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Making a case for PATIENT EDUCATION
Patient ed project puts pharma company on ‘Write track’ with cancer patients
EVER CONSIDER PITCHING YOUR BOSS ON A LARGE-SCALE PATIENT EDUCATION PROJECT THAT: A.) WOULD BE VERY EXPENSIVE, B.) WOULD NOT DIRECTLY SUPPORT ANY OF YOUR PRODUCTS, AND C.) WOULD DEFY ANY ATTEMPT TO QUANTIFY A RETURN ON INVESTMENT?
Before relegating such a notion to the scrap heap of impossible dreams, consider the story of The Write Track. Underwritten by Bristol-Myers Squibb, it is a treatment journal for cancer patients that was conceptualized by a pharmacy professor while he was being treated for colon cancer. Although it is an ambitious project that doesn’t support a specific brand, The Write Track is regarded within Bristol Myers Squibb as a huge success and is about to enter its third printing.
“I may not be able to tell you what it means to the bottom line, but I can say with certainty that it generates good will and it helps get our reps in the door at doctors’ offices,” says Christine DelVecchio, the project ‘s manager at Bristol-Myers Squibb’s oncology unit.
Perhaps even more significantly, The Write Track stands as an example of the real benefits of patient education, the kind of benefits that yield substantive improvements in a patient’s outcome and quality of life, according to Peggy Wiederholt, a healthcare and patient education professional, and who is the widow of the book’s author.
“It’s well-established that better informed patients have better outcomes,” says Ms. Wiederholt, a clinical nurse specialist in the Heart Failure Transplant Program at the University of Wisconsin Department of Medicine in Madison. “But particularly in cases where the patient may be terminal, there’s no question that the greatest benefit of patient education is improved quality of life.”
A PERSONAL JOURNEY
That was certainly the experience of Joe Wiederholt, Ph.D., a professor at the University of Wisconsin School of Pharmacy, who guided development of The Write Track while fighting colon cancer. First diagnosed in 1994, he succumbed to the disease in 2001, but not before applying his professional and personal experience to the task of helping to create the journal.
Part resource guide and part advice manual, but mostly a personal health diary, The Write Track was born during a discussion between Joe Wiederholt and one of his friends and former graduate students, Gabriel Leung, who was then senior director of marketing at Bristol-Myers Squibb.
“It was after he’d finished one of his early courses of treatment,” recalls Mr. Leung, who is now group VP for global oncology at Pharmacia Corp. “Joe was describing how he had developed away to track the side effects of his chemotherapy and manage his weekly sessions in such a way that he could make the most of his good days and spend them with his family. We kind of both realized that it would be a great thing if we could provide a tool to other cancer patients to help them manage their chemotherapy side effects.”
Mr. Leung authorized the project and enlisted the help of HealthEd (formerly Doctors+Designers), a New Jersey-based health education agency that he’d worked with in the past. “They put together a project advisory board of nurses, doctors, patients, and other experts, but Joe was really the guiding force,” he says.
Eight months later, 100,000 copies of The Write Track were printed, and the Bristol-Myers Squibb sales force started distributing the books to doctors and nurses in offices, hospitals, and at conferences. It was an instant success. “You measure the appeal of a project like this by monitoring the demand,” Mr. Leung says. “I remember shortly after the first printing almost the entire supply of The Write Track was gone. Nurses were giving them out and calling us for more.”
The Write Track is regarded within Bristol-Myers Squibb as a huge success and is about to enter its third printing.
The journal prompts patients to track and rate their symptoms and side effects on a daily basis, using a 10point scale to indicate their severity. It also includes sections for chronicling the treatment sessions and any comments or questions to convey to the doctor.
“The Write Track is an excellent example of what we call patient-centered education,” says Susan Collins, senior director of health education at HealthEd. “It addresses each patient as an individual and it gets patients actively involved in their own care. By sticking to the journal, patients can pinpoint any problems earlier and manage their side effects better, and this can improve outcomes.” For instance, she explained, cancer patients who use The Write Track are quickly alerted to changes in their condition, and they can easily identify issues and questions to raise with their doctor.
But the biggest benefit for patients, Ms. Collins says, relates to the issue of control. “The book gives patients a sense of control over their therapy and their lives, and this is important because people with cancer tend to feel out of control.”
Bristol-Myers Squibb’s oncology unit
I may not be able to tell you what it means to the bottom line, but I can say with certainty that it generates good will and it helps get our reps in the door at doctors’ offices.
As a pharmacy professor and healthcare professional, Joe represented the model of a well-educated patient. Yet when he was first diagnosed with colon cancer eight years ago, he was overwhelmed by the information he received and unprepared to influence his course of treatment. “He felt very helpless as a patient at first,” recalled his wife, Peggy Wiederholt, also a healthcare professional. “We both felt over whelmed by the amount of information thrown at us.” By keeping his own journal, she said, her husband was able to communicate more effectively with his doctor and schedule his chemotherapy sessions to better manage his side effects.
MAKING THE MOST OF EVERYDAY
“Joe didn’t want to give up living,” Ms. Wiederholt recalls. “By tracking the side effects that he had during chemotherapy, he could plan his day-to-day activities accordingly and do all the things that he liked to do on the days that he was feeling better. For instance, some patients like to schedule their chemotherapy on Fridays, so they can recover over the weekend in time for work on Monday. Joe opted to have it earlier in the week so that he’d be feeling well enough on the weekend to spend enjoyable time with the family.”
For Bristol-Myers Squibb, the decision to fund the development and printing of The Write Track was made quickly and enthusiastically, recalled Mr. Leung. “I was empowered to undertake a project like this on my own budget authority, so that made it a little easier,” he says. “But at the same time I’d say we all recognized that The Write Track would be an almost revolutionary new tool that we could bring to cancer patients. It was definitely in line with the type of services that we provide as a pharmaceutical company to patients who receive cancer therapy — even if it’s not our therapy specifically.”
According to Joe Wiederholt’s wife Peggy, there’s no question that the greatest benefit of patient education is improved quality of life, particularly in cases where the patient may be terminal.
Another important consideration was that the project directly supported the mission of the company’s oncology unit, Ms. DelVecchio says. “Our corporate mission says that we will work to extend and enhance the lives of people with cancer,” she says. “The Write Track has a direct affect on that mission.”
There have also been more tangible benefits for Bristol-Myers Squibb. “The demand for the book is very high,” Ms. DelVecchio explained. “When a nurse knows that our reps have it, they let them in to see the doctor. It has also generated excellent PR and made doctors more aware of us, and it has given us some very strong advocates in the oncology community.”
For everyone involved in The Write Track project, though, the intangible benefits have been the most rewarding. For instance, at Bristol-Myers Squibb the book helps bolster employee morale. “Our people are very proud to hand it out,” Ms. DelVecchio says.
For Ms. Collins, the project leader at HealthEd, the benefit came from working with Joe Wiederholt.
“Getting to know Joe was probably, for me, the best thing to come out of this,” Ms. Collins says. “His outlook on life was truly incredible.”
REACHING OUT TO OTHERS
And for Joe himself, who benefited by using The Write Track during his own chemotherapy, there was the added benefit of seeing his work help others.
In her preface to the latest edition of the book, Peggy Wiederholt writes, “He gained much satisfaction from knowing that perhaps he played a role in helping other cancer patients cope with their dis ease. When interviewed by a local television station … Joe smiled broadly and said, ‘The neatest thing had happen when I started therapy the second time was … I sat in the clinic, people didn’t know who I was, and a patient pulled out The Write Track. That was — WOW!'”
Joe didn’t want to give up living. By tracking the side effects that he had during chemotherapy, he could plan his day-to-day activities accordingly and do all the things that he liked to do on the days that he was feeling better.
For pharmaceutical brand managers, the lesson of The Write Track is clear. If patient-centered education programs like this can yield significant benefits to an oncology unit, where often times branding and patient compliance to chemotherapy may be less of an issue, imagine what a similarly effective program could do for a chronic care product whose success is highly contingent on brand awareness, consumer choice, as well as patient compliance adherence and persistency.
Time to go back to your boss with that ambitious patient education plan.
Joe Loftus is VP of Sales and Marketing at HealthEd. Before joining HealthEd, he was Global Marketing Director in the Infectious Diseases Department at Bristol Myers Squibb. Earlier in his career he held marketing positions at Knoll Pharmaceutical Co., Schering-Plough Pharmaceuticals, and AstraZeneca Pharmaceuticals.
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