We lift weights to improve strength, run laps to maximize conditioning and tailor our diets to ensure our bodies of nutrients needed to perform. All are areas worthy of attention not only for our overall health, but for both our internal mindset and external appearance. The fact that these elements are regular fixtures of our day-to-day routine is of little surprise (it’s more surprising if they’re not part of our complete breakfast). What is a bit awe-inspiring, however, is how frequent our brain is passed over as a body part that stands to benefit from a little exercise.

Our brains are complex; easily the most complicated and mysterious feature of our bodies. It’s also easy to overlook the brain since it’s a part we (and others, hopefully) can’t see and have no way of truly tangibly attributing the impact we can make regarding its performance. To state the obvious, without proper communication from the center of our nervous system, arms won’t lift, feet won’t push and mouths won’t open. Then shouldn’t it seem like the obvious thing to do to have a plan we can follow geared toward optimizing the performance of our single feature that’s at the controls of everything we do?

Outside of the routine digestion of words, thoughts and visuals, most of us exhibit little conscious effort toward injecting the brain with some extra muscle (have we ever really thought of reading a comic book or speaking with Aunt Edna as brain fuel, anyway?). Yes, the statement about us using only 10% of our brain is false; we use all of our brain, some just use it better than others. Or do they? Could it be that some just settle for the brain capacity their given, which is the equivalent of eating a bag of popcorn before it’s popped? Sure, it still has some of the taste and will fill your belly, but it lacks all of the buttery goodness and flavor if we actually put it in the microwave for a minute (sorry, bad example for a ‘health’-related topic).

A recent article in Smart Money examined a growing trend of flexing our mental muscles  – known as brain plasticity – in places like brain gyms and through activities typically associated with the, shall we say, less chiseled. From phone applications to video games to whatever else fills the $265 million mental-fitness-product market, more and more are setting out to improve their health and strength through brain training that works just like weightlifting: undertake difficult and unfamiliar activities that force new connections to be formed. Memory, attention span, stress and aura are just some of the attributes that stand to be affected by a mental fitness program, not to mention more obvious benefits like sharpened response times, better problem solving ability and heightened awareness.

Academics warn not to expect too much too soon from these products, but brain stretching brings to the surface some underutilized points of potential for pharma marketers. From metabolic management research, we already know behavior can be changed by better understanding a patient’s mindset, improving the odds of adherence to a prescription or helping curtail unhealthy behavior, such as smoking. Providing doctors with the tools to more easily identify those mindsets, however, is an area where the concepts of gaming, interactive exercises and smartphone applications might provide doctors with the behavioral insight needed to improve their patient’s lives. Even without a doctor’s presence, custom-built programs and challenges specifically for helping guide a patient’s thought process regarding a condition or treatment can be effective in driving motivation and communicating in ways physicians can’t.

We all know reshaping human behavior is no easy feat, but it’s virtually impossible without a greater understanding of what’s going on in someone’s mind. Whatever windows into that world are available must be considered, especially if science is on its side. Although creating effective training programs will likely be expensive and difficult to personalize, it’s a step in the right direction and one of the few solutions that might help both patient engagement and patient-physician communication. That’s truly some heavy lifting.

CVS Caremark shared findings regarding some recent adherence research in patients using their online ordering system. They found that when presented with the offer to sign up for automatic refill reminders in advance of renewing the prescription, patients were twice as likely to sign up vs. those who were passively presented the choice to sign up after receiving the prescription.

Sometimes it’s just very simple changes and offers that can make a huge difference. I applaud CVS Caremark for their focused study of actual patient behavior and for utilizing a more active strategy to engage patients.  But, the problem with simple, singular approaches like this is that I am not sure that they add up to a whole lot.

While it’s easy to point fingers at cost and forgetfulness, they aren’t the only challenges that patients face when it comes to taking their medications. Patient adherence to medications is very complex. And while reminders are certainly helpful, they’re only a small piece of the puzzle. Pairing solutions that address more functional and rational barriers (like cost and forgetting) with behavioral science-based educational offerings that address patients’ underlying emotional and psychological barriers to adherence could truly make a huge impact.

Because adherence is such a challenge for patients with metabolic diseases, MicroMass recently released some researchthat illustrates the key psychological/behavioral “buttons” of people suffering from hypertension, high cholesterol, type 2 diabetes and/or obesity.   When I think about key counseling moments that pharmacists, healthcare professionals and even marketers have with patients that have metabolic diseases  – I truly believe that  these interactions  could not only be more effective, but also more efficient if they addressed patients’ psychological hot buttons.

Brandy Barnes, Founder and CEO of DiabetesSisters

Today we are honored to have Brandy Barnes, Founder and CEO of DiabetesSisters, sharing her thoughts with us.  DiabetesSisters is an international organization that provides education and support services to help women of all ages with all types of diabetes live healthier, fuller lives.  Find out more at www.diabetessisters.org

If you live in the US, it’s pretty much a given that you know that pink is the color for breast cancer.  It’s everywhere- on television, billboards, newspapers, and radio.  In fact, it’s even on the products we buy- from cereals to garden tools.  We even see men’s professional teams donning pink uniforms in support of women with breast cancer.  There is absolutely no way you could get through the month of October without knowing that it is breast cancer awareness month.  Why is it that we see breast cancer awareness campaigns everywhere?  Is it because it is the most frequently diagnosed disease among women?  Is it because more women are dying from breast cancer than from any other disease?   Is it because breast cancer treatment places a heavier financial burden on consumers, the health care system, and the government than does breast cancer?  It must be because of one of these very important reasons, right?

Wrong.  In fact, there are many more diseases that affect more women than breast cancer.  Let’s consider diabetes, for example.   In 2010, 750,000 women are expected to be newly diagnosed with diabetes compared to 192,370 women expected to be diagnosed with breast cancer.  Currently in the US, 11.5 million women have diabetes compared to 2.8 million women living with breast cancer.  Regarding mortality, over 40,000 women will die from breast cancer this year compared to more than 116,000 women dying from diabetes.  The total cost of diabetes was estimated to be $174 billion in 2007 (of which approximately half– 87 billion can be attributed to women) compared to $7 billion in 2007 spent on breast cancer treatment.  Indeed, there are many, many more women affected by diabetes than by breast cancer.  In fact, if you are reading this, it is likely that you have a female family member, friend, or co-worker who has been diagnosed with diabetes.  However, because diabetes is often viewed as a personal failure, many do not disclose their diagnosis.  Since nothing physical happens (such as hair falling out) to a person with diabetes, it is relatively easy to hide the disease if one chooses to do so.  Yet, it is important to not lose sight of the fact that diabetes is a very serious disease that kills millions of women every year. 

You may or may not be aware that November is Diabetes Awareness Month.  Obviously, it does not receive the same kind of fanfare and media support that breast cancer does, but it’s time for someone to change that.  As the Founder/Executive Director of a nonprofit focused on improving the health and quality of life of women with diabetes, I know it is time for women with diabetes (and their loved ones) to stand strong together, support each other, and save each other’s lives.  We have the facts and statistics to back us up.  Diabetes IS affecting more women than breast cancer, it is killing more women than breast cancer, and it is even costing more money. 

Let’s make orange the color that represents women with diabetes.  This Fall, when November 1^st rolls around, dig out your orange shirts, skirts, jackets, and purses.  When someone asks you why you are wearing orange every day, explain to them that orange is the color that represents women with diabetes and November is Diabetes Awareness Month.  No doubt, you’ll catch them by surprise!  Tell them why diabetes is a special cause for you (Aunt Rosa had diabetes; my friend, Sandra, has diabetes; my co-worker, Jennifer, has diabetes) and share the statistics about women with diabetes—11.5 million women with diabetes in the US; 750,000 women expected to be diagnosed this year; and we will lose 116,000 women to diabetes this year. Encourage them to be tested for diabetes if they are over the age of 45 or if they are under the age of 45 and overweight.  Explain the symptoms of diabetes: being very thirsty, urinating a lot, feeling very hungry, feeling very tired, losing weight without trying, having sores that are slow to heal, having dry, itchy skin, losing feeling in or having tingling in the hands or feet, having blurry vision, and having more infections than usual.  Finally, encourage them to support women with diabetes in any way they can.  It is up to each of us individually to make our own small difference in this world.  When the small differences are done as part of a larger group, the impact can be huge!  

**Note: It is not my desire to take media attention away from breast cancer.  Breast cancer is, indeed, a devastating disease that is deserving of the attention it receives.  My only wish is to create the same kind of awareness in November around diabetes, an equally deserving disease that affects millions of women in the US.  In fact, I credit the breast cancer team’s superb marketing tactics and strong collaboration-building skills with their huge success in raising awareness and money for the cause.  I only wish that I could be an intern at the breast cancer office to learn how they do what they do so well.

I was browsing my inbox last week when a headline caught my eye – Why Spouses of Dialysis Patients Get Kidney Disease Too. Huh? Yes, I know that blood relatives are often at increased risk of diabetes and hypertension – two conditions that are often precursors to kidney disease. But spouses?

Sure enough, a study from Taiwan in the May 2010 issue of the American Journal of Kidney Diseases demonstrated that the risk of developing kidney disease for spouses of patients on dialysis is just about as high as it is for blood relatives. When the researchers compared the spouses of dialysis patients to a control group, they found higher rates of smoking, and high blood pressure. They also found that diabetes is a significant risk factor among those spouses.

Guess I need to pick up some of my old health education textbooks and brush up on the socio-ecological model. This model recognizes the intertwined relationship between the individual and their environment.

When you think about behaviors like what we eat and whether we exercise – there are so many things that stand in the way of making healthy choices.

I know – I face them every day. I walk in the office in the morning and my internal voice tells me it’s okay to eat just three chocolate donut holes (it’s not a whole donut anyway). Then at three o’clock my chocolate radar resumes as I roam the office to give my body just a little energy to get through the afternoon. And don’t get me started about exercise. In my environment, just 20 feet down the hall, stands a convenient piece of work out equipment. Also in my environment, my husband gets out of bed at 6:30 every morning and goes for a 4-mile run.

My personal health behaviors aside – as a health educator focused on creating (often non-personal) health communications, it’s easy to get fixated on trying to impact those factors within a person that often stand in the way of healthier living. I often don’t think of impacting environmental factors such as policy and organizational changes. However, in marketing, there still is the opportunity to impact families, social networks, and communities.

Believe it or not, there is room for public health in marketing.

It usually goes something like this:

• Patient goes to see doctor for an ailment
• Doctor assesses patient
• Doctor writes patient a prescription
• Patient thanks doctor and leaves, prescription in hand
• Patient decides not to fill the prescription.

From then on, the doctor and patient are operating under conflicting assumptions—a great plot for a 70s sitcom, but bad news for better medical care.

Recent research looked at primary nonadherence, that is, patients failing to fill an initial prescription. Rates of nonadherence were highest in metabolic diseases such as diabetes (31%), hypertension (28.4%) and high cholesterol (28.2%).

If so many people are failing to fill their scripts, but the doctor assumes that they are taking the medication as prescribed, how can treatment progress effectively?

Doctors are only as good as the information they have.

Given the high rate of primary nonadherence, doctors should make the following direct question a standard part of follow up visits, “Did you fill the prescription for Drug X that I gave you?” People are less likely to lie in the face of a direct question.

Obviously that one question won’t solve the communication disconnects that plague doctors and patients, but it’s a start.

So don’t lie to your doctors.  Trust me, they’d rather hear the ugly truth.

It’s no surprise that women are often the target when it comes to healthcare and pharmaceutical marketing. They are often the gatekeepers to medical care and information for their families. They are more likely than men to search for online health information, search on someone else’s behalf, and seek online support.  

Being a part of communities is the fabric of women. Perfect example – in today’s “wired” world women are drawn towards online applications that allow them to connect with others and share information vs. men whose online activities tend to be more transactional in nature.

As marketers, that means that women are an easy target, right? After all, it’s not difficult to find where to connect with women, especially online.  But the key is figuring out how to engage them. 

The mistake that many marketers make is speaking broadly to women, assuming that based on a few demographic variables that they are targeting key interests and pain points in women.

 Yes, as women, we do often have a lot in common.  As a thirty something woman, I can easily find another thirty something woman who struggles with making time for herself, consistently disciplining children and figuring out what to fix for dinner.

But when it comes to health and illness, as a marketer, there is much more I need to understand about my audience in order to change their behavior – it’s the “why” that is so important. It’s those behavioral buttons that we can leverage to have greater relevance and impact.

We recently conducted some research in women diagnosed with cancer.  What we found is that even women experiencing the same type of treatment, in the same stage of cancer – their experience of living with cancer and psychologically, how they cope, is dynamic and individual.  Some women are very active in how they cope. They are forward looking, optimistic, wanting to know pragmatically what’s next. They want to reach out and help others. On the other hand, other women are passive. They follow physician advice, want to be cared for and they are constantly looking back – asking “why me?” No doubt that different marketing strategies and messages would be required to have a powerful connection to these different mindsets.

We can’t address every variation in our audience. But with an insightful approach, we can prioritize and focus on those core behavioral drivers that lead us to more meaningful, authentic conversations and greater trust.

Recently, the FDA approved Dendreon’s Provenge, a vaccine for prostate cancer. The vaccine is a milestone for immuno-oncology, as well as for personalized medicine. It’s really interesting – each dose of the vaccine is made from a patient’s own cells so every therapy is unique to the individual.

Testing individuals to customize therapy is nothing new. It’s been done for years in oncology and infectious disease, but usually as a guide for selection of existing therapies.

The potential for further advances in personalized medicine is huge, potentially reaching many important therapeutic areas. But one key issue that I can see from this is re-training physicians to think differently about treatment than they do now.

We know that physicians often treat patients in a predictable way, usually based on their own experience, expectations, and assumptions about a condition or medication. Most of the time this is OK, especially when you consider the time constraints in most practices and the prevalence of many chronic conditions. But illness affects everyone differently, and a one-size-fits-all approach may not be ideal.

Perhaps the evolution of personalized medicine will help health care practitioners to think differently about the way they practice. By learning more about the personal characteristics, values and behaviors of patients and not just the condition they have, their approach to treatment could become more individualized. Personalized medicine already has its own advocacy group. Lets encourage more frequent use of patient insights to create a personal medicine movement.

In pharma marketing and in healthcare in general, we expect a lot of patients – sometimes too much. We get so focused on what we are trying to get them to do, that we sometimes lose sight of what patients want and are trying to do.

To be effective, we need to understand the context of patients’ lives  – those important little nuances that can get in the way of, or propel, behavior change.

A recent New York Times editorial discussed the complexity of health behavior and the assumptions that we (Americans) place on others who are sick and don’t take care of themselves. It’s easy  to cast a stone.  We do it every day. We put ourselves at arms’ distance, we cast judgments and make assumptions about other people and their health.

Doctors do the same. Patients come in their office and they quickly make assumptions based on a way a patient looks, or the way that they interact with them. Not to blame doctors – they are humans too. Plus the demands and structure of our healthcare system have forced them to run their businesses like an assembly line at times.

As marketers, we make assumptions too. We try to grasp the patient experience.  We do our due diligence but mostly we just scratch the surface.

We fail to go to a deeper level – because maybe we are afraid of getting messy. Maybe we are afraid of being exposed to the holistic picture – of learning about the messy lifestyle “stuff” that we believe we cannot do anything about.

It’s true – there IS a lot that we cannot change but if we actively listen, opportunities arise that allow us to connect with our customers in more meaningful and relevant ways.

How do you listen?

At MicroMass, we’ve been exploring some ethnographic approaches utilizing social media to gain a richer and more accurate picture of patients’ mindsets and attitudes.  So, we are looking at conversations.  And it’s not just about what patients are saying. It’s the way they say it and even more importantly, what they are not saying. 

Our collaborative work with Verilogue enables us to examine patient and healthcare professional conversations as well, adding another layer to our understanding of the patient experience.

As a recent MedAd News blog so eloquently stated “social media may help the pharma industry figure out the complex psychology and needs of each patient” and help them “focus less on the brand and more on the patient.”

So, don’t be afraid to get a little messy. It’s worth it.

You can’t hide anymore. At least your health problems can’t.

Even those of you who won’t go to the doctor can be assured that SOMEONE is looking out for your well being. In what would seem like something out of a Dav Pilkey science fiction film, scientists from San Diego and Taiwan are developing bio-sensing underwear. The idea is great – non-invasive sensors constantly monitor the skin for various biomarkers and could alert the wearer when something is wrong

If that’s too creepy for you (or if you prefer boxers), there’s another technology in development that’s more subtle, involving implantable, gold nanoparticle probes. These are supposed to be able to continuously monitor specific protein levels and signal dangerous levels are reached.

We’ve seen in our research that peoples perceptions about their health or chronic conditions don’t always match reality. With an objective source of data from new technologies like these, perhaps that gap can be narrowed and quality of care can improve.

There can be a tendency within the pharmaceutical industry—although I’m not pointing fingers—to sacrifice emotion and authenticity in communications for the sake of “playing it safe.” But, particularly in patient-facing communications, we must keep in mind that patients’ illnesses—whatever they might be—are indeed emotional issues for them. And for their families, friends and all of the others who care about them. So, in order for companies and their brands to authentically connect with patients, it’s essential—not optional—to find a way to tap into the emotions they’re feeling. Acknowledging them. Honoring them. And addressing them. All the while staying out of trouble with the folks up in the legal department.

For the purpose of today’s post—and to keep this from becoming a dissertation—let’s focus on how we communicate with patients through Web sites. At the SXSW Interactive conference last month, I was reminded (thanks to Kristina Halvorson, CEO and founder of Brain Traffic) that our arsenal for creating powerful Web site user experiences is larger and more powerful than ever. Among the tools we have for building compelling online content are:
Text
Data
Graphics
Video
Animation
Audio

And, within the subsets of these groups of tools are even MORE tools—like data visualization, metadata, user comments, error messages (yes—they, too, are part of the user experience and should be given careful thought), forms, links, search results, and a whole host of others.

Any and all of these tools, when used correctly and implemented with strategic consideration regarding their core purpose, can be used to create a genuine interactive experience with patients. And, notice I said “interactive.” A Web experience should never be static. The more back and forth there is between your brand and the user via the Web site—the more probable it is that a very real and lasting connection is being made.

In my opinion, Lilly is one of the pharmaceutical companies out there doing a really nice job of simultaneously recognizing and addressing both the informational and emotional needs of its audience. In the Diabetes TouchPoints section of LilyDiabetes.com, users are greeted by a video of Virginia Valentine. Not only is she a Certified Diabetes Educator, but she also has the disease herself. So, between that and the fact that she’s a natural on camera, the emotional connection with site users is immediate. And that’s the way it should work. Plus, she delivers relevant information in a very warm, conversational style that makes it feel like you’re sitting across from her in your living room.

Other features of Lilly’s site include an area for users to rate which content they find most useful, a Virtual Kitchen in which Chef Robert Lewis walks site visitors step-by-step through diabetes-healthy recipes and relevant downloadable educational materials for adult and pediatric patients, as well as for their caregivers. It’s evident that the entire Web-based experience was given careful and very deliberate consideration and that—at all times—the needs of the patient drove that process.

We have a lot of new Web-based technologies at our fingertips to enhance the age-old process of storytelling. A process that in and of itself has connected human beings for all time. While it can be a bit nerve-wracking for those whose role it is to keep us out of legal quagmires, there are ways to use these technologies that satisfy the needs and interests of everyone involved. We just have to have the creativity, commitment and patient-centered focus to implement them in ways that bring emotion and warmth back into what is all too often a very cold and sterile experience.