In a game of pharma buzzword bingo, the term “patient centric” would be the key to unlocking a full house, but how much real meaning is behind it? A cursory investigation into clinical trial and patient engagement shows a lack of diversity of all kinds: from gender and race to socioeconomic background and geographic location. Discrepancies are clear; in the USA, minority racial and ethnic groups account for 40% of the population, while 75% of clinical trial participants are white.
To achieve greater diversity and inclusion (D&I) in patient engagement, a critical factor in becoming truly patient centric, it is crucial that steps are taken to reach all patient communities — not just those who are able to take a seat at the table. Can we really call ourselves a patient-centric industry if we are not ensuring that all patients get the same opportunities to have their voices heard?
From revamping patient communication to setting measurable targets, these five ways to improve D&I are focused around authentically, consistently, and honestly embedding patient centricity into your company’s DNA.
1. Rethink Patient Communication
To make meaningful change, a fresh approach is needed in patient communication. The current level and type of engagement are driven by traditional communication methods, which are not hitting home with more diverse patient populations.
The blend of different languages within any one country is a key consideration in patient communication. In the UK alone, there are more than 300 languages spoken. Patient populations are richly diverse, and communication needs to be tailored to reflect that. With the power of the internet, patient engagement groups can be held in different languages online to communicate with and bring together diverse groups of patients wherever they are in the world.
Generic patient communication may also not resonate with minority demographics due to cultural nuances. COVID-19 vaccine uptake, for example, was impacted by vaccine hesitancy among ethnic minorities, but there is a plethora of evidence showing that these groups are hesitant to other vaccine programs, such as flu inoculations. With this knowledge, it is clear that these patient groups would require a different type of communication, which acknowledges and addresses their concerns, rather than just encouraging uptake.
It is also important to consider not just the communication itself but the channels through which you’re reaching patients. One initiative, which made headlines in recent years, helped African American men to lower blood pressure to a healthy level in a project that created partnerships between local barbers and pharmacists. By meeting this population in an environment where they felt comfortable, patients were open to receiving communication and, even more importantly, to acting upon it.
2. Make Patient Engagement Easy
More work is needed to make patient engagement easier for people from all backgrounds. One barrier to participating in clinical trials, for many patients, is the complex jargon and detailed paperwork that must be tackled to do so. The use of jargon can make it difficult for some patients to understand what they are signing up for, which can instill an inherent nervousness in the process. There needs to be greater support for patients to translate what is being said into something clear and concise — and to lower the barrier to involvement and representation.
Similarly, patients from lower socioeconomic backgrounds or those with extenuating life circumstances, such as being a single parent, can have limited ability to take time away from their work or home life to participate in trials or engagement sessions. Patients should be engaged even before clinical trials begin so that we can find new ways to participate that are easier for them to incorporate into their personal lives. Only by taking note of the barriers to involvement can we begin to give every patient a seat at the table.
3. Set Tangible Targets and Measure Progress
Stating that you are committed to becoming more diverse and inclusive is the first step, but after hearing this, audiences want to see action. Setting measurable targets shows people that you are making a clear promise on what you want to change and on what scale. It also helps to make your internal teams accountable and gives them something to benchmark progress against.
D&I key performance indicators (KPIs) should outline where you have started as a company, for example, “75% of patients in your clinical trials are white,” and then outline, with a figure, where you intend to reach. It is important that such targets are paired with a carefully considered strategic plan, which is given just as much attention as your other company goals.
And when setting targets, shoot for the moon: ensure that progress milestones are achievable but ambitious. Improvements in D&I are long overdue, and such initiatives need to reflect the gravity of the issue.
4. Avoid Tokenistic Gestures
When it comes to corporations’ D&I efforts, audiences are naturally skeptical and, with an online world of information at their fingertips, can and will find out if a company is not practicing what they preach. Making tokenistic gestures can actually harm a company’s reputation, and they will appear dishonest and disingenuous. Already-hesitant patients are unlikely to want to engage with companies after this trust is lost.
If, as a company, you truly care about improving D&I in your patient engagement activities and clinical trials, it is critical to ensure that any initiatives are centred around tangible and honest actions that have one clear aim: to make a real difference. Improving D&I must also go beyond being a one-off effort — it should be embedded into the company’s core goals.
Of near equal importance is the way that such initiatives are communicated — communication must be equally authentic. When it comes to improving D&I, some believe that companies are simply fixing something that has been done badly before rather than creating something positive. It is important that messages reflect this and acknowledge that this is a start, but that more still needs to be done.
5. Be the Change You Want to See
Improving D&I needs to happen, not just in patient engagement but across the entire pharmaceutical industry. Patients can view companies with a critical eye if they are focusing efforts in external areas but not considering their own D&I. In the top 50 pharmaceutical companies, one third still have no women on their boards, and as little as 8% of the boards are represented by ethnically diverse directors. Statistics such as these can make it challenging for diverse patients to feel comfortable to begin interacting with such companies.
Having greater diversity at every level of your company fosters an environment of innovation due to a wider breadth of experiences and knowledge. Making D&I an intrinsic part of your company’s DNA will lead to more awareness of the best way to reach diverse patient populations, due to having greater understanding within internal teams and greater willingness from patients who can see better representation.
Driving authentic change
Improving D&I is critical to becoming a truly patient-centric industry, but a vast amount of work is still needed to achieve this. From more easily implementable changes, such as improving the variety of languages that are included in communication efforts, to more complex changes, like involving patients in the design of a clinical trial, there are so many areas in which we can focus our attentions.
As long as the intentions driving change are authentic and made a key priority for your company, then every action, big or small, will help us as an industry to take a step closer to ensuring the level of diversity and inclusion in our engagement and trials that our patients deserve.