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Health literacy, diabetes and pharmaceutical companies

Posted Nov 11 2012 2:32am
It's heartening to see that pharma companies in India are investing money in educating patients about diabetes. MSD took a full page advertisement in the Times of India on World Diabetes Day, to create more awareness about the disease. India is supposed to be the diabetes capital of the world, and since diabetes is a chronic, lifelong disease pharma companies understand that there is a lot of money to be made in treating these patients. This is why it makes business sense for them to invest in patient education ; and I am pleased that they are now reaching out directly to patients to empower them with information. Diabetic patients need information , and pharma companies have the deep pockets to be able to use the mass media to reach out to them effectively.

However, there are some major lacunae with the advertisement. For one, it did not feature a single expert patient. While it’s important to listen to what diabetic specialists have to say about the disease, isn’t the viewpoint of someone who has successfully lived with the disease for many years equally
important ?

Also, there is no reference to any educational website  in the advertisement. This is a tragic waste of a huge  opportunity ! Information needs to be provided on an ongoing basis, and this is best done online. Patients could have easily been provided with website addresses or QR codes, which they could have bookmarked, so they would continue to get updated knowledge. Educational efforts cannot just be a one-off full page expensive advertisement in a newspaper - they need to be run as digital campaigns, so they can reach patients where they are - at their homes, through SMSes, smartphones and PCs.

It’s high time pharma companies in India invested in promoting health literacy. Diabetes is something which we can effectively treat , but we cannot cure.  Since it's a chronic, lifelong disease , it's very hard for patients to remain motivated over the long-term , and a lot of them will dropout of treatment.  They will not follow up with their doctor; or will not do the tests they are asked to , until they suffer from a complication. However, by this time, the damage has already been done ! Poor compliance is a major bugbear for doctors and pharma companies ( and the spouses of diabetics as well !) , because it's not much fun to stick a needle into your finger in order to check your blood sugar; or to have to follow multiple restrictions about your diet and your exercise. For many diabetic patients, life seems to have become a long lists of  “do’s and don’ts” !

While doctors are quick to complain that patients do not follow their instructions, part of the problem is that doctors continue to issue orders to their patients , without investing the time and energy in explaining to them why they need to follow these instructions. Since diabetes has no symptoms , and since the complications which it causes occur after many years, it's very easy for patients to cut corners and be indisciplined. This lack of compliance ends up hurting the pharmaceutical companies as well. If patients do not check their blood sugars regularly, or they do not take their insulin because they are needle phobic, this reduces the sales of insulin and hurts the pharma company’s profitability.

While pharma companies have done a great job in teaching doctors about the new types of insulin molecules and how they need to be administered in order to control blood sugar effectively over the long term , they need to spend money in educating and coaching patients as well, so that they can learn to manage their diabetes for themselves.

The good news is that it's possible to motivate diabetic patients to take better care of themselves. Pharma companies need to learn to put patients first , and the most effective way of doing this is by promoting health literacy by investing in information therapy . This is a great opportunity for a forward thinking company to create a win-win situation , for themselves , for diabetic doctors , and for their patients as well !

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