28.05

2018
Patient Centricity Versus Personalised Care
Written By Athena Kolivos

 

Recently, there has been an increasing focus on patient centric approaches to healthcare by various stakeholders in the quest to improve outcomes and value for patients and their support networks. These parties include regulators, payers, healthcare providers, health technology assessors, as well as device and pharmaceutical companies. They seek to understand patient experiences throughout the course of a disease in addressing the needs and improving the outcomes that matter most to patients.

From regulatory agencies such as the FDA, EMA and TGA, to payers seeking patient reported outcomes evidence, it seems patient centricity is on everyone’s agenda.1,2 Indeed, the TGA in March 2018 held a consumers’ workshop to discuss introducing patient cards and consumer device information for all permanently implantable medical devices and plans ongoing consumer engagement for this initiative.2

However, it is important to balance patient centricity at the ‘macro’ patient population level with personalised care for individual patients.

 


 

Patient centricity has been defined as “keeping benefits to patients a primary concern” via “integrated measures for listening to and partnering with patients, and placing patient well-being at the core of all initiatives. In essence, it represents a holistic approach to disease management.”1,3

This definition suggests focus at a population level as opposed to the individual patient. Thus, it has been argued a fundamental shift by medical device and pharmaceutical companies is needed to engage or collaborate with, and achieve value for, patients and their families/carers and so move beyond a brand/product focus.1,3 This means having an innovative outlook whereby companies involve patients throughout the product development lifecycle in deciding the best course of action.1

Some proposed changes include1,3:

  • Shifting the cultural company mindset from a product to patient focus so patient centred outcomes become the core of business strategy. This means capturing patient perspectives and establishing associated performance indicators based on patient input.
  • Restructuring staff roles, responsibilities and how their behaviours are rewarded.
  • Building trust with patients, healthcare providers and the public, e.g. via collaborative initiatives of mutual interest.
  • Gaining insights from other organisations within the healthcare sector experienced with patient interaction or who have established frameworks for patient engagement (e.g. NICE, EMA, TGA, PBAC and other regulatory/health assessment technology bodies).
  • Patient engagement in R & D and commercialisation activities.
  • Standardising patient reported outcomes, i.e. outcomes important and relevant to patients, which should properly reflect patient experience of the disease and its management.

However, there are some challenges to achieving patient centricity, among which is that all healthcare stakeholders need to be aligned and working together as this is not a feat for device or pharma companies alone.1

Does adopting a patient value focus have to be so grandiose? In the age of digital technologies and medical devices that help drive patient centric outcomes, much can be gained by focusing on the individual patient, their ecosystem and needs, rather than a ‘one size fits all’ approach. This does not require seismic shifts in company structures and processes. Instead, it means personalising the management of a patient’s condition such that their individual preferences, experiences and personal ecosystem (healthcare networks, carers, providers) are considered in tailoring a solution or program for them.

Diabetes is one condition gaining momentum in the area of personalised medicine with the emergence of alternative monitoring technologies to blood glucose testing. These newer devices are helping the individual patient to ‘see’ their own glucose patterns and understand and manage the likely causes of fluctuating levels. Future technologies such as saliva based, pain-free non-invasive methods offering patient ease of use and convenience, combined with accurate/reliable results, can only further improve a patient’s health literacy so he/she takes an interest in, and gains control of, their glucose levels. It is important that the patient data from these technologies be used to educate, encourage and empower individuals to make appropriate lifestyle/behavioural changes that will lead to improved outcomes in diabetes. Now such personalised (tailored) disease management is true patient centricity.

 

References

  1. Du Plessis D et al. Patient Centricity and Pharmaceutical Companies: Is it Feasible? Therapeutic Innovation & Regulatory Science 2017;51(4): DOI: 10.1177/2168479017696268
  2. https://www.tga.gov.au/tga-presentation-health-consumers-workshop-medical-devices-1-march-2018
  3. Beveridge D. Medical Devices: A Practical Guide to Maintaining Patient Centricity. August 2017 https://www.alexandergroup.com/blog/medical-device/medical-devices-a-practical-guide-to-maintaining-patient-centricity/