Patient Compliance Report 2013

Star Life Sciences Medical Monitor™
2013 Healthcare Communications Study Among Patients
Healthcare Communications Study Among Patients | ©2013 Star Group Communications, Inc.

Healthcare Communications Study Among Patients | ©2013 Star Group Communications, Inc. 2
Star Life Sciences partnered with Plesser & Clifford,
a 30-year-old market research company specializing
in medical marketing research, in designing
and implementing this study.

• Background, Objectives and Research Methodology
• Executive Summary/Implications
• Detailed Findings
• Compliance
- Factors that motivate people to take their medications (open-ended)
- Brainstorming ideas that may improve compliance (open-ended)
- Rating usefulness of ideas that could help respondent take medicine (close-ended)
- Ranking “most useful” ideas
• Sources of Health Information
- Usage of social media to discuss health issues
- Healthcare plan contact
- Sources of information
• Reaction to Passage of Patient Protection and Affordable Care Act
• Respondent Characteristics
• Appendix: Screener and Questionnaire
Contents

Background, Objectives
& Research Methodology

• Star Life Sciences wishes to build its learning base of what motivates patients
to be in compliance with their medication regimen and stay current on where
patients get their information regarding their healthcare.
• This study is very similar to the Star Life Sciences Medical Monitor™ study
conducted in 2007. Where possible, comparisons will be made to that study.
Background
Background | Objectives | Research Methodology

The objectives of this study are:
• To learn among patients with specific disease states:
- What motivates them to be compliant
- What they would like that they do not have now to help with compliance
- Reaction to compliance idea concept statements
• To learn among patients of different ages:
- Where they get their information regarding their health and the role the
computer, smart phone and social media play
-Their initial feelings regarding the passage of the Patient Protection and
Affordable Care Act.
Objectives

• Online interview
• 5-7 minutes in length
• Respondents were 100 patients taking regular medication for arthritis,
hypertension, diabetes, asthma, depression, or cholesterol
• All interviews were conducted by the Reinvention Panel between
January 17 and January 18, 2013
Research Methodology

Executive
Summary

The strongest motivating factors for taking prescription
medication are personal:
• Symptom relief
• Worry about disease state getting worse
• Feel better for self
Compliance Motivation
Executive Summary

Ideas to increase compliance are thought to have more of an impact if they “find them
where they live.” For younger people, this is their smart phone, for older people this
is via email.
When asked for suggestions on ways to increase compliance, respondents focused on:
1. Pillboxes (current use and improved aesthetics and functionality)
2. Smart phone – apps, text reminders, alarms (younger respondents)
3. Email
This is a significant change from the 2007 Star Life Sciences Medical MonitorTM
Report when suggestions focused on free-standing alarms, alarms on pillboxes,
better-designed pillboxes, and email.
In this year’s study, while almost half of all comments from the 36-55 year old group
involved mobile phones, no one over the age of 56 in this study mentioned using a
mobile phone in any way to help them remember their medicine.Those in the older
segments were more reliant on computer reminders such as emails. While apps were
considered a good idea, nobody in this study mentioned currently using an app to help
them remember to take their medicine.
Compliance Brainstorm Ideas
Executive Summary

On a closed-end rating, the ideas rated most useful to help patients take their
prescription medicine were:
• Discount coupons
• Educational material
• Reminder text, email and calls from pharmacy
The preference of reminder ideas varied widely across age segments:
• 18-35 year olds prefer technology involving their smart phone including apps,
reminder texts and actual calls
• 36-54 year olds closely resemble their younger counterparts and also prefer
notification via smart phone
• 55-64 year old segment are more computer- than phone-driven and feel
reminders via the computer (emails, online diaries) would be most useful
• Over 65 year olds also like emails, but also read written materials and would
appreciate phone calls
Compliance Rating/Ranking Ideas
Executive Summary

While the motivation for taking prescription medicine is personal, there is an
opportunity to create a communication relationship with the patient via reminders
for usage compliance.The best way to do this is to “meet them where they live.”
For young people this is increasingly on their smart phones, for older people, this
is on the computer.
Compliance Implications
Executive Summary

In addition to personal interaction with physicians, pharmacists, and friends/family,
online resources have increasingly joined the stream of information regarding
healthcare available to patients.
In this study we also found that people are just as likely to use an online resource
as their personal medical connections to get advice on their healthcare. Most of
their online usage is a general search, but specific sites such as WebMD are
frequently mentioned.
Social media (e.g., Facebook) is also used (34%) to discuss illnesses/medications,
but it isn’t a primary source of information.
Sources of Health Information
Executive Summary

Respondents overall were just as likely to talk to their healthcare professionals as to
go online regarding their healthcare issues. However, this varies greatly by age.Those
under 36 were twice as likely to address their problems via the internet rather than
their personal providers; those 36-54 also used the internet slightly more.Those over
55 also used the internet frequently but sought out their healthcare professionals more.
Sources of Health Information
Executive Summary

Historically, people have always tried to answer their health questions at home
(with friends and family), or with their physicians. Many, especially younger people,
have now added the internet to their personal health toolbox.This opens the door of
opportunity for companies—that in the past would not have had access to patients
in their physician’s office—to “meet” them online and perhaps influence their
healthcare opinions.
Information Source Implications
Executive Summary

Respondents were also asked how they felt about the passage of the Patient Protection
and Affordable Care Act. Opinions were mixed with 35% happy it passed, 41% having
no opinion yet, and 24% not happy it passed.There seems to be a lot of uncertainty as
to what this new law will do to respondents’ healthcare plans and bank accounts. Star
Life Sciences and its clients may be able to help bridge that knowledge gap.
Patient Protection and Affordable Care Act
Executive Summary

Detailed Findings
Compliance
Factors that Motivate People
toTakeTheir Medications

There were four major motivations for patients to take their medicines:
1. Symptom relief—make the pain go away—38% of open-ended responses
2. Worry about getting worse—avoid the consequences—37% of responses
3. Feel better for self—enjoy life—15% of responses
4. Physician/authority figures—8% of responses
Motivating Factors
Compliance: Motivating Factors

• 38% of open-ended reasons
• Deals with specific physical symptoms:
- Not emotional
- Related to physical need to stop the pain (arthritis) or
correct a symptom(breathing difficulty)
• A sub-theme is product efficacy
• Spans all disease states, but most frequently mentioned for:
- Arthritis
- Asthma
- Depression (approximately half the depression patients)
MakeThe Pain Go Away: Symptom Relief

• “Pain is the biggest motivator. When I take my medications, I can function” (Arthritis)
• “Pain is the prime motivator. Since I also have peripheral neuropathy, the tramadol
and a methadone treatment are all I have to control pain that varies between a 5
and a 7 on a 10-point scale even with the dual treatments” (Arthritis)
• “For ease of joint pain” (Arthritis)
• “If it makes me feel better seeing results that I am supposed to see when taking
meds, improves my body function” (Arthritis)
• “Asthma/breathing difficulty, which becomes more severe during the spring and
summer months or during excessive physical activity” (Asthma)
• “To be able to breathe” (Asthma)
• “So I don’t have asthma attacks, so my chest isn’t tight, so I can breathe freely, so I
can exercise and do physical activities” (Asthma)
• “So I can breathe, so I don’t have rapid heart beats” (Asthma)
Manage Symptoms: Pain Relief Sample Verbatims

• “So I won’t be depressed or moody” (Depression)
• “I have many meds. I have Fibromyalgia, COPD HepC cfd, IBS, I am on fentanyl
patches 100 every 48 hours instead of 72 hours. Just so I can move from pain which
depresses me. I have to take my meds so I can get up and try and have a somewhat
normal life” (Depression)
• “It works effectively” (Depression)
• “Alleviate pain; avoid withdrawals; lessen depression symptoms” (Depression)
• “Meds control medical conditions” (Diabetes)
• “Keep blood sugar in control” (Diabetes)
• “Lowers blood pressure, helps my sugar and cholesterol” (Diabetes)
• “Lower cholesterol” (Cholesterol)
• “Keeps my high blood pressure under control. Stay alive” (Hypertension)
• “To keep my blood pressure regulated. For my heart health” (Hypertension)
• “To lower blood pressure and reduce headaches” (Cholesterol)
Manage Symptoms: Pain Relief Sample Verbatims

• This group of reasons is emotional; driven in large part by fear
of getting worse
• Words that describe the motivations of these respondents include:
- Avoid
- Control
- Worry
- Prevention
• Respondents with diabetes, hypertension and approximately half of
cholesterol and depression patients were the most likely to be in this group
Control/Avoid Consequences

• “To maintain my health, reduce risks of further diseases” (Arthritis)
• “It helps control my condition and helps me breathe better” (Asthma)
• “It helps control my mood” (Depression)
• “It keeps me out of depression” (Depression)
• “Keeps me from having panic attacks” (Depression)
• “I take my depression meds so I feel good. I don’t sleep all the time. I have happy
thoughts. I am not depressed. And I enjoy things in life” (Depression)
• “Do not want to get sicker” (Diabetes)
• “Control condition and prevent further complications” (Diabetes)
• “Fear of health problems in the future, my family, trying to feel my best” (Diabetes)
Control/Avoid Consequences: Sample Verbatims

• “Stay healthy, control issues and regulate problems, help control the problems until I
can get them under control without medicine” (Diabetes)
• “Keep blood sugar in control; help my spouse so she doesn’t have to worry; make
life easier with good health” (Diabetes)
• “I need to for my health, or it would be serious repercussions” (Cholesterol)
• “Do not want to get sicker” (Cholesterol)
• “I take them so I can feel better and stay alive” (Cholesterol)
• “PREVENT HEART ATTACK, STROKE” (Cholesterol)
• “Prevent me from future problems with heart as far as stroke or heart attack”
(Cholesterol)
• “Helps me feel myself and keeps me from other symptoms” (Hypertension)
• “My blood pressure is high and I’m at risk for a heart attack or stroke.
My doctor put me on medicine to minimize that risk” (Hypertension)
Control/Avoid Consequences: Sample Verbatims

• Respondents in this group believe that taking medication enhances their
quality of life:
- On a daily basis
- May extend life span
• More about emotions than physical symptoms
• Some from each group—but approximately half the cholesterol patients—felt
this was why they took their medicine
Feel Better for Self/Quality of Life

• “Prolong life, feel better each day, doctor’s orders, common sense” (Arthritis)
• “So I can be able to live each day and keep myself healthy and not get sick” (Asthma)
• “I have happy thoughts, I am not depressed and I enjoy things in life” (Asthma)
• “So I can be able to live each day and keep myself healthy” (Depression)
• “To feel better and be more productive.To ensure that I am around for my wife and
children as long as possible” (Depression)
• “Feel better, live longer “ (Diabetes)
• “Help my spouse so she doesn’t have to worry; make life easier with good health”
(Diabetes)
Quality of Life: Sample Verbatims

Quality of Life: Sample Verbatims
• “Be healthier, feel better, live longer” (Cholesterol)
• “Better Life” (Cholesterol)
• “To be healthy and live a productive life” (Cholesterol)
• “To maintain healthy levels for maintaining health and longevity” (Cholesterol)
• “I want to remain healthy. Better life” (Hypertension)
• “To feel better and be more productive.To ensure that I am around for my wife and
children as long as possible” (Depression)

Physician Recommended: Sample Verbatims
• 8% of reasons to take their medications
• These people put their faith in their physician.They believe that the physician
is the expert and knows better
• “My doctor says I need it” (Depression)
• “My doctor’s prescription” (Asthma)
• “Doctor recommendation to control condition, prevent further
complications” (Diabetes)
• “Doctor’s orders. Don’t want to die!” (Cholesterol)
• “Doctor said to” (Hypertension)

Detailed Findings
Compliance
Aid to Remembering to
Take Medicine Brainstorming Ideas

Brainstorming Ideas
Compliance: Brainstorming Ideas
• Respondents were asked to answer the question, “When thinking about what you
do to make sure you take your medicine as prescribed, is there anything whatsoever
that you would like that would help you to take your medicine as prescribed?”
• There were 94 ideas reported, as follows:

“Top Mentions” Brainstorming Ideas
There were no differences across disease types. (There were some differences among
age groups, and these will be noted.)
Pillboxes (34% of all comments)
• Approximately one third of the comments mentioned pillboxes. For many,
this is what they currently use and they are satisfied with their functionality.
A few of the comments mentioned ideas for improvement.
Nothing (23% of all comments)
• Approximately 25% of these respondents believed they already had
a successful system.
• Some also felt that their physical symptoms were adequate reminders,
especially Asthma sufferers.

Ideas Utilizing Smart Phone or Computer
35% of all suggestions had to do with using the computer and/or smart phone as a
reminder to take medicine in 2013.This is a significant increase from 2007.
Additionally, where there were many suggestions for alarms in 2007 (13%), but they
were on the pillbox, clock or stand-alone devices.The mentions of alarms in 2013 were
tied into alarms on cell phones.

Ideas Utilizing Smart Phone
(19% of all comments)
This group of ideas included suggestions of:
• Text messages
• Apps
• Alarms
These alerts would remind them to take medicine. Some are currently using their
phones to remind them already (setting an alarm) but many suggest that an app or
receiving a text message would be helpful.
• The comments involving using the smart phone were from the segments under
56 years old. There were no mentions from anyone over 56.
• Interestingly, almost half of all comments among the 36-55 year olds were to
utilize their phones.

Ideas Utilizing Computer
Computer Utilization–Email (15% of comments)
Some of the respondents (across all ages) felt email reminders would be useful.
The comments included reminders to take medicine daily as well as messages from
the pharmacy reminding them to refill their medicines. No one mentioned that their
pharmacy was currently doing that.
New Ideas–Packaging/Novelties (<10% of comments)
There were a handful of new ideas revolving around packaging, etc.
Most had to do with ideas for alarms.

Brainstorming Ideas:
“Pillbox” Sample Verbatims
• “I want a box for them” (18-35)
• “Pill boxes, the date and time written on it clearly” (18-35)
• “Having a pill box with the days of the week on it helps remind me to take my
medicine and also so I don’t take my medicine twice” (36-55)
• “I have a pill box and I love it” (36-55)
• “I use a seven day pill box to make sure I take care of taking my meds everyday”
(36-55)
• “I use pill boxes with the days of the week and am/pm” (36-55)
• “Pill boxes for each day of the week” (36-55)
• “Each month I place my medications into pill boxes so that I have enough for
4 weeks. I start on whatever day it is and if I miss a dose I know right away by
looking at the case. I then take them if I have forgotten, but that only happens
maybe twice a year, and like I said if I don’t take them then it hurts very much to
walk, so I don’t usually forget to take them” (56-65)

• “I take more meds than noted, I also take COPD meds. I have a pill box that works
really good for me. I load them every week. With my inhalers, I write on a little
notepad when I used them so I don’t overuse the inhalers” (56-65)
• “I use a pill box and place it at a certain spot I have to look at everyday so it reminds
me to take my medicine, sometimes I use my smart phone, sometimes I use online
tools if I am online and don’t remember to take my meds” (56-65)
• “I use a pill box now, and it is helpful.Thank you for offering” (56-65)
• “I use pill boxes for the week. It helps me to tell if I have taken my pills” (56-65)
• “I use pill boxes with the days of the week, seems to work” (56-65)

• “Nothing really. I have a pill box and take my pills the same time each morning”
(56-65)
• “Pill box on kitchen counter” (56-65)
• “Pill boxes. I take my insulin at set hours so I really don’t need anything to
remind me” (56-65)
• “There are some people that are forgetful and if they have and check email daily
this might be an accurate way to remind. Older people may not have/use email so a
daily phone reminder from their healthcare provider may be a good thing. Using
daily/weekly pill usage containers may also be good” (over 65)
• “Currently use pill boxes w/days of week on it. Nothing else is needed” (over 65)
• “No I use a pill box” (over 65)

“Nothing” Sample Verbatims
• “None of the above. I take my medication when I need it, which is how it was
prescribed to me” (18-35)
• “I do not have an issue for taking it, I put it on my nightstand and when I wake up
I take it, every day around the same time.This works for me very well” (36-55)
• “I take my medicine at the same time each day. I keep my pills next to my bed by
the alarm” (36-55).
• “Nothing really, since my schedule is pretty routine” (36-55)
• “I always take it at the same time every day. I take it at dinner time” (56-65)
• “I can not think of anything. I take my medication once a day prior to going to bed”
(56-65)
• “My pain is all the reminder I need” (56-65)

“Nothing” Sample Verbatims
• “Nothing needed. I just take in morning along with breakfast juice as matter
of course” (56-65)
• “I take drugs at certain times of the day” (over 65)
• “I don’t need any help. I always take them on time” (over 65)
• “I don’t need reminders. I always remember” (over 65)
• “I play a Dale Carnegie trick, a sentence that makes sense and gives me hints as
to time of day for doses, i.e., (10) ten to (2) six (6) o’clock! When I say ten two six
that gives me a rhythmic sentence that reminds me of the three times in every 18
for the methadone, with the 12 = 4 = 8 = coming two hours in between. It may
sound a bit complicated, BUT IT WORKS EVERYTIME” (over 65)

“Smart Phone” Sample Verbatims
• “A text message on my phone so it’s the first thing I see every day the first time
I go to use it” (18-35)
• “An alarm that is always with me. I currently use my cell phone but it would be easier
if there was something smaller to remind me” (18-35)
• “An app for your smartphone would be a good idea. One where you could customize
the settings that tells you what drug to take, and maybe an app that automatically
calls in a reminder” (36-55)
• “An alarm system on my phone where I could enter pill names and times all on one
alarm. Currently my phone only holds 5 alarms and I take meds more than that a
day, and I would have to set all of them individually which would be a pain. I can’t
do this anyway because it would leave me no alarms for getting up, etc.” (36-55)
• “I have a pill container that is for the days of the week and I also have an alarm
on my phone that reminds me to take my pills at the time that I usually forget
to take them” (36-55)

• “I think that text messaging would be awesome. Everyone has a cell phone and an
alert to take meds is easily set up” (36-55)
• “I use the daily med boxes for my regular meds. An alarm or app on my smart phone
set for the time I am supposed to take my meds” (36-55)
• “Nothing really, I use my smart phone setup with alarms for times to take my
medicines. Unless you can create a smart phone app for this and then I expect a
royalty from the idea” (36-55)
• “The best for me is a smart phone app that would let me know remind me of my
meds and times and alarms to remind me” (36-55)
• “Maybe a text reminder during the same time every morning” (36-55)
• “Pill box, alarm on my phone, email reminders for myself” (36-55)

• “Email reminders would be a good idea” (18-35).
• “Reminder to take my meds maybe by email would help or an app to remind me”
(36-55)
• “An app for medication reminders or emails” (36-55)
• “An email would be helpful” (56-65)
• “Email reminders may help, generally don’t have trouble remembering my meds”
(56-65)
• “I do need something. Even though I have one pill to take I find myself forgetting.
I think having a pill box for one pill would not help me remember. A reminder in an
email would make me get off my chair to go take my meds” (56-65)
• “Pill boxes with days of the week on it. Email from pharmacy before refill date”
(56-65)

“Computer/Email” Sample Verbatims
• “Since this medication is an inhaler, pill boxes would not work. An email reminder
would be great or a timer set on my computer that would ding or beep when I am
not logged onto the internet. A small decorative timer that could be worn as a
necklace or bracelet would be ideal” (56-65)
• “Daily emails could help since I read my emails each day” (over 65).
• “Emails from pharmacy” (over 65)

“New Packaging/Miscellaneous”Verbatims
• “Flashing light on the fridge” (36-55)
• “An automatic pill dispenser would be nice, something I could fill on a weekly or
monthly basis and have it dispense the pills I need. If I need certain pills in the
morning a push of the button and it doles the quantity I need out. Same thing for the
rest of the day. I picture this as being able to be on the fridge with magnets or able
to install on a wall. It would need to have biometrics or password so only you and
no one could access the pills” (36-55)
• “A clock that says please take meds before u eat” (56-65)
• “A pill box with an alarm on it or an actual phone call instead of an email alert. A
program that displays alerts on yourTV or computer screen, like caller ID” (56-65)
• “An electronic timer that the medications and times to be taken could be
programmed into and at the designated times an alarm would sound off” (56-65)
• “Counter rack design to hold bottles of pills so it is always in sight” (56-65)

“New Packaging/Miscellaneous”Verbatims
• “An electronic timer that the medications and times to be taken could be
programmed into and at the designated times an alarm would sound off” (56-65)
• “Counter rack design to hold bottles of pills so it is always in sight” (56-65)
• “Since I have different meds to take at different times of the day and night I would
like to see a medicine box that was for a month that had some sort of timer for u
to put on the day that would go off when it was time to take your meds and could
be programmed for more than 4 times in a day” (more than 65)

Detailed Findings
Compliance
Rated Usefulness of Listed Ideas

Perceived Usefulness of Ideas
Compliance: Usefulness of Ideas
• Respondents rated the usefulness of 14 “ideas that could help you to take your
medicine as prescribed and that would be made available to you at no cost”
• Discount Coupons received the highest “useful” and “very useful” responses,
followed by educational material
• Communication from pharmacy either as text, email or call was rated as the next
most useful, followed by an online diary
• Differences were found regarding usefulness between the different age segments
surveyed (charts following pages)
• Differences were also found where comparisons could be made between 2007 and
2013 (chart following pages)

Overall, the respondents in 2013 were more responsive to all communication
suggestions to increase compliance.The most significant differences were more
positive ratings to phone calls.This is probably explained by the increase of cell phone
ownership over the time period, making them easier to reach.

Detailed Findings
Compliance
Rated Usefulness of Each Idea by Age
(Note: the 18-35 year old group likes to be communicated with in ALL ways so many of
their answers are higher.They are used to being connected at all times (via smart
phones and computers) so they may not see the reminders as an annoyance.)

Discount Coupons
Compliance: Usefulness of Ideas by Age
Discount coupons were the highest evaluated idea. 67% of all respondents thought
this was a useful idea. All age groups felt this was a useful idea.

Educational Materials on the Benefits/Side Effects
The second highest-rated idea overall was educational materials. 55% of all
respondents thought this was a useful idea (half of those felt it was very useful, half
useful).Younger people thought this was more useful than older people.

ReminderText Message from Pharmacy
Text communication from the pharmacy is perceived to be very useful. 52% of all
respondents thought receiving a text from the pharmacy was useful.There were major
differences in age and evaluation of usefulness of text messages. As expected, younger
groups rated text messages higher. In fact, this was the second highest-rated idea
following coupons for those under 56.

Reminder Call from Pharmacy
52% of all respondents also thought reminder calls from the pharmacy were a useful
idea. More felt it was useful than very useful. While there is some variation in ages, all
ages found this to be a useful idea. For younger people, a text was rated higher than a
phone call from pharmacy.

Reminder Email from Pharmacy
52% of all respondents thought that emails from the pharmacy was a useful idea.This
method was less favorable to the 56-65 age segment than the other segments. For the
segments under 56, email was not rated as highly as text from pharmacy.

Online Diary of Medication Usage
51% of all respondents thought this was a useful idea.Those over 65 years old felt it
would be less useful than the younger groups. Perhaps they are less inclined to use
their computers to track their behaviors.

Reminder Calls from Physician’s Office
48% of all respondents thought reminder calls from the physician’s office was a useful
idea, although only 18% found it very useful.

Reminder Email from Physician
48% of all respondents also felt a reminder email from the physician’s office was
a useful idea. For the groups under 56, reminder emails from the pharmacy and
physician’s office were rated equally.

ReminderText Message from Physician’s Office
48% of all respondents thought a text message from the physician’s office was a useful
idea. Again, this idea was rated very highly by the youngest segment and this idea was
rated very high among the 36-55 segment, as was text messaging from pharmacy for
this group (71% useful).

Mobile App Reminder
44% of all respondents thought this was a useful idea. None of those over 65 felt it was
a useful idea, but those younger than 56 were very favorable. Among the youngest
group, an app was rated as high as a text.

Ability toTalk to Medical Affairs Department
of Pharmaceutical Company
42% of all respondents thought talking to a pharmaceutical company was a useful idea.
Those over 65 were much less favorable towards the idea.

Reminder Postcard from Physician
Only 14% of all respondents felt postcards were a very useful form of reminder.Those
under 35 like this form of communication better than other segments.

Reminder Postcard from Pharmacy
Only 11% of all respondents felt postcards from a pharmacy was a very useful idea.
Those under 35 like this form of communication better than other segments.

Community Blogs
Community blogs received the lowest rating of all the ideas, with 31% feeling they are
a useful reminder. 42% of all respondents thought this was a useful idea.

SummaryTable of “Top Ideas”
The highest-rated ideas varied across age segments:
• 18-35Top Idea - ReminderText Pharmacy
• 36-55Top Idea - Coupons
• 56-65Top Idea - Coupons
• Over 65Top Idea - Emails Pharmacy

Detailed Findings
Compliance
Ideas Ranked Most Useful

Idea Ranking: Idea Perceived to be “Most Useful”
Compliance: Most Useful Ideas
Following their rating of all ideas,
respondents were asked which 3
ideas they found to be most useful.
Discount coupons, the online diary
and reminder emails from the
physician’s office generated the
highest “Most Useful” rankings for
the total sample.

SummaryTable of “Top Ideas”
The highest-rated ideas varied across age segments:
• 18-35 Call from Pharmacy
• 36-55 Mobile App Reminder
• 56-65 Online Diary
• Over 65 Emails from Doctor or Pharmacy
Note:These results varied somewhat from the highest ideas when they were rated on the previous table.

Idea Ranking: Estimated Frequency of Use
39% of the respondents indicated that they would use their preferred reminder daily;
another 25% said monthly.

Detailed Findings
Sources of Information
Usage of Social Media to
Discuss Healthcare Issues

DoYou Ever Use Social Media, Such as Facebook,
to DiscussYour Healthcare Issues?
34% of all respondents say they use social media to discuss healthcare issues.
Sources of Information: Social Media

The Vast Majority of RespondentsThat Use Social
Media to Discuss Healthcare Issues Use Facebook
Verbatims
Ages 18-35
• “Facebook”
• “Facebook social”
• “Facebook to talk to others about similar conditions”
• “Facebook, blogs”
Ages 36-55
• “Facebook looking at medical companies”
• “Facebook”
• “Facebook and linkedTwitter”
• “Facebook andTwitter”

Social Media Verbatims
• “Facebook, Myspace”
• “I interact with friends who suffer the same thing”
• “I use Facebook and Pinterest and discuss with other patients like me”
• “I use Facebook and only chat with my friends. All in all I have a
great support system”
• “I use Facebook but not regarding my healthcare”
• “Just the cost of healthcare, Obamacare”
• “Sometime we have same condition, we can help together”
• “Web MD”
Ages 56-65
• “Facebook. Once in a while I’ll reference a medical or healthcare issue and ask for
some feedback...or respond to someone else’s comment/question. I also read/post
share information about health-related issues”
• “Facebook..talk with friends”
• “I discuss health with friends and family on what conditions they have and what they
do to remind themselves when to take medication”

Social Media Verbatims
• “I use Facebook and I just talk with my fb friends about my health issues
and they talk about theirs”
• “I use my social media for interacting with groups. Something in relation
to a problem”
• “WebMD.com, Mayo Clinic, quality health website, don’t use Facebook for my meds,
use tools online”
Over 65
• “I Would NOT use social media for healthcare issues. Privacy concerns”
• “Use Facebook. I make comments about how I’m feeling and get responses
from those who have had same experiences with suggestions”

Detailed Findings
Contact Healthcare Plan

Frequency of Contact with Healthcare Plan
for Information on Condition, Medical Diseases
or Drugs
People do not have their healthcare plan on speed dial. Half the people rarely call their
healthcare plan. Only 16% say they contact them frequently.The younger group contact
them more often. Perhaps they are newer to their conditions/medicines.
Sources of Information: Healthcare Plan

Detailed Findings
Top of Mind

Sources of Healthcare Information
Respondents were asked,
“When thinking about all the
sources you can go to for
healthcare information, list
the two you use the most.”
The table below summarizes
their open-ended responses.
Sources of Information: Healthcare Plan

Sources of Healthcare Information
Sources of Information:Top of Mind
• We know from the previous table that people are not contacting their healthcare plan
for information; instead they go to their physicians and the internet.
• Just as many people use the internet (44% of mentions) as their top source of
information as use the personal connection of their physician, pharmacist or
family/friend (45% of mentions).
• People under 35 years of age mention the internet more than twice as often (67%)
as a personal connection (26%).
• People 36-54 source the internet (50%) a little more than a personal connection
(44%).
• People over 55 rely most heavily on their physicians.
• Most of the internet searches are general search engine searches, but WebMD is cited
by 12% of all respondents as where they go for information most often.
• Only 9% say they use their healthcare plan as their primary source of information.

Detailed Findings
Perceptions of the Patient Protection
and Affordable Care Act

Which DescribesYour Reaction to the Passage
of the New Healthcare Bill Known as the
“Affordable Care Act”?
The largest proportion (41%) have no opinion yet on the passage of the Bill. 35% are
happy it passed and 24% are not happy.

Perception of Act by Age
The youngest group and the oldest group are a little happier it passed than the 36-65
year olds.The 18-35 year olds are the most positive with 47% happy it passed.

“Happy Act Passed”Verbatims
The majority of those that are happy it passed felt it was for the greater good of
society.There were very few references to their own specific benefits.
• “Because I think it will benefit Americans” (18-35)
• “Could save me money” (18-35)
• “I think all people should have access to healthcare, especially preventative care,
to keep them from having to go to the emergency room later on and costing us
even more” (18-35)
• “I’m not completely happy with it but it’s a step in the right direction” (18-35)
• “It makes it easier to afford” (18-35)
• “Because if I can’t afford my medicine I can get help” (36-55)
• “Because medical is very expensive” (36-55)
• “I don’t have enough money to pay my bills” (36-55)
• “I think it is a good thing” (36-55)
• “I think, with all the money this country spends aiding other countries, we need
to be helping ourselves” (36-55)

• “It helps people in need” (36-55)
• “No insurance right now, so I hope it will help me get the care I need,
low cost clinics are useless” (36-55)
• “So that everyone can have healthcare” (36-55)
• “Because everyone should be able to afford healthcare and they could not the way
the healthcare companies were charging people” (56-65)
• “Because it is important” (56-65)
• “Cause everyone should have the right to health insurance” (56-65)
• “EVERYONE NEEDS COVERAGE” (56-65)
• “Everyone should have access to affordable medical care” (56-65)
• “Healthcare should be made available to as many people as possible. My only
concern is that the law doesn’t go far enough in so far as providing single payer
coverage” (56-65)
• “Hopefully, it is a stepping stone for single-payer healthcare” (56-65)
• “I am glad that more people will be covered by health insurance” (56-65)

• “I don’t think it’s perfect and not as comprehensive as needed to be effective
(e.g. cost-saving, universal), but it’s a step in the right direction” (56-65)
• “It was the 1st step in correcting of healthcare system” (56-65)
• “We need all the extra help we can get” (56-65)
• “So they don’t put any burdens on the elderly and disabled” (56-65)
• “Because I think it is necessary to give all Americans good healthcare” (65+)
• “Because it can help people obtain healthcare at an affordable price” (65+)
• “Helps many people” (65+)
• “It will help me pay for medical expenses” (65+)
• “It cuts costs all around the circle, and brings good healthcare to so many more
who never had a chance to afford it before. A double header!” (65+)

“No Opinion on Act”Verbatims
In general these people do not know how the Act will affect them so they feel they will
have to wait and see.
• “Have to wait” (18-35)
• “I really don’t trust it at this point. I need to see more of what it is all about” (18-35)
• “Not sure of the facts” (18-35)
• “New plan, new year has started so have to see what new plan is going to do to
impact me and my economy” (18-35)
• “I want to wait first” (18-35)
• “I don’t know anything about this issue” (36-55)
• “I don’t know much about it, so I’ll have to see what it is and the cost” (36-55)
• “I don’t know the specifics, and I’m on Medicare so I’m not sure how it affects me”
(36-55)
• “I have no issues with my health plan, my company pays all of it for me, and all its
employees. I am not sure it is is going to effect us for now” (36-55)
• “I want to see how it will benefit me” (36-55)
• “I really am confused about that bill, needs to be simplified for me” (36-55)

• “I need to wait and see how it works” (36-55)
• “It’s too soon to know that much. I did however see that big companies are cutting
employees hours back to avoid having to pay for their health insurances. I feel this
is a bad flaw and cheap” (36-55)
• “Wouldn’t know enough for my opinion to count” (36-55)
• “You have to wait to see what happens to your healthcare plan” (36-55)
• “Need to wait and see if it works the way it is supposed to” (36-55)
• “I am not sure how it will benefit me” (56-65)
• “I need to see just how this bill will affect both my health insurance coverage and
those who presently do not have coverage” (56-65)
• “Law is confusing” (56-65)
• “I really don‘t completely understand how it is going to work. I would like to see
exactly how it is going to impact my financial situation, medical costs and
healthcare” (56-65)
• “Need to see what is actually in it that will affect me” (56-65)
• “Not real familiar with” (56-65)

• “Not sure exactly how it will affect me, not sure what it says” (56-65)
• “When a President gets re-elected they make all these promises and some come up
with their solution but what is good for some is bad for others so I have to wait and
see where I fall, and friends and loved ones, especially the elderly” (56-65)
• “I don’t know how it will effect me yet” (65+)
• “I don’t know the details and I don’t want to make a judgement before I know more.
Initially, I was against it” (65+)
• “I don’t know all the details of this. I know some of them but they don’t really directly
affect me” (65+)
• “I don’t understand what it is all about and how it will affect me” (65+)
• “I have good health insurance” (65+)
• “The devil is always in the details. And so it remains to be seen whether it is a good
idea or not. I must say, though, that I don’t expect it to be much other than a good
start” (65+)

“Against Act”Verbatims
Over half the comments regarding why respondents were against the Act dealt with
the perception that costs would go up.
• “Because of the “tax” that the government says is a penalty, yet will be collected
through the IRS, think it might put small business out of business, it will increase the
cost of ALL healthcare, most plans have a minimum of $5,000 up to $20,000 dollars,
just looks very expensive”(36-55)
• “It will change my insurance and cost me more, limit my choices” (36-55)
• “My insurance has changed for the worst. I pay more and get so little” (36-55)
• “Too many hidden costs” (36-55)
• “I know some of the particles [sic] of the cost per person and they are unreasonable
and ridiculous” (56-65)

• “Increase cost and taxes” (56-65)
• “I think I will end of paying more” (56-65)
• “People aren’t going to be able to afford any insurance with families that have
children and don’t make much, same with senior citizens” (56-65)
• “If this is ‘Obamacare’ it will force people with very little income to get medical
coverage. I think it will also cause the general population to see an increase in medical
costs” (65+)
• “It has virtually nothing to do with healthcare and has only made healthcare more
expensive” (65+)

Others against it felt it was bad for our society.
• “Because it is NOT about healthcare, it is about political power and taking
freedoms away” (36-54)
• “I can’t afford health insurance and now the dumb ass president wants to force me
to buy it. Where is the money going to magically appear?” (36-54)
• “It is going to hurt a lot of older people, and it is unfair to force an individual to buy
health insurance while the economy is in such a deplorable condition” (36-54)
• “No one should push another” (36-54)
• “The changes that are going to be made are not going to be beneficial to veterans/
retired military or active duty members” (36-54)
• “It is under the authority of the IRS. Aside from black ops programs, they are the
most reckless agency in our government.They only know money and how to ruin
lives, not a thing about healthcare.This will turn into a nightmare when they decide
you can afford healthcare even though 30% of your income goes to drugs alone. It’s
for healthy people only” (55-64)
• “It’s a communist takeover of people.The lefties want to turn this into a communist
country where they control everyone and everything” (55-64)

A few people felt the passage of the Act would have a negative affect on
finding physicians.
• “Doctors won’t earn money so they’ll leave.That means less good doctors left.”
(18-35)
• “I have fears about being able to see the doctor in a timely manner and the cost
of my insurances to help pay for those who can’t afford healthcare” (36-54)
• “Not enough doctors” (56-65)

Making Plans to Address the Impact the New
Law Might Have onThem orTheir Family
22% of all respondents say they are making some plan to address the impact of when
the Patient Protection and Affordable Care Act is enforced.There were a few in each
age range. Among those people who are planning, most are still trying to educate
themselves on the plan and how they can save money. A couple have changed plans.
• “I am trying to find out every thing I can about it, looking into what will be the
best plan for my family”
• “I’ve contacted my provider to give me updates on any changes to my health plan”
• “Joined a Medicare supported HMO directly instead of contributing to the costs of
Medicare.The HMO works hard to keep costs down since they are “for profit”, which
the huge apparatus that keeps Medicare going does NOT!”
• “Keep studying the new law”
• “Saving more money to defer the cost of medical visits and pharmacy costs”
• “Saving up and looking for better insurance”
• “Talk to my doctor”

Respondent
Characteristics

Respondent Characteristics

Appendix:
Screener and Questionnaire

Tim R. Garde
Managing Partner
Star Group / Star Life Sciences
Synegrated Communications
235 S. 17th Street
Philadelphia, PA 19103
215.875.4313
stargroup1.com
starlifebrands.com
For more information please contact:

Patient Compliance Report 2013

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