How HCPs and patients are partnering to transform care

By Danny Buckland

In a world of scientific absolutes and mathematical rigour, it can be difficult to find a place for emotional capital; feelings don’t lend themselves to the disciplines of comparator arms, pharmacovigilance reports and clinical endpoints.

But how new therapies flow from industry to patients via healthcare professionals (HCPs) is determined by the chemistry that drives personal relationships as well as the science, even though each party can be motivated by conflicting interests, use different language and have a propensity to find fault rather than understanding.

Differences can seem intractable and solutions distant but healthcare has its own relationship counselling service available in the form of shared decision-making (SDM), the process where everyone prioritises listening, understanding and communicating to find mutual ground.

This medical mediation is more than an exercise in human dynamics and its influence is growing as it becomes increasingly valued as a tool to optimise patient needs, support healthcare systems and advance the reach and success of new therapies. The benefits of patient/HCP unions radiate across patient populations and pharma performance.

A British Medical Journal paper by Victor M Montori et al that examined SDM as a distinct method of care stated: ‘Every consultation with a patient is an opportunity to get care right – intellectually, practically and emotionally – for that person using SDM as a method of care.’ Tellingly, it added: ‘Patients and clinicians can find problems that matter along with possible ways of addressing them, deciding among the possibilities, and putting it all together in a plan that the patient wants, is likely to help, and is feasible and sustainable. Within the constraints of any situation, including systemic constraints, SDM is a method of creating the best care; it is also the human, kind and caring thing to do – the sort of thing that breathes life, joy and purpose into the practice of medicine.’

Matt Eagles, Head of Patient Voice at global healthcare communications agency Havas Lynx, is convinced that uniting clinical expertise with lived patient experience can create a potent force, saying: “SDM is crucial to the future of healthcare. It has the potential to be the glue that keeps systems like the NHS together by uniting patients and HCPs.

‘By involving patients from the beginning and working collaboratively, we can achieve better, more efficient, outcomes’

“Too often we focus on the needs of one or the other in isolation when it needs to be both. If HCPs and patients actively listen to each other and communicate with empathy, the results will be so much better for everyone. Patients will feel more compelled to better follow treatment plans because they will be more aware of the reasoning behind them.”

Matt has a deep, personal perspective on SDM as he has lived with Parkinson’s Disease since he was seven years old and experienced myriad HCPs along a journey that has led to trusted, collaborative relationships with his current consultants and their teams.

“I’ve lived with the condition for over 50 years and it is clear to me that we learn from each other, which is very positive,” he adds. “Importantly, as patients become more confident in their knowledge, and in advocating for themselves, they become more visible and credible.

“Take Parkinson’s, for example, where historically treatment has been focused on and developed for men. However, women also suffer from the condition and their reaction to therapies can vary widely. It is only through patient voices, mainly via social media, that this has been fully recognised, and treatments and outcomes improved.

“But this happens across a lot of therapy areas and we have to speak to patients and learn from their experiences and, by doing that, we can learn more, while enabling them to become more invested in their own health journey.”

Time is often cited as a barrier preventing HCPs from developing relationships with their patients and a Cochrane Review found that adopting SDM protocols prolonged consultation time by 7.5%. On the plus side, evidence is growing that as SDM adherence improves and repeat clinical visits are reduced, time and resource stress are taken out of pressurised pathways.

Havas Lynx is championing patient voices and making them a key part of strategies across campaigns, from clinical trials to public awareness. Matt observes: “Time management is tricky for HCPs, who are under significant pressure, but the benefits of SDM are evident. And work still needs to be done to understand the stresses patients, HCPs and pharma are under to build mutual trust and understanding. I think pharma has a big role to play here – by involving patients from the beginning and working collaboratively, we can achieve better, more efficient, outcomes for everyone. It makes ethical and economic sense.”

Podcasts, webinars and social media are now powerful sources of knowledge and forces for changes and Matt believes that, as a result, HCPs are now better able to connect with a patient’s lived experience and collaborate on effective, sustainable care.

A key challenge is to empower HCPs with relevant knowledge in an era of dwindling face-to-face engagements and bursting communication channels. Research from Veeva Systems, a leader in cloud-based software for the global life sciences sector, revealed that industry access to HCPs dropped from 60% in 2022 to 45% over the last two years.

This is a cause for alarm that is tempered by an expanding hunger for scientific engagement, with Veeva studies showing that 94% of key opinion leaders (KOLs) believe scientific exchange between pharma companies and clinical experts is becoming more important.

“The amount of medical information that patients can access is increasing and that is empowering them to be part of the medical decision-making process. But HCPs also need fast access to the right information to enable a productive two-way conversation,” says Christoph Bug, vice president of global medicine at Veeva. “As a treating physician, it is extremely challenging to keep up to date with the latest scientific information and, occasionally, patients may know more about their condition than the physician.

“HCPs depend on the pharmaceutical industry to help them stay up to date. The industry can address HCP needs through faster and more comprehensive scientific exchange to enable physicians to better inform their patients.

“The science is a strength of industry but, to communicate that more effectively, there is a need to shift resources from marketing content to scientific engagement. Biopharma is creating around 20% more content each year, but around 77% of it is rarely or never used. There is scope to refocus on scientific information and the feedback we get from HCPs is that they trust the pharmaceutical industry and they want to have more scientific dialogue with information supplied via their preferred channels.”

The need for scientific information that generates understanding is the critical input into the SDM equation – particularly as many new therapies are complex entities – and digital advances continue to open up new vistas for patients to become more knowledgeable and able to contribute insights to SDM.

Christoph draws on Veeva’s extensive data, his background as a practising physician and his extensive experience in medical affairs at Janssen before taking up his Veeva role. He comments: “At Janssen, we ran patient education programmes that were very successful in helping patients improve their knowledge and be part of decision-making, which made them more committed to their treatments.

“The pharma industry now has to do a similar job with HCPs and this approach has to be a dedicated element of a company’s strategy: it cannot be a hobby or an add-on. Biopharma makes substantial investments in getting a product to market. It makes economic sense to help HCPs with scientific evidence so they can fully understand it and discuss it with patients as part of the SDM process.

“But you can only have a voice in SDM if you are informed and have a willingness to share – that is what biopharma needs to focus more on. Ultimately, SDM will change healthcare and the industry because biopharma will need to generate scientific evidence and ways of sharing that information to get the best from its products.

“There is a strong pull from patients now and that has to be recognised and satisfied. Facilitating that will lead to better outcomes and more effective and economic use of medicines.”

Annarita Egidi, Head of Oncology for Europe and Canada at Takeda, who oversees the company’s oncology portfolio across 37 countries, underscores that SDM has to be driven by widespread collaborations that give patients the space and confidence to speak and be heard.

“At the heart of any successful shared decision-making project is input from the communities they serve. I am a firm believer that meaningful progress cannot be achieved in isolation; collaboration is key,” she observes. “We must really listen to the experiences and needs of patients, caregivers, patient organisations and HCPs – and then act on the advice they give. It’s vital to involve the community at every stage – from first identifying challenges, to scoping out a project, right through to delivery. This collaborative approach allows us to co-create useable tools and resources to facilitate discussions between patients and their care teams, driving real impact.”

Takeda’s ethos of Patient, Trust, Reputation and Business were exemplified, she says, in a recent project where it convened a patient panel from the metastatic colorectal cancer community from across Europe to generate actionable insights.

‘SDM is crucial to the future of healthcare, offering the potential to be the glue that keeps systems like the NHS together by uniting patients and HCPs’

“This session allowed us to deep dive into the significance and barriers to shared decision-making. Hearing directly from the community about the impact of key challenges, such as the urgency in decision-making and the complexity of the treatment landscape, was incredibly valuable,” Annarita says. “To me, the panel underscored the vital role of collaboration. Only by working with the community can we truly understand the lived experience and develop meaningful programmes to make progress on shared decision-making.”

Takeda is also exploring how digital technology, data and predictive analytics can support HCP-patient relationships to improve knowledge transfer and help patients engage with treatments and make informed decisions.

“Informed decisions lead to better care, and better care changes lives. Patients bring invaluable insight into their own needs and priorities, while clinicians offer medical expertise; blending these together, we strive towards more personalised care,” says Annarita. “I am particularly enthusiastic about the potential for shared decision-making to foster increased trust and transparency in relationships between patients, caregivers and HCPs – a shift that can transform the care experience for everyone involved.

“At its core, shared decision-making is about feeling heard. Everyone has unique values and needs that deserve to be respected, especially when it comes to their health. It’s about equipping patients, carers, and loved ones with the tools and understanding to make choices that are right for them.”

References are available on request.

Danny Buckland is a freelance journalist specialising in the healthcare industry