Bedrock Healthcare Communications has a passion for changing behaviour by fusing creativity and science to create compelling medical communication solutions. In this article, Chris Barton (Strategic Solutions Director) shares his thoughts on how pharmaceutical companies and medical communication companies, like Bedrock Healthcare Communications, can support healthcare systems to work through the backlog of patients.
1. What has been the biggest impact on long-term condition management in relation to COVID-19?
It is no secret that healthcare services have been severely disrupted as a result of the pandemic. Most healthcare teams are faced with a backlog of patients who are either already recognised patients in the system or have yet to be diagnosed.
- If all countries increased their normal surgical volume by 20% after the pandemic, it would take a median of 45 weeks to clear the backlog of operations resulting from the 12 weeks of the first wave of disruption.1
- In the UK, up to 60,000 potentially new type 2 diabetes patients will have gone undiagnosed between May and December 2020.2
The challenges remain very real as healthcare systems face continued disruption due to lockdowns and under-resourcing, working with exhausted teams who have been operating at maximum capacity for over a year.
2. What does this mean for the pharmaceutical industry and its relationship with healthcare professionals?
There is a great opportunity to change the dynamic between the pharmaceutical industry and healthcare professionals (HCPs). From my experience working in the pharmaceutical industry, these are my top two thoughts:
a) Best-practice guidance that helps HCPs with their current challenges would be hugely valuable. We need to help HCPs understand that traditional thinking is unlikely to get them to where they need to be. Traditional thinking would involve recruiting bigger teams to increase capacity, but simply put, there isn’t enough money or space to run services at 120% for the next 45 weeks or longer.
Working harder is just not possible but could we work together to work smarter?
For example, can teams prioritise workload according to need, spending time with more urgent patients and reducing workload further downstream? A recent example of this approach from the Association of British Clinical Diabetologists (ABCD) was issued at the end of 2020.3 Their rationale states: ‘We also need to reshape the use of our human and physical resources, moving away from a system of 3–6-month routine appointments to a system that is responsive to individual needs.’
ABCD provides clear guidance on categorising patients (red, amber, green), based on clear clinical parameters, which should be readily available for all, e.g. HbA1c >10 is red. They also provide recommendations on how frequently people in each category need to be seen by a HCP (e.g. red: see within 3 months, likely to need 4–6 contacts per year; green: see yearly, unlikely to be within 6–9 months unless the patient moves groups). By using this guidance, a local diabetes team could assess and allocate its workload and resources for the year accordingly. However, many teams are unlikely to have never worked this way before and working their way through the waiting list in time or alphabetical order may seem the most logical approach.
This is where the pharmaceutical industry and medical communications teams have an important role. Can we work together to identify the needs of HCPs and patients, develop potential solutions in a tailored fashion and then ensure an efficient roll out across different locations, building long-term partnerships along the way?
b) Aligning product messages and data to demonstrate potential efficiencies may support reducing the backlog. When it comes to efficiencies and increasing the number of patients treated effectively, increasingly drug acquisition costs are being considered alongside other product characteristics such as ease of administration. In this situation, does the product have a competitive advantage that previously would have been designated as ‘low impact’? Branded products, previously held back for use as second or third line treatments, but which require fewer titration steps and deliver better outcomes, may be prioritised over generics. Products that patients can safely administer themselves are prioritised in favour of those that require HCP team involvement. The well-intentioned, but possibly paternalistic mindset that administering as drug for the patient will improve compliance, has been overtaken by needing to get life-saving medications to the right people at the right time. Choices are being made now based on the impact they can have on workload, which in turn increases team capacity to review, assess and treat patients. Could a product’s messages or strategy be updated to catch this wave? In the UK, oral anticoagulants were being prioritised over warfarin even before the COVID-19 pandemic due to the very reasons given here. With the changes we’ve all experienced, could now be the time to both re-map HCP needs and tailor the product messages to address them?
3. Bedrock Healthcare Communications can support with this
At Bedrock Healthcare Communications, we always seek to understand before we try to be understood. We believe that only when all the layers of a picture are applied does the true story emerge. Bedrock Healthcare Communications has the time and experience to impartially review the changed landscape and assess the strategy, to ask the difficult questions and to co-create compelling solutions that achieve more … for patients, for HCPs and for the pharmaceutical industry. If any of the above ideas strike a chord, why not contact us to discuss further?
- Healthcare’s COVID-19 backlog: how pharma can help. Available at: https://pharmaphorum.com/views-analysis-patients/healthcares-covid-19-backlog-how-pharma-can-help/. Accessed June 2021.
- Carr MJ, Wright AK, Leelarathna L, et al. Impact of COVID-19 on diagnoses, monitoring, and mortality in people with type 2 diabetes in the UK. Lancet 2021;9:413–5.
- Choudhary P, Wilmot EG, Owne K, et al. A roadmap to recovery: ABCD recommendations on risk stratification of adult patients with diabetes in the post-COVID-19 era. Diabetic Medicine 2020;38:e14462.