Parkinson’s Awareness Month

M3 Global Research is currently recruiting patients with Parkinson’s to participate in usability testing for a new device used in conjunction with a smart phone (both provided) in the United States and in Germany. We’re offering generous compensation to the patients taking part and also the physicians referring them. If you are a member of the M3 Global Research panel, contact to find out if you qualify. If you are a patient who is not a member and wish to participate, please register by clicking here if you are in the USA and here if you are in Germany. You will then receive an invite by email.

Around seven to 10 million people worldwide live with Parkinson’s disease, a condition that currently has no cure. For this year’s WordParkinson’s Day, Parkinson’s UK, a charity that works towards finding a cure and improving life for everyone affected by the condition, has launched the campaign #UniteForParkinsons. It aims to give voice and platform to the Parkinson’s community by featuring their experiences in a world-wide campaign video and encouraging others to do the same. Watch it here:

Complexity of Parkinson’s ‘massively underestimated’ in the UK

In a survey to mark World Parkinson’s Day (Wednesday 11 April), Parkinson’s UK has discovered that 78% of the public massively underestimate how many symptoms of Parkinson’s there are. Although most people are aware of visible symptoms like tremor, Parkinson’s can also come with more than 40 less well-known symptoms such as sleep issues, anxiety and hallucinations. Shockingly, more than a third (37%) thought there were fewer than ten symptoms of Parkinson’s and more than 41% thought there were fewer than 30.

The charity is warning that this lack of awareness means that people with Parkinson’s often feel they need to hide their symptoms in public, or don’t want to go out at all due to being incorrectly judged or mocked. Previous findings from the charity have uncovered:

  • A quarter (25%) have had symptoms mistaken for drunkenness
  • 11% have been laughed at because of their symptoms
  • More than a third (34%) feel they would be judged if they were out in public
  • Almost a third (32%) don’t feel like their symptoms are socially acceptable

These symptoms are merely the tip of the iceberg, it warns, and do not reflect what people with Parkinson’s most want addressing. In a recent project carried out by the charity to identify priorities to focus on for improving everyday life, tremor came 26th on a list of what people with Parkinson’s want research to tackle.

Artificial intelligence to help develop new Parkinson’s treatments

Parkinson’s UK is actively involved in research, and recently one of its research proposals has won the BenevolentAI Award. The project demonstrated how AI technology could solve specific research challenges in Parkinson’s.

There have been no major breakthroughs in Parkinson’s treatments in the last 50 years. Current treatments revolve around medication that works by restoring the level of dopamine in the brain or mimicking its actions; deep brain stimulation (DBS), a type of surgery where electrodes are implanted deep inside specific parts of the brain, but which is not suitable for every patient; and physical therapies such as physiotherapy, speech and language therapy and occupational therapy, that are important in the management of the condition.

Parkinson’s UK’s proposal will use BenevolentAI platform’s capabilities to reason, deduce and suggest entirely new treatments for Parkinson’s. The aim is to identify at least three currently available medicines that can be repurposed to address Parkinson’s, and two brand-new ways to treat the condition with new drugs. Read more about the project: Artificial intelligence to help develop new Parkinson’s treatments.

*All rights belong to Parkinson’s UK. We would like to thank the charity for sharing this content with us.

Understanding healthcare market research

Working in the pharmaceutical industry includes frequent use of market research and collaboration with fieldwork agencies like M3 Global Research. The M3 blog spoke to someone working regularly at that interface about how healthcare market research affects their decision making. Read the full interview:

How does market research support the development of a new therapy at each stage (of its development and trials)?

In the pre-launch phase we use market research (MR) to understand the needs of HCPs and patients, and which of those are currently unmet. We then consider whether we can monitor these gaps as part of our clinical trial data collection programme. Additionally, we research patients and allied HCPs to understand if there is an opportunity to build a support programme to better help those living with, caring for those living with, or treating those living with the illnesses we’re researching.

After a new therapy is launched, the need for market research changes. How does it continue to play a role in ensuring the best possible outcomes for patients?

Clearly, we use MR to assess the markets, and then track our penetration, so we can better understand prescribing, patient numbers, effectiveness of advertising and communications and patient types and characteristics. These activities help us see how our medicines are being used outside a trial setting. MR can tell us if there are anomalies in patient characteristics in greater numbers, as individual cases may not look unusual to a busy HCP. It is important to note we are required to report any adverse events (AEs) or product quality complaints (PQCs) through MR, which provides another layer of patient safety.

In addition, we have our own sets of goals and objectives that can only be measured using MR. One important factor in doing this is to anticipate usage so that we can forecast demand and make sure we never run out of medicine, but also whilst considering their “shelf lives” so this process needs to be carefully managed.

As the pharma industry continues to evolve and guidelines in how we interact and promote our medicines become ever more stringent, we use MR to better inform our touchpoints with customers, so that we don’t bombard them with un-necessary promotion. We are not there yet, but we hope to move more towards constructive discussions around meeting customer needs and away from “please use my product” discussions. Also, in this modern age, we are aware that different customers like to interact using different channels and media, therefore we use MR to understand which channels we should maximise use of, so the HCP does not have a waiting room full of reps!

We also use MR to understand the educational needs of HCPs, in order to build our medical education programs to deliver meaningful and useful disease area education. Finally, we use MR to understand potential opportunities to buy new medicines, or licence in from other manufacturers (some companies don’t have a commercial presence). MR will tell us if this is an investment worth making – will it address an unmet need or is it just another “me too”?

A cynic may argue that market research only exists to help pharmaceutical companies make money and it has little to do with promoting the best patient outcomes. How would you counter this argument?

I won’t pretend that market research does not help us commercially. Unfortunately, there are some companies who do not have resources to be able to run multiple projects, so will try and capture as much as they can in one survey. Our clinical trial data helps us understand where our medicines are optimal and therefore set expectations on usage – we use MR to see what is happening in the real-world, where these patients are not in a clinical trial setting and are instead impacted by the reality of their day to day lives. We use MR to ask the HCPs (and patients) about their experiences of these real-world settings and we use these outputs to help tailor our communications to identify the most relevant patients and help the HCP identify those who will best benefit from our medicines. An example might be patient adherence to medication – this could be identified as an issue during MR, where usage may differ from clinical trials and therefore may put the patient at risk from sub-optimal self-management. MR will help us send focused communication on these findings to HCPs and potentially deliver better patient support solutions.

Patient centricity has become increasingly important for pharmaceutical companies over recent years. What is it and how does market research with patients and doctors support it?

Personally, I think this is a buzz word – patient centricity SHOULD be the focus of everyone in pharma, it’s what we get out of bed for – but patient research is often the first to be cut when budgets are restricted. I believe this is a reaction to needing to inform the financial side of the business and keeping shareholders up to date, as these are how we are measured externally. MR can help us understand more about the patient side and then use this data to communicate internally about patient needs and how well (or not) we are meeting those needs. Because we are not permitted to communicate directly with patients, HCPs are the gate keepers to contact with them, and therefore are perceived to be the most knowledgeable. However, patient research can turn our head towards the important topics that may not be picked up in HCP research. Patient associations and pharma work together to support their activities and help them raise a voice when Patient Association Groups don’t have the resources to do this alone. MR can help us understand more about the patient side and subsequently use this data to communicate internally about patient needs and how well (or not) we are meeting those needs.

Thinking of a typical market research project, what types of people have a role in developing and reviewing the questionnaire before it is presented to doctors or patients?

This is very dependent on who us asking the questions. If it is for a commercial research project it will be the MR manager, medical approver, compliance, marketer or pharmacovigilance. For health economics research, everyone from the commercial research team will also be involved, plus the people responsible for outcomes research and market access. In patient research we’ll also involve the communications manager and the patient liaison team.

Technology investment in the healthcare sector

Our first monthly Pulse of 2018 asked the M3 Global Research community their opinions on technology investment in healthcare. The healthcare sector has experienced dramatic changes over the last 25 years and will likely continue to change and evolve in the immediate future. Technology is already powering new models of care and disrupting traditional ideas about care provision. However, the level of investment will become a key driver in the speed of delivery. For this Pulse survey we asked healthcare professionals which areas of potential technology investment they think would have the most impact patients over the next five years. Participants could choose up to three of the following:

  1. Preventative medicine (home test kits, measures for disease prevention and identification of risk factors)
  2. Self-diagnosis (recognising or identifying medical conditions for oneself using online resources)
  3. Telemedicine (online or telephone consultations with HCPs without face-to-face contact)
  4. Social prescribing (a means of enabling primary care professionals to refer patients to a range of local, non-clinical services)
  5. Self-care (actions that individuals take for themselves in order to protect, maintain and improve their health or wellbeing)
  6. Care navigation (using signposting and information to help patients and their carers identify their treatment and care options)
  7. Patient access to online health records (patients can access, electronically, their own records from all primary and secondary care interactions)
  8. Other

January’s Pulse revealed that the majority of respondents in Europe, Canada, and the US believe that telemedicine, with 2,752 votes, is the area of technological investment that will most improve patient care over the next five years.  This might include Skype consultations, or digital clinics, and would be particularly useful in improving access to care in remote areas or for specialist treatment. Preventive medicine followed as the next most popular option, with 2,495 votes, and was particularly popular in the United States. Preventative medicine is seen to be a way of reducing healthcare costs, and also improve efficacy of treatments by early diagnosis, and so might include the  development of home testing kits, for example. Social prescribing was deemed to have the least potential impact, with only 485 votes, but this could be because its application is less well understood outside the UK, where it is quickly gaining traction. In the UK, primary care clinicians are able to refer patients to a range of local, non-clinical services, often provided by the voluntary and community sector, thus reducing costs for the NHS.

In Europe specifically, results broadly reflected the global findings, with 2,710 professionals surveyed in UK, Germany, France, Spain and Italy choosing telemedicine as the area of technological investment that they thought would most improve patient care over the next five years. Preventive medicine followed, with 2,436 votes. Social prescribing was the option with the least votes, with 485.

healthcare sector

Interestingly, in the USA results were different. Preventive medicine was chosen as the area of technological investment that will most improve patient care over the next five years, with 1,136. Telemedicine came in second, with 517 votes. Self-diagnosis apps were deemed to have the least potential impact, with only 86 votes.

Technology investment

By registering with M3 Global Research you will receive the monthly Pulse straight to your inbox so you can give your opinion about topical healthcare-related issues and compare your thoughts with those of your colleagues around the world.

Talking to… Dr. Devika Umashanker

Dr. Devika Umashanker is an Obesity Medicine specialist practising in the US. In this interview with the M3 Blog, she speaks about fat-shaming, personalisation of treatment, the use of MDTs in the management of obesity issues, and taxing sugary products. Read the full interview below.

What inspired you to specialise in obesity medicine?

After completion of residency I worked as a hospitalist for a couple of years during which I noticed that the underlying cause of many of my admissions was obesity. During medical school or residency, there was not a significant amount of time allocated to teaching obesity medicine or nutrition. After studying the subject on my own and going to various conferences on obesity medicine, I was fascinated and intrigued with the sub specialty, which then led me to pursue a fellowship in obesity medicine at Weill Cornell Medical College.

If you look at data shared by The World Obesity Federation, it is clear there are differences between the percentage of obese adults in each country around the world. What could influence the level of obesity from country to country?

In my opinion, possible factors influencing the level of obesity from country to country are access to food, access to care and being able to treat obese patients effectively.

Further data shows the differences between the percentage of obese men and women in every country. Biologically, are there main differences between male and female metabolisms?

Women tend to have greater adipose tissue compared to men. Increased adipose tissue leads to increased insulin resistance, increased inflammatory markers, and decreased adiponectin levels, which all play a role in the pathogenesis of obesity and affect metabolism.

Would you say that the treatment for obesity must be personalised? In what way?

The treatment of obesity must be personalised because each patient is different. For example, each patient with obesity has a different set of comorbidities and a different combination of medications treating their comorbidities, which then leads to a different treatment plan.

Data shows that on current trends 2.7 billion adults worldwide will suffer from overweight and obesity by 2025. In your opinion, what would be the main points to work on in order to treat and prevent obesity?

The main points to treat and prevent obesity are early intervention, nutrition and exercise counselling, availability of anti-obesity medications, and universal insurance coverage for bariatric surgery, when appropriate.

What is your opinion on taxing sugary drinks, a measure that has recently been approved in the UK? Do you believe the impact will be significant? Are there other similar measures that you think would have a bigger impact?

In my opinion, obesity is similar to cancer. Obesity decreases quality of life, increases mortality, and individuals die from the complications associated with obesity. If cigarettes are taxed to prevent consumers from purchasing the product to reduce lung associated disease such as lung cancer and COPD, we should strongly think about the impact that taxing sugary drinks will have on our consumers in regards to obesity. In my opinion, I think the impact will be significant as it will make the consumer think twice before purchasing a sugary drink. Would taxing sugary drinks eliminate obesity? The answer is no. However, it may be a good starting point to consider.

How can physicians treating obesity benefit from working with different healthcare professionals, such as psychologists and psychiatrists, nutritionists, physical education professionals etc?  

Working with a multi-disciplinary team including psychologists, exercise physiologists, bariatric surgeons and nutritionists is the most effective way to treat individuals with obesity.

What do you think about so-called ‘fat-shaming’ by healthcare professionals towards patients dealing with obesity? How can this be tackled?

I think ‘medical fat-shaming’ is prevalent in the medical community, but this can be tackled through education on the pathophysiology of obesity. Obesity is not volitional but rather a disease. Neuro hormonal dysregulation and hormonal imbalances play a significant role in obesity and as a medical community we need to come together and understand this universal concept.

 Is there anything you would like to add?

Obesity medicine has come a long way but we still have a long way to go.

How will technology impact medical practice?

Original research by M3 Global Research was featured in City AM and Business Reporter this week. Our findings on how physicians think technology will impact medical practice was included in Anna Delaney’s article ‘What healthtech can learn from fintech’.

With healthcare being touted as one of the tech trends to watch over 2018, the text is built on the idea that technology in healthcare might soon have the same impact it has had in consumer’s banking behaviour.

Delaney highlights that, according to the survey conducted by M3 Global Research earlier this year, 26% of UK doctors see that investment in self-diagnosis technology will have the most impact on patients over the next five years. And she goes on to ask: will this make people increasingly independent from their doctors?

The article doesn’t fail to mention the importance of developing trust, and suggests that having trained and accredited physicians involved is key.

Click here to read the full text.