The following transcript has been edited for clarity.
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Opening soundbite: The aim with Clarivate is we’re going to support 100 million patients in our first year. That is meaningfully supporting patients and helping prevent premature death. Our ambition, from experience in what we’ve achieved to date across hundreds of campaigns, our aim here is to prevent 200,000 premature deaths.(1) That is walking the walk of sustainability.
VOICEOVER: Ideas To Innovation from Clarivate.
Host: Every year, nearly 41 million people worldwide die prematurely from non-communicable diseases. (2) Yet 80% of premature deaths could be avoided if patients and healthcare professionals alike had the right information at the right time to make better decisions.(3) According to the United Nations, ensuring healthy lives and promoting wellbeing at all ages, is essential to sustainable development. Today, we’ll discuss how the medical community governments and other public groups can address the UN’s Strategic Development Goal 3 of reducing premature mortality by one-third by 2030.
Hello, and welcome to Ideas To Innovation Season 2, I’m Neville Hobson. In this second episode of the new season, our guests will share how companies can play a more significant role in addressing these issues with their resources, expertise, and innovation. I’m pleased to welcome Dr Grace Lomax the clinical director at Patient Connect, a part of Clarivate that enables life science companies to identify and support patients at the point of care and the point of dispensing. Grace’s experience as a physician, highlights numerous unmet needs beyond just clinical issues, especially around healthcare literacy and education at the point of care. Welcome, Grace. Thanks for joining us.
Dr Grace Lomax: Thanks. It’s a pleasure to be here.
Host: You founded Patient Connect together with your sister Zoe Barker in 2008. In December 2021, your company was acquired by Clarivate. Can you tell us about how you started this venture 14 years ago now, and what galvanized you to do something like setting up a business called Patient Connect?
Grace: Yes, happily. I worked as a hospital doctor for several years and then as a GP for several years, and it became very apparent that there was not enough information for patients to help them to better understand their illnesses, better understand their treatment [and] what to do with their medications. Of course, in 2008, it nearly predates the internet. Patients would find information from leaflets and wall racks in waiting rooms. Of course, there’s only so many leaflets you can stick into a wall rack, and this was compounded by a culture within the medical community of telling patients what we thought they needed to know, rather than listening to what patients would like to know and explaining choice and risk and the likelihood of a treatment working or not. There was a culture of patriarchy rather than collaboration.
I ran a survey with patients to better understand what they wanted to know and who from and when, and how they’d like to receive the information. We got some really surprising answers back from that. We found, for example, that 63% of patients worry that they will become addicted to their medication if they keep taking it. That’s all medications, not just the two classes of drug, so opioids and benzodiazepines that cause addiction. [The survey found] two-thirds of the population worry that if they stay in a medicine, they’ll either develop tolerance to it or addiction to it or will need ever higher doses for it to work. Understanding what the patients want to know is an imperative to being able to support them in their unmet needs.
Host: It sounds [like] what you’re saying, Grace it’s actually quite interesting. There was obviously a gap in the market, I suppose, one way of putting it. If people didn’t have [an understanding] — did you get a lot of resistance to what you’re doing after, or you were disrupting something, weren’t you?
Grace: That’s so interesting. Surprisingly, no, we received [a] huge level of collaboration. We worked with 67 professors [and] another 120 consultant physicians to create information that address those questions that the patients wanted answered. We came from it from a different place rather than, here is asthma, a page on asthma. It was answering the questions that the patients want answered around asthma or the treatments for asthma or any of the other treatments.
With this huge team of key opinion leaders and consultants, we [made information available to] 95% of patients who present. We chose the most common diseases within each therapy area, so that there was more information available and answering the questions that the patients [wanted] answered. We also threaded into it information that they needed to know. What side effects should you contact a doctor about immediately, or what are the risks of a procedure and the likelihood of success? Information they need to know in information they want to know.
Host: Right. We’ll actually talk a bit more about that communication understanding in a bit. Here we are 2022, 14 plus years on from those early days, two particular points I’d like to get your insights on which are very pertinent to this overall conversation that we’re going to have. The first one is why do you think the promotion of wellbeing is critical to sustainable development? It’s an important connection I think to make in the context of what’s actually happening. Why do you think that is?
Grace: I think wellbeing in sustainability is around improving the health of people. It isn’t just around happiness levels, and the burden of disease is vast and debilitating for many. As we progress through life, we develop chronic diseases. The average 65-year-old has 3 different chronic diseases. The average one, that means half of them have more than three. The burden of disease is cumulative and is widespread. If we can improve that for patients, we can improve the quality of their lives and reduce the limitations around their lives.
Host: I guess that leads to the second point. What can companies do? You’ve started the answer of that. Do you see this actually happening? [What are] companies doing to help drive the prevention of premature death, or is that too much of a stretch to connect it all in that way – helping the prevention of premature death?
Grace: No, you can, definitely and absolutely, contribute to reducing premature death. There are many different types of premature deaths. There are road accidents, drug overdoses, neonatal mortality. The area we are focused on is what is called non-communicable disease. That is the majority of disease in the Western world. It’s all of the hypertension, diabetes, COPD, stroke, depression, et cetera. Those long-term conditions, the burden of death, which is the area that we are looking to tackle, and we have experience in helping patients improve is, by helping the patients better understand their medications and the need to take them, we help improve their persistence and adherence with their medication.
There’s plenty of data in the scientific press that demonstrates if patients take their medicine, it contributes to preventing death, and we’ve run hundreds of campaigns now where we help patients better take their medicines. We’ve supported 80 million patient interventions across the last 15 years. We typically on average improve patient persistence and adherence by 15%.(4) That is really meaningful. If you look at something like hypertension, so a common disease, it’s a chronic disease. We don’t cure it. We manage it on a day-to-day basis, and it is treated on a huge scale.
Where you have 100 million people, you will have 150 million prescriptions for antihypertensives.(5) That is how many antihypertensives are prescribed in the Western world. There’s one and a half prescriptions for every single person in the Western world and yet only 18% of people treated for hypertension achieve normal tension.(6) What that means is 82% of hypertensive patients remain hypertensive.(7) The problem with that, it’s not about the hypertension. It’s the fact that hypertension causes heart attacks, it causes stroke, it causes premature death. 500,000 people die from hypertension in America alone.(8) That’s the first entry on their death certificate. Yet we only managed to control the blood pressure of 18% of the patients with it.(9) There’s a huge unmet need there and a significant level of the problem is the patients aren’t even taking the medicines. We know that only 8% of patients take 12 prescriptions in a given year. 8% that means 92% don’t.(10)
Host: [What] do you think the reason for that primarily is? What did you say it is? They’re not adhering to compliance with their medication education guidance if you will, with the serious potential consequences for those patients. What’s behind that?
Grace: These patients, they’re not naughty.
Host: No. [chuckles]
Grace: This is a lack of understanding. There’s a casualness to the adherence and collecting the next script. There’s the fear of the addiction and the tolerance. There’s a worry that it might mess with the other medicines. There’s no understanding the risk and why you’re bothering to treat the hypertension. There’s a lack of understanding and you need to recognize, even in the Western world, health illiteracy runs at 20% of the population. (11) What that means compared to just normal illiteracy is the ability of a patient to read the box, understand how they’re meant to take it, understand why they’re taking it. 20% of the population can’t even manage to understand the writing on the box of medicine.(12)
Host: Is this across the board in all the places you’re operating in or is this in particular places only?
Grace: Clearly in impoverished towns and cities the numbers get worse, but it’s certainly across the Western world, we work in 15 countries now and health illiteracy is a commonality across all of them.
Host: I think that’s probably a good segue into an important point I wanted to ask you about where your data shows there’s millions of people not adhering to medication compliance as a manner of putting it. What is Clarivate doing to address this problem? I guess putting that in the right framework is kind [of] part of the commitment to achieving that UN sustainable development goal or sustainability development goal number three. The one that looks to reduce premature mortality by one-third by 2030. Where are we in that picture?
Grace: Clarivate has big ambitions to contribute meaningfully, so properly walk the walk of sustainability in healthcare. Whereas with Patient Connect, we’ve supported 80 million patient interventions in 15 years. The aim with Clarivate is [we plan] to support 100 million patients in our first year. That is meaningfully supporting patients and helping prevent premature death. Our ambition from the data, from experience in what we’ve achieved to date across hundreds of campaigns, our aim here is to prevent 200,000 premature deaths. Contributing to preventing 200,000 premature deaths. That is walking the walk of sustainability.
Host: You mentioned earlier that the data you’ve got in a sense identify the clinical need for what needs to be done and the education element that falls along from that. I’m curious to know that if people aren’t understanding their medication and how to use it, how big a problem is that really in the context of what you just mentioned?
Grace: It’s massive. This lack of persistence and lack of adherence is not an old story, it’s happening here today. We’ve done quite a bit of work in depression, so mental health and again very common, unfortunately, there are as many prescriptions for depression as there are people [and] as many prescriptions as there are people. By the time they see their physician these are souls in crisis. There are twice as many suicides as homicides. Even in America, twice as many suicides as homicides. Yet half of patients treated for depression, give up their medicines within six weeks.
Half of them, that’s an extraordinary number. Yet we know there’s plenty of data in the scientific press, if you can just get a depressed patient to go from one prescription to two or more prescriptions, you reduce by two-thirds their risk of suicide.(12) Two-thirds, that’s an extraordinary number from one to two, you reduced by two-thirds then, unfortunately, successful suicide.
Host: I agree. That leads to my next question. If communication is an important factor here to help people understand what to do with the medication, how to take it, how to help themselves. I guess this is such a huge scale, you must be working with healthcare professionals, other organizations throughout the world. Can you share a bit of thought on how that’s actually working?
Grace: Yes. Thank you. We’re working with the largest pharmaceuticals who want to champion better outcomes for their patients across each therapy area. We’re doing this in tandem with the pharmaceuticals who focus on cardiovascular disease or focus on respiratory disease so that we can benefit from their expert knowledge and we can bring our expert knowledge at addressing the unmet needs of patients. Together we will do great things here.
Host: That sounds fabulous. Do you think then taking into account all of that and particularly that collaborative work with global partners that the UN target of reducing premature mortality by one-third by 2030, how genuinely achievable do you think that is?
Grace: In healthcare, we plan to contribute significantly up to 30%. The ambitions are so big, more broadly within the UN SDG. It’s going to be interesting to watch, we have eight years before the end of 2030, don’t we?
Host: We do.
Grace: To achieve that across road accidents, drug abuse, neonatal death in poorer countries, it’s so ambitious. It’s only by trying and focusing on it and bringing the world experts from around the world that we have a chance of achieving it.
Host: That’s excellent. Grace, thank you very much, indeed your insights have given us a good view of how significant this will be for millions of people worldwide when effective health communications can stimulate innovation leading to real change. Thanks very much, Grace.
Grace: It’s been a real pleasure. Thank you for the opportunity.
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Host: You can find more information about the topics Grace speaks about on clarivate.com. Search for Patient Connect. Season 2 of ideas to innovation continues with the next episode coming soon. Visit clarivate.com/podcasts for information. Thanks for listening.
VOICEOVER: Ideas to innovation from Clarivate.
[00:18:32] [END OF AUDIO]
References:
1. Source: Patient Connect for Clarivate Report, Sustainability References, Clarivate. Accessed May 2022, Clarivate.
2. Source: World Health Organization Noncommunicable Diseases. https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases#:~:text=Noncommunicable%20diseases%20(NCDs)%20kill%2041,%2D%20and%20middle%2Dincome%20countries. World Health Organization. 2022.
3. Source: The Financial Burden of NCD’s. https://ncdalliance.org/why-ncds/the-financial-burden-of-ncds. NCD Alliance. Accessed 2022,
4. Source: Patient Connect for Clarivate Report, Experience Database, Clarivate. June 2022.
5. Source: Patient Connect for Clarivate Report, Sustainability References, Clarivate. Accessed May 2022, Clarivate.
6. Source: Patient Connect for Clarivate Report, Sustainability References, Clarivate. Accessed May 2022, Clarivate.
7. Source: Patient Connect for Clarivate Report, Sustainability References, Clarivate. Accessed May 2022, Clarivate.
8. Source: Facts about hypertension- National Center for Chronic Disease Prevention and Health Promotion, Division for Heart Disease and Stroke Prevention. https://www.cdc.gov/bloodpressure/facts.htm. Centers for Disease Control. Accessed June 2022.; Source: Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)01225-8/fulltext. The Lancet. December 2015.
9. Source: Patient Connect for Clarivate Report, Sustainability References, Clarivate. Accessed May 2022, Clarivate.
10. Source: Patient Connect for Clarivate Report, Sustainability References, Clarivate. Accessed May 2022, Clarivate.
11. Source: Low health literacy: Implications for managing cardiac patients in practice; Kathleen T. Hickey, EdD, FNP-BC, ANP-BC, FAHA, FAAN. Ruth M. Masterson Creber, PhD, MSc, RN, Meghan Reading, PhD, MPH, RN, Robert R. Sciacca. EngScD, Teresa C. Riga, BS, Ashton P. Frulla, NPC, and Jesus M. Casida, PhD, RN, APN-C; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6391993/. The Nurse Practitioner. August 2018
12. Source: Low health literacy: Implications for managing cardiac patients in practice; Kathleen T. Hickey, EdD, FNP-BC, ANP-BC, FAHA, FAAN. Ruth M. Masterson Creber, PhD, MSc, RN, Meghan Reading, PhD, MPH, RN, Robert R. Sciacca. EngScD, Teresa C. Riga, BS, Ashton P. Frulla, NPC, and Jesus M. Casida, PhD, RN, APN-C; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6391993/. The Nurse Practitioner. August 2018
