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How Emotions Are the Key to Better Healthcare

New research shows how emotions work to influence behaviors that promote health.

National Cancer Institute CC Upsplash
Source: National Cancer Institute CC Upsplash

A recent change in the healthcare industry is the adoption of practices used in consumer marketing. For example, after visiting a doctor’s office or hospital, it is very likely that the patient will receive an email with a survey asking them to rate their “satisfaction” with that experience.

Many healthcare professionals, especially physicians, object to this approach, finding it at odds with their singular focus on curing diseases and helping patients make healthy life decisions. One of their arguments is that the evaluation of physician performance on the basis of non-medical factors (e.g. dissatisfaction resulting from how long the patient waited before seeing the doctor) can influence practice management in ways that are not in patients’ best interests.

However, there are concepts of consumers’ experience beyond rudimentary satisfaction surveys that can make valuable contributions to patient care. This is because, just as the experiences of consumers determine decision-making and product purchase, patient experience influences important behaviors that determine health.

Individual experiences, whether in the physician’s office or retail store, are emotional constructs. And it is emotions that drive almost all behavior. This fact, unfortunately, is often ignored in our increasingly data-driven world that has fallen head-over-heels for algorithms and artificial intelligence.

The enormous role that emotional experience plays in patient health can be seen in studies conducted by this author on the reasons why patients are non-adherent to medications prescribed by their physicians.

For context, consider the prevalence of medication non-adherence among U.S. patients with chronic diseases: 30% do not have their prescriptions filled and, among those that do receive their medications, 50% do not take them as prescribed. Medication non-adherence in the U.S. results in the deaths of an estimated 125,000 people each year – a toll greater than the deaths resulting from Alzheimer’s and almost as great as that from cardiovascular disease or stroke. This data shows that medication non-adherence in and of itself is a huge healthcare problem.

Historically, the healthcare industry’s efforts to solve the non-adherence problem have been based on the assumption that adherent behavior is the result of patients’ rational, conscious decision-making. Accordingly, the vast majority of interventions are designed to promote the “right” decision by providing patients with more information about their disease and medications. However, studies show that over 60% of these interventions have zero to little effect. And those that do work only achieve a 4% TO 11% increase in adherence.

My research was designed to discover the emotional causes of non-adherence. Studies were conducted on the non-adherent behavior of patients being treated for diabetes, cardiovascular problems, nutritional issues, and others. This research identified disease-specific emotional triggers that have a negative effect on patient adherence. The results revealed a model of emotional intervention that can be effective in removing psychological barriers to adherence.

This emotion-based model reflects the current thinking in healthcare programs and methods that go beyond disease-specific monitoring, analysis, and treatment to also include broader concepts of optimal patient outcomes.

This expanded approach to healthcare was evident at the recent Digital Health World Congress held in London (November 2019). Many of the healthcare companies presenting (e.g. pharma, research and data systems, health providers, including the UK’s NHS) envision digital technology (primarily the smartphone) as the gateway to better patient experience. As an example of how this was expressed, Saj Shah, Digital Health leader at AstraZeneca (UK), discussed the need to think beyond treatments and medications to also embrace the “state of the patient as a person” – a view that includes patient emotions.

My research on diabetes (types 1 and 2) is an example of how this approach can be implemented. The study explored the emotions responsible for non-adherence related to medication, diet, and other behavior. The emotion-based intervention is delivered through videos on the patient’s smartphone.

Peter Noel Murray
Diabetes video
Source: Peter Noel Murray

An example of the video can be found at the following (click here to view diabetic emotions video). The video evokes negative “trigger” emotions associated with diabetes. It challenges the diabetic’s self-perceptions that cause non-adherence. And it enables the diabetic to re-experience these feelings in the context of positive emotional end-benefits.

Patient emotions are the pathway to improving health. The powerful force that drives patient behavior is the emotional end-benefits that they perceive will be experienced. Promoting and supporting these positive emotions while addressing physical needs is the formula for improving outcomes and the state of the patient.

Copyright 2020 Peter Noel Murray PhD