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How can internet-based interventions help to motivate and sustain desired behaviour? Experiences from the pharmaceutical

How can internet-based interventions help to motivate and sustain desired behaviour? Experiences from the pharmaceutical industry. Katja R ü dell + Tara Symonds Global Outcomes Research Pfizer Ltd. Experiences with internet in the pharmaceutical industry.

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How can internet-based interventions help to motivate and sustain desired behaviour? Experiences from the pharmaceutical

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  1. How can internet-based interventions helpto motivate and sustain desired behaviour?Experiences from the pharmaceutical industry Katja Rüdell + Tara Symonds Global Outcomes Research Pfizer Ltd

  2. Experiences with internet in the pharmaceutical industry • Internet databases used to identify subpopulations of disease and characterise the patient (difficulty about trusting the validity of these databases and their representativeness?) • Internet/ PDAs used to gather data on symptoms, medication use and side effects during clinical trials (experiences with the awkwardness of the internet for technophobic individuals, good experiences with handheld devices, cost a main driver) • Internet to run quick studies? • Internet-interventions

  3. Internet for Epidemiological studies • Allows you to access many thousands of subjects across a variety of countries • Can be completed very quickly • Can mitigate representativeness of the sample by ensuring correct sampling rules at the outset.

  4. Electronic data capture • Pharmaceutical companies are moving more and more towards the use of electronic systems for capturing patient data in clinical trials • Use of PDA, particularly for diary data • Computers for questionnaire data

  5. Internet study to determine patient understanding of information materials • Study completed in 1500 men • Representative to general population re age and educational attainment • For example 41% of UK men have no or minimal qualifications, this mirrored in the sample of 1500 • Subjects read information about a product and then make a judgement about whether they are suitable to take the product

  6. Internet suitability study (cont.) • Subjects then complete a questionnaire to allow us to judge their suitability. • Test concordance between subjects suitability and our questionnaire. • Down-side, no physician interaction to truly determine suitability • Up-side, allows a broad spectrum of men to be recruited quickly, which allows you to conduct sub-analyses e.g. • By specific age • By educational level • By particular co-morbidity

  7. Internet suitability study (cont.) • Data collected from required 1500 men across the prespecified age/educational levels in 4 days. • Data seems representative, analysis still on-going.

  8. How IT interventions could help patients with chronic illnesses (COPD) • Educating patients about their illness • Determining whether medications are appropriate for patients • http://www.spiriva.com/consumer/managing-copd/index.jsp

  9. How IT interventions could help patients with chronic illnesses (COPD) • Instigating lifestyle changes – Developing a support package for medication – e.g. Action plans associated with Spiriva and Smoking Cessation support online • http://www.spiriva.com/consumer/managing-copd/index.jsp

  10. PROS Magnitude of patients you can reach Opportunity to give patients what they want, when they want? Good for Access & Monitoring Low in budget and resources financially cost-effective Environmentally friendly CONS Lack of personal review and tailor behavioural change with patients Only suitable for specific people – i.e. those who like to access online interventions Ethical considerations Litigation Pros and Cons of Internet Interventions

  11. Questions from our experience • How scientifically credible is the Internet suitability study? • Does the ability to recruit large numbers quickly outweigh the potential bias of recruiting only those subjects with easy access to a computer? • How can we be sure that we reach a representative proportion of the disease population? • Whilst health promotion material to monitor illnesses or lifestyle changes are acceptable, trying to replace clinical processes is probably more difficult from ethical, clinical and also legal perspectives. • How can we protect ourselves as health psychologists or, as a pharmaceutical company, from being seen as irresponsible? • Who is responsible for patients that get worse as a result of an internet intervention? • How can we evaluate internet intervention studies appropriately? What are the criteria that signify excellence in internet interventions?

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