Study Objectives. To understand the influence of socio-economic factors, from a physician viewpoint, regarding the patients :

Size: px

Start display at page:

Download "Study Objectives. To understand the influence of socio-economic factors, from a physician viewpoint, regarding the patients :"

Logan Cummings
6 years ago
Views:

Subsequent Compliance with their Treatment Regimen ISPOR,

1 1 Impact of Socio-Economic Factors on Patients Knowledge of their Condition, Involvement in Treatment Decisions and Subsequent Compliance with their Treatment Regimen ISPOR, Dublin Oct M Palm, V Higgins, R Lawson, J Piercy Adelphi Group Products

2 Study Objectives 2 To understand the influence of socio-economic factors, from a physician viewpoint, regarding the patients : knowledge of their disease involvement in treatment decisions compliance with medication

3 Patient Sample and Study Timings 3 Countries: Germany, Spain, USA Patient sample: 2,526 patients in total Patient criteria: Patients 12 years and older who present with a diagnosis of asthma Fieldwork timings: Q1 2007

4 Methodology and Recruitment 4 The Adelphi Disease Specific Programme (DSP ) is a cross-sectional, observational study of consulting patients. Data were collected by physicians who recruited the next 6 consecutive patients consulting for asthma from a specified start date. The key factor analysed for this study was employment status (higher versus lower socio-economic status). Data were analysed using Chi-square and Fisher's exact tests to test for differences.

Disease Specific Programme Methodology 5 PHYSICIANS Primary Care & Specialists ATTITUDINAL Doctor Level Data Face-to-Face interviews with doctors PRESENTATION DATA Patient Level Data Workload page

5 Disease Specific Programme Methodology 5 PHYSICIANS Primary Care & Specialists ATTITUDINAL Doctor Level Data Face-to-Face interviews with doctors PRESENTATION DATA Patient Level Data Workload page completed by doctors BEHAVIOURAL / DOCTOR PERSPECTIVE Patient Level Data Patient record forms completed by doctors prospectively PATIENTS Consulting Physician completed Patient completed PATIENT PERSPECTIVE Patient Level Data Self-completion questionnaires completed by matched patients matched sample

6 Higher versus Lower SES* Categorisation Patient-reported 32. What is your current employment status? (Please tick one box only) * Socio-economic status 6 Professional Skilled - manual Unemployed Managerial or Technical Partly skilled Retired Skilled non-manual Unskilled Homemaker Armed forces Student Higher SES Lower SES Excluded from this analysis Higher SES 73% Lower SES 20% Not employed 7%

Patient Categorisation Physician-reported 7 Knowledge 1a. What is the level of knowledge this patient has about their asthma and treatment options?

7 Patient Categorisation Physician-reported 7 Knowledge 1a. What is the level of knowledge this patient has about their asthma and treatment options? (Please tick one box only) None Limited Some Moderate High Low High Involvement 1b. How involved is the patient in the treatment decision? (Please tick one box only) Not at all Seeks advice Asks several Discusses treatment Requests specific occasionally questions options in detail products Low High 1c. How compliant is the patient with their asthma treatment? (Please tick one box only) Compliance Not at all Has poor Has variable Fairly Fully compliance compliance compliant compliant Less Compliant Fully Compliant

8 Knowledge and Involvement by Employment Status 8 60% High Knowledge about asthma and treatment options 60% High Involvement in treatment decisions 50% 50% 40% 40% % of patients 30% 20% % of patients 30% 20% 10% 10% 0% 0% US Germany Spain US Germany Spain Higher SES Lower SES Knowledge: p<0.05 in Germany, US; p=0.062 in Spain Involvement: p<0.05 in Germany, US; p=0.132 in Spain

9 Compliance by Employment Status 9 60% Full Compliance with their asthma treatment 50% % of patients 40% 30% 20% 10% 0% US Germany Spain Higher SES Lower SES p < 0.05 in US and Germany p = 0.52 in Spain

10 Correlation between Knowledge and Involvement 10 Knowledge (1: No knowledge 5: High level) Involvement in treatment decision (1:Not at all 5:Requests specific products) Significant positive correlation between knowledge and involvement (p<0.01)

11 Knowledge versus Compliance Correlation 11 Knowledge (1: No knowledge 5: High level) Patient compliance (1:Not at all 5:Fully compliant) Significant positive correlation between knowledge and compliance (p<0.01)

12 Conclusions (1) 12 There are significant differences in knowledge, involvement and compliance between socio-economic groups in the US, Germany and Spain. In the US, involvement of disease engagement amongst lower SES patients is on a par with higher SES patients level of involvement in Spain. We suggest this may reflect varying healthcare systems and environments, including the DTC and DTP prevalence in the US. The correlation between level of involvement and compliance may indicate that if physicians made particular efforts with lower socio-economic groups in treatment decisions, compliance levels would improve.

13 Conclusions (2) 13 Increase Knowledge Increase Involvement Increase Compliance

14 Further Research 14 The DSP allows us to include many other relevant factors including: Age / gender / ethnicity Comorbidities Concomitant medications Length of time since diagnosis Future plans to develop analyses to include some or all of the above Any other ideas?

Across the Cognitive Impairment Continuum Increasing Patient Dependence is Associated with an Increase in Caregiver Burden

Across the Cognitive Impairment Continuum Increasing Patient Dependence is Associated with an Increase in Caregiver Burden Loretto Lacey Janssen Alzheimer s Immunotherapy Dublin, Ireland Alzheimer's Europe