Diabetes is a chronic disease that affects developed and developing countries around the globe. On November 14, we recognize #WorldDiabetesDay
Among Canadians, a form of diabetes is present in 29% of the population.1
As with any health and drug recommendation, patient adherence to a treatment plan is the key to success ― and the biggest challenge. It is the treatment regiment adherence, or lack thereof, which eventually leads to control or chaos within a body. According to Diabetes Canada, diabetes has the potential of reducing an individual’s lifespan by five to fifteen years. Furthermore, because this disease affects multiple systems in one’s body, people with diabetes have a significantly higher rate of being hospitalized for heart, kidney, or lower-limb amputations when compared to the general population.2
What if healthcare practitioners (HCPs) were able to tap into their patient’s internal motivations, resulting in increased buy-in toward patients' prescribed treatment plans and a path to slowing the progression of the disease?
There are several ways to take a closer look at patients based on neighbourhood or social groups to better understand their internal drivers. Patient analysis by affluence, urbanity, or ethnicity would each produce different results in how we view and treat these patients. What’s important to emphasize is that this type of analysis, using one or more variables, should be an integral part of how we choose to treat patients and motivate them toward lifestyle changes that can slow the progression of the disease.
For this article, I looked at Type 2 diabetes prevalence across Canada using Community Health Survey data from Statistics Canada based on urbanity. This approach provides a simple but effective view of Type 2 diabetes patients. We can see three distinct groups that index higher for this disease state across urbanity using our PRIZM segmentation system. To understand what drives our behaviour and how it can be influenced, scientists at Environics Research Group, our sister company, have been conducting a national survey for over 30 years to measure Canadians' personal and social beliefs as well as attitudes. When we link this psychographic data set (known as SocialValues) to population disease prevalence data, we can learn what differences in our communication can effectively drive behaviour toward disease treatment adherence.
Here's what I found:
Diabetic Patient Group 1 (Rural)
When working with more rural, older patients, these groups tend to highly value nature – in fact, “Attraction to nature” is their greatest value, indexing at 159. When motivating this group to partake in exercise, relating exercise to the natural world rather than a generic gym with weights and machines could significantly impact getting this group to move.
On the opposite end of the spectrum, this rural group does not value “Pursuit of novelty.” These patients will benefit from messaging that focuses on the history of known diabetes treatments, their effectiveness, and that these treatment protocols are tried, tested and true. This group is not chasing the “latest and greatest”; instead, they will take comfort in knowing that they’re following traditional treatment regiments and protocols.
Diabetic Patient Group 2 (Suburban)
The next group are older, suburban patients with diabetes. These segments score high for having an "Aversion to complexity." Diabetes treatment information needs to be relayed using high-level concepts and without diving into the details – keep it simple.
Furthermore, this group also ranks high for "Obedience to authority" and low for "Equal relationship to youth." In this case, these patients would respond well to information being communicated by clinic physicians and diabetes educators with a track record.
Diabetic Patient Group 3 (Urban)
Lastly, let’s look at older, urban singles. This group scores highly for “Fulfillment through work.” Indeed, there is a lot of life change and work that needs to occur if one is to adequately address this disease through lifestyle modifications. Furthermore, they score high for “Fatalism” or lack of control over one’s life and low for “Community involvement,” so they won’t benefit from community support groups.
When speaking with this group, messages need to be simple, straightforward and factual, focusing on what can change if the work is put in.
Bias surrounding one's view of a typical person living with diabetes is well known. Many diabetic patients are assessed and treated using one broad stroke without considering the patients' differences. This is a problem.
As pre-diabetes and diabetes progress, patients move down a typical treatment path of diet and exercise recommendations, oral pills and eventually injectables. Patient buy-in to the treatment plan is essential to slow the progression of this potentially debilitating disease. A one size fits all approach to delivering a treatment plan risks failure if it isn't designed for the patient and communicated effectively by the healthcare provider.
Instead, we can understand diabetes patients based on their lifestyle behaviours and preferences, as well as their values and beliefs, to inform how we choose to treat them and motivate them to change their lifestyles to slow the disease progression.
By the year 2030, Diabetes Canada estimates that there will be a 30% increase in diabetes from today’s rates. With an already aging population, these numbers will put more strain on our public healthcare system and cost our taxpayers more.
If we can look at the complete patient, who they are, where they come from, what internal and external factors affect them and match our messaging to this, we have a far better chance of getting patient buy-in to treatment plans. This can lead to better patient outcomes, less burden on our healthcare system and a greater quality of life.
1Diabetes in Canada Backgrounder Ottawa: Diabetes Canada; 2020
2Diabetes in Canada: Facts and figures from a public health perspective Ottawa: Public Health Agency of Canada; 2011 p. 126.