Introduction
Simply put, personalization is the act of tailoring communication so that it evokes positive experiences and resonates with an individual based on data regarding personal preferences and circumstance. Personalized communications matter and they resonate with customers. A 2021 survey, quantifying the significance of personalization in consumer engagement, noted that 71% of consumers expect personalized interactions and 76% get frustrated when they do not receive a personalized experience. Propelled by digital technology and artificial intelligence, personalized customer experience has unequivocally become the key strategic focus of companies across all industries.
Medication adherence, a global opportunity, is defined by the World Health Organization (WHO) as “the degree to which use of medication by the patient corresponds with the prescribed regimen”. Medication non-adherence is estimated to cause 125,000 avoidable deaths each year in the United States and $100–300 billion in preventable health care costs.,, Approximately 50–60% of patients with chronic conditions are non-adherent to prescribed therapy in the first year alone., Motivating patients that are disinclined to engage in positive health behavior is a notable challenge. Personalization strategies have been successfully applied in adjacent industries and can be replicated to good effect. Advanced technologies and data make possible the delivery of personalized patient communications through different delivery channels at scale and positively impact medication adherence.
Medication Non-Adherence Is Multi-dimensional
Diverse factors and barriers that affect a patient’s ability to remain adherent to their prescribed therapy are well-documented and can be categorized broadly into five groups, namely: patient-related, therapy-related, healthcare team and system-related, condition-related, and socioeconomic-related.
Tackling Medication Non-Adherence Is Complex
No two individuals are the same, therefore, the complexity of adhering to prescribed therapy is decidedly determined by an individual’s unique situations and sentiments that define and motivate their actions. Individual adherence patterns and behaviors vary widely, even among patients experiencing the same medical condition and taking the same prescribed medication. Successful interventions can be generally categorized into one of the following domains: patient education, medication regimen management, patient incentives, clinical pharmacist consultation, medication-taking reminders, cognitive behavioral therapies, and accessibility to healthcare., Although the majority of conditions influencing a patient’s adherence are modifiable, given the complicated subject matter at hand, the requisite interventions to affect change are equally complex, diverse, and multi-faceted. A multifactorial intervention strategy that combines two or more of the aforementioned interventions may be necessary to improve adherence.
Delivering Medication Adherence Interventions Through Digital Channels
In the United States, use of mobile phones is now ubiquitous. Today, 97% of Americans own a mobile phone and approximately 87% of them own a smartphone. Globally, adoption of mobile phones is ever increasing with almost 8.9 billion mobile phone subscriptions worldwide, significantly exceeding the number of people on the planet (n~8 billion)., Given the omnipresent nature of this technology, and its convenience and feasibility, mobile health interventions to support public health are widely deployed in commercial healthcare environments and are also well-documented in peer-reviewed literature.
Research driven evidence increasingly supports the use of SMS text messaging to positively affect health behaviors and improve medication adherence by helping address barriers and providing a venue to impart education and motivational support., , SMS also provides an avenue to better interact and engage with patients by enabling implementation of SMS chatbot systems, a technical enhancement and an interactive offering that has also demonstrated high efficacy in influencing positive change.
An avatar, also often referred to as virtual humans—within the domain of computer-mediated communication—can be defined as a digital representation of a human within an online interaction. To further potentially enhance the user experience and trustworthiness of SMS messaging or chatbot, organizations can also choose to utilize an avatar. Research has found avatars can provide socio-emotional benefits and patients often feel more comfortable sharing sensitive health information with an avatar rather than a human. Avatars have the potential to closely simulate patient/health professional interactions and ultimately affect positive behavioral change to impact medication adherence.
While we acknowledge the impact of SMS delivery channels, we also recognize other delivery channel mechanisms (e.g., email, direct mail, etc.) and their impact on improving adherence—a deep dive is beyond the scope of this perspective. We recommend a multi-channel delivery strategy to ensure patient engagement success.
Effective Patient Engagement Is The Goal
Historically, adherence to prescription therapy is low because patient actions govern the delivery of healthcare outside of controlled health environments. A successful messaging intervention is dependent on the individual and whether that individual finds the message compelling enough to take the appropriate desired action.
Development of impactful communication interventions to facilitate positive behavioral change requires both an understanding of the patient’s psyche and their surrounding environment. Understanding the patient informs personalization of the communication that in turn results in optimal patient engagement.
Persuasive Patient Engagement Demands Personalization
In marketing science, personalization is defined as the method to acknowledge the uniqueness of each customer by satisfying them with products that are tailored according to their needs, preferences, and motivations., Personal and behavioral data is the key to personalization, a byproduct of technology that has become all pervasive in our modern society. Effective personalization requires active consumer engagement and ongoing feedback.
While interventions such as mobile SMS messages have been successful, albeit to varying degrees, much more can be done to further improve their effectiveness. Generic content that is not tailored to an individual is less likely to be compelling and unlikely to result in the desired outcomes. Documented work conducted in marketing and behavioral sciences clearly demonstrates the impact of personalized communications in affecting positive behavioral change.,
In the context of improving medication adherence, personalization should be described as an act of tailoring an intervention, specifically the tone of the delivery content and its call-to-action message, informed by the recipient’s needs, preferences, and motivations.
Today’s patient is also a modern consumer and has become accustomed to the perks of personalization offered by ecommerce and mainstream digital media such as Amazon, Instagram and Netflix. Individual preference is no longer a nice-to-have, it’s critical to the user experience and meaningful engagement.
Patient Segmentation Informs Personalization
To impact medication adherence at scale using employed communication channels, segmenting a heterogeneous patient population into smaller, more homogeneous groups with shared traits is necessary. Different types of segmentation strategies have been employed to target specific populations and affect change.
Patient segmentation, in the context of personalization to impact medication adherence, can be broadly defined as dividing a patient population into distinct groups, who have different needs, characteristics or behaviors, and therefore most likely require tailored intervention(s) or who may respond differently to various combinations of outreach efforts. Therefore, such segmentation results in the creation of distinct micro-cohorts that share the same traits, and essentially embody a unique patient persona. Once such detailed segmentation is accomplished, communication content can be accordingly crafted to meet the unique needs of each micro-cohort and achieve personalization.
Closing
Medication non-adherence is complex and multifaceted and therefore strategies to impact positive change and improve patient adherence to prescribed therapies are also equally complex and multifactorial in nature. Use of mobile phones as a communication method is now the status quo. SMS-text messaging has proven to be an effective intervention strategy and this platform also enables implementation of newer and supposedly more impactful bi-directional communications such as chat-bot and avatar capabilities. However, in order for adherence communication to be more compelling, it has to be personalized to an individual’s unique needs, characteristics, behaviors, and motivations. Patient segmentation is a critical step to inform personalization and persuasive patient engagement.
