density by Square Mile
Geographic Distribution of Responders
to the 2013 NCSME
U.S. Census Divisions
National Consumer Survey on
the Medication Experience
• http://www.d.umn.edu/gac/main/schommer.html
Context: Heart Disease in the United States
Context: Health Professional Shortage Areas
Context: Medically Underserved Areas
Context: Prevalence of COPD
Context: Median Household Income
Context: Median Age
Health Care Consumer Type
HEALTHY HALF
DOCTOR LED
12%
SELF MANAGERS
SOLUTION SEEKERS
14%
36%
38%
The SOLUTION SEEKER was more likely to:
1.
2.
3.
4.
5.
6.
7.
Be of moderate age
Be moderate user of prescription drugs
Experience highest financial hardship
Use mail order pharmacies
View meds as a necessity, but not a burden
Report low patient activation
Prefer a shared relationship with their physician
and interact with their pharmacists for advice,
negotiation, or professional relationship.
Medication Beliefs: Necessity / Concern
21%
30%
HI SAVE HI BURDEN
HI SAVE LO BURDEN
LO SAVE HI BURDEN
21%
LO SAVE LO BURDEN
28%
The LO SAVE/HI BURDEN was more likely to:
•
•
•
•
•
•
•
Be of moderate age
Be a low-to-moderate user of prescription drugs
Experience moderate financial hardship
Vary in terms of health consumer type
Have the highest OVERUSE/HARM beliefs
Report medium patient activation
Experience low satisfaction and high overload with
information about medications
• Vary in their preferences regarding the nature of
interactions with their physician and pharmacist.
Medication Beliefs: Overuse / Harm
17%
32%
LO OVERUSE LO HARM
LO OVERUSE HI HARM
23%
HI OVERUSE LO HARM
HI OVERUSE HI HARM
28%
The HI OVERUSE/HI HARM was more likely to:
•
•
•
•
•
•
Reside in the West census region
Be a low-user of prescription drugs
Experience moderate financial hardship
Use a clinic pharmacy or no pharmacy at all
Have LO SAVE/HI BURDEN medication beliefs
Experience low satisfaction and high overload with
information about medications
• Vary in their preferences regarding the nature of
interactions with their physician and pharmacist.
Patient Activation (involved/engaged)
14%
25%
HIGH
MEDIUM
LOW
61%
The HIGH PATIENT ACTIVATION was more likely to:
•
•
•
•
•
Be of younger age
Be female
Be a Self-Manager health care consumer type
Have LO SAVE / LO BURDEN medication beliefs
Experience high satisfaction and low overload with
information about medications
• Be in the ALL HIGH segment for shared decision
making with healthcare providers (that is, highly
engaged).
Information Seeking Behaviors
18%
35%
HIGH
MEDIUM
LOW
47%
The HIGH INFORMATION SEEEKING was more likely to:
• Be of younger age
• Be Black
• Prefer a shared relationship with their physician and
want to interact with their pharmacist for advice,
negotiation, or professional relationship.
Information Evaluation
16%
52%
HI SAT LO LOAD
MED SAT MED LOAD
32%
LO SAT HI LOAD
The LO SAT / HI LOAD was more likely to:
• Have HI SAVE / HI BURDEN medication beliefs
• Have HI OVERUSE / HI HARM medication beliefs
• Be in the LOW Patient Activation segment
• Prefer an informed/paternalistic relationship with
their physician and prefer to use their pharmacist as
an information source only.
Interactions with MD and RPh
24%
46%
MD Shared RPh Information
MD Shared RPh Adv,Neg,Rel
39%
MD Informed/Paternalistic RPh
Information
The MD Informed/Paternalistic and RPh Information only
was more likely to:
• Moderately high financial burden
• Be the Self-Manager healthcare consumer type
• Have HI SAVE / HI BURDEN medication beliefs
• Have LO OVERUSE / HI HARM medication beliefs
• Be relatively low information seekers
• have relatively low satisfaction and high overload with
information about medications.
Shared Decision-Making
9%
49%
HIGH
MEDIUM
LOW
42%
The HIGH Shared-Decision Making group tended to be:
• Female
• High for Patient Activation
Conclusions
• The medication experience is more than a
clinical experience – it is a social and personal
experience.
• The medication experience is rooted in
medication beliefs, personal abilities and
motivations, information processing, decisionmaking relationships, finances, and the effects
of life experiences.
Future Work
• Expand the identification and description of
segments based on components of the
medication experience.
• Incorporate components of the medication
experience into patient care processes
• Build systems for identifying and matching
patients and providers based upon
preferences and capacities in the medication
experience domain.
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