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Slide1

1

Doctor

- Patient

Global Communication Performance

Insights from the Worldwide Independent Network (WIN™) of Market ResearchFall, 2011 Slide2

2

Contents

1. Background & Research

3

2. Context and Methodology

4

3. Key Findings

6

4. Communication Assessment Tool

7

5. Medication Usage

10Slide3

3

Background

WIN™, the Worldwide Independent Network of Market Research, the largest independent organization of Market Research firms with members in

64 countries, prepared this landmark review of physician-patient communication.

ResearchPhysician-Patient communication critically influences the effectiveness of medical education initiatives, treatment decisions and patient compliance to recommended treatments.WIN™ conducted this ground-breaking study on physician-Patient communication throughout the world to provide the healthcare stakeholders with a better understanding on how patients perceive communication skills of their doctor, how patients engage their physician, how treatment choices are influenced, the frequency and preferred modes of interaction and sources of influential information.

1. Background

& ResearchSlide4

4

2. Context

and Methodology

Methodology and Geographical distribution: In total, the study was carried out in 39 countries

. In each country, the most appropriate interviewing methodology was used given local conditions. Fieldwork dates:Fieldwork was conducted between July 19th 2011 and October

3

rd

2011

.

Sample:

The total size of the sample is

31 577

cases representative of

1 938 990 516

people.

Sample in each country is probabilistic and was designed to represent the general adult population

.

General coverage of the sample is as follows:

75% national

25% urban

Weighting:

The data was

weighted in two steps to

obtain representation by country and worldwide. The data was first weighted to generate data representative of the general

population for

each country. A second weight, according to the size of the population surveyed, was then applied to obtain global and regional totals

.

The margin of error per country is between +/- 2.34% and 5.66%, 19 times out of 20.

The table on the next page presents a summary of the methodology used in each country to conduct this survey.

Each sample is representative of its country’s population in terms of socio-demographic variables. Sample sizes ensure accurate generalizations to the total population and allow a very

precise

interpretation of the results

.Slide5

5

2. Context

and Methodology…

Country

Firm

Method

Sample

Total Population

Sampling

Method

Sample

representation

Population

represented

by

sample

Age

Weighting variables

Fieldwork

dates

Margin

of

error

+/-

Armenia

MPG LLC (Marketing Professional Group)

CATI

1003

7 953 438

Quota Sampling

National

3 356 000

18+

Gender, Age

Aug. 12-25

3.09%

Australia

Colmar Brunton

Online

910

20 000 000

Stratified

National

18 200 000

18+

Gender, Age, Region

Aug. 4-10

3.25% 

Austria

Gallup

Austria

Face to Face

532

8 400 000

Random quota sampling

National

7 300 000

14+

Gender, Age, Region,Employment, Income

Jun. 20 - Aug. 3

4.25%

Bosnia

Mareco Index Bosnia

CATI

750

3 850 000

Multistage random sample

National

2 950 000

15+

No

Jul

. 19 -

Aug

.

5

3.58%

Brazil

Ibope Inteligencia

Face to Face

1410

190 000 000

Probabilistic

National

141 248 576

16+

Gender Age, Employment

Aug. 11-15

2.61%

Bulgaria

BBSS

Face to Face

633

7 300 000

Random

National

6 500 000

18+

Gender, Age, Region, Type of settlement

Jul. 28-Aug,04

3.90%

Canada

Leger Marketing

Online

1004

33 739 900

Random

National

24 750 000

18+

Gender, Age, Region, language

Aug. 8-15

3.09%

Chile

IBOPE Inteligencia Chile

CATI

473

15 116 435

Random

Urban

5 408 150

18-60

Gender, Age, Location

Aug. 19- Sep. 5

4.51%

China

Wisdom

Asia

Online

400

1 300 000 000

Random Sampling with online Panel

(

Shanghai, Beijing and Guangzhou)

Urban

51 520 000

15+

No

Aug. 11-17

4.90%

Colombia

CNC (Centro

Nacional

de

Consultoria

)

CATI

612

44 000 000

Two-stage design applied simple random sampling

Urban

13 826 630

18-65

No

Aug. 23-29

3.96%

Czech Republic

Mareco Ltd.

Face to Face

1000

10 224 626

Random route sampling

National

8 392 530

18+

Gender, Age, Region, Size of Community

Aug

. 4-15

3.10%

Denmark

DMA Research

Online

510

5 600 000

Random

National

4 200 000

18+

No

Aug. 12-15

4.34%

Finland

Taloustutkimus Oy

Online

522

5 385 000

Random

Nationl

4 577 250

15+

Gender, Age, Region

Aug. 12-19

4.29%

France

BVA

Online

999

65 000 000

Quota

Method

National

50 700 000

18+

Gender, Age, Region,

Occupation

Aug. 1-4

3.10%

Germany

Produkt+Markt

Online

1006

81 800 000

Random

National

56 500 000

18-70

Gender, Age, Region

Jul. 25-Aug. 2

3.09%

Greece

Centrum S.A

CATI

300

10,961,758

Statified

Urban

6,351,506

18-74

Region

Jul. 18-Aug. 3

5.66%

Hong Kong

Consumer Search

CATI

800

7 100 000

Random quota sampling

National

6 130 300

15+

Gender, Age

Jul. 30-Aug. 19

3.46%

Iceland

Capacent

Online

717

320 000

Random from our Web-panel

National

247 437

16+

Gender, Age, Region

Aug. 10-18

3.66%

India

DataPrompt

CATI

803

1 210 193 422

Random

Urban

963 600 000

18+

No

Jul. 23-Aug. 19

3.46%

Ireland

Red C Research

CATI

839

4 580 000

Random digital dial including both

landline

and mobile numbers

National

3 203 814

18+

Gender, Age, Social class and Regio.

Aug. 8-10

3.38%

Italy

Doxa

CATI

882

60 300 000

Random

National

50 000 000

18+

Gender, Age, Region,

Size of Community, Occupation

Jul. 21-24

3.30%

Japan

NRC (Nippon

Research

Center )

Online

1000

126,475,664

Random

National

99,604,610

18-79

No

Aug. 11-15

3.10%

Kenya

Infinite Insight

Face to Face

1003

38 610 097

Random

National

26 254 865

18+

No

Jul. 30-Aug. 8

3.09%

Lebanon

Reach

CATI

1000

3 759 136

Random

National

2 781 760

18+

No

Aug. 1-30

4.38%

Luthuania

UAB RAIT

Face to Face

703

3 200 000

Random Probilty Routine

National

2 625 400

15-74

Gender, Age, Education

Aug. 1-18

3.10%

Macedonia

BRIMA

Face to Face

820

2 052 722

Multi stage stratified random probability

National

1 689 265

15+

Gender, Age, Region size, Nationality

Sept. 1-7

3.42%

Pakistan

Gallup Pakistan

Face to Face

1752

187 342 721 

Stratified Probability Sampling

National

88 000 000

18+

Gender, Age, Region, Type of settlement

Aug. 7-13

3.70%

Palestine

PCPO

Face to Face

992

4 170 000

Random

National

1 876 500

18+

No

Jul. 20-Aug. 15

2.34%

Peru

Datum

Face to Face

918

27 412 157

probabilistic, multistage stratified allocation

Urban

16 085 385

18-69

Gender, Region

Aug. 5-8

3.11%

Poland

Mareco

Face to Face

305

38 200 000

Stratified random

Urban

5 100 000

15-65

No

Jul. 28-Aug. 2

3.23%

Romania

TNS CSOP

Face to Face

750

21 431 298

Stratified Probability Sampling

National

18 190 003

18+

Gender, Age, Region

Jul. 24-Aug. 1

5.61%

Russia

Romir

Online

1180

143 000 000

Random

Urban

69 000 000

18-44

Gender, Age, Region

Aug. 5-9

3.58%

Saudi Arabia

PARC

CATI

1155

27 000 000

Random

Urban

13 000 000

15+

No

Jul. 19 - Aug. 24

2.85%

South Africa

TRS (

Topline

Research

Solutions)

Face to Face

400

49 320 000

Random

(

Johannesburg, Durban,

Capetown

)

Urban

33 819 800

18+

Gender, Age, Region

Jul. 29-Aug. 10

2.88%

Korea

Gallup Korea

Online

500

49 773 145

Random Soft Quota

National

40 359 211

18+

Gender, Age

Aug. 9-18

4.90%

Sweden

CMA Research

Online

1049

9 446 812

Statified

National

7 250 000

15-75

No

Aug. 9-13

3.03%

Swizterland

Isopublic

Face to Face

343

7 870 134

Random-quota

National

6 050 314

15-74

Gender, Age, Region

Sept. 21-Oct. 3

5.29%

Tunisia

EMRHOD

CATI

600

9 910 872

Stratified (governorates are strata)

National

732 326

18+

No

Aug. 22-27

4.00%

USA

TRiG

Online

1002

313 232 044

Random

National

234 265 000

18+

Gender, Age, Region, Race

Aug. 8-12

3.10%Slide6

6

3. KEY

FINDINGS

Doctor-Patient

Relationship Around the WorldCommunication effectiveness between doctors and patients is related to being compliant to taking prescribed medication exactly as the doctor directed.

Communication Assessment Tool (CAT™) showed the communication between

doctor and

patients is poor with a very low score of 22

%.

Asian markets are amongst the lowest on communication

effectiveness.

Directionally, comparing results from prior years, communication

effectiveness between doctors and

patients on a global level trended downward.Slide7

7

5

. Doctor

Communication Assessment Tool

Q. Thinking of your most recent visit, please rate the doctor’s communication with you.Compared to last year, fewer citizens rated their doctor as excellent this year in all of the

15 communication assessment

categories asked in the survey.

Only a quarter or less rate

their doctor as excellent in all of the

categories

.

Only 18% of respondents felt their doctor encouraged them to ask question.

With only 25%, “talk in terms I could understand” this is the attribute that received the rating of excellent most frequently.

7

*Global totals represent the averages of the top boxes scores in every surveyed

country

**In 2010, 23 countries participated in the survey. IN 2011, 39 countries participated in the survey of which only 15 were recurrences from 2010.

CAT (

Comunnication

Assessment

Tool

)

Attributes

2011

%

2010

%

Talked in terms I could understand

25

â

32

How would you rate the care provided by your doctor

24

â

30

Paid attention to me (looked at me, listened carefully)

24

â

32

Treated me with respect

24

â34Greeted me in a way that made me feel comfortable 23â29Showed care and concern 23â30Understood my main health concerns23â30Discussed next steps, including any follow-up plans 22â29Gave me as much information as I wanted 22â30Let me talk without interruptions 22â31Showed interest in my ideas about my health 22â29Spent the right amount of time with me 22â30Checked to be sure I understood everything21â27Involved me in decisions as much as I wanted19â25Encouraged me to ask questions18â23 Total22â29 

Key Finding:

A

quarter or less of citizens rate their doctor as excellent in all of the categories. Slide8

8

5

. CAT

(Communication Assessment Tool)

Overall, the CAT score in the 39 surveyed countries is at a low of 22.The country with the highest CAT score is Ireland with a score of 66. On the other hand, Pakistan continues to record a low CAT score with the lowest this year at 5 (Pakistan scored a 7 in 2010).Of the countries that participated in the survey for the past two years, Austria’s CAT score most decreased (-19) while Italy (+10), Lebanon (+8), Korea (+7), China (+7) most increased.

8

Key Finding:

On average, citizens throughout the world give their doctor a low CAT score.

Communication

Assessment

Tool

(CAT)

Country

2011

%

2010

%

Ireland

66

NA

Armenia

66

NA

Chile

59

NA

Macedonia

56

NA

Bosnia

51

NA

Australia

49

NA

USA

48

â

52

Lebanon48á40Saudi Arabia45â51Canada43â47Sweden37 NAGermany36 NAFrance35â39Switzerland33NAGreece32 NAColombia28 NAIceland27â30

South Africa

25

NA

Bulgaria

24

-

25

Brazil

23â30Lithuania23NARussia23 -22Tunisia22 NAKorea22á15Austria21â40Denmark21 NAItaly21á11Czech Rep.20NARomania20 NAFinland19 NAIndia16 -17Kenya15 NAPalestine14 NAHong Kong13NAPoland11 NAChina11á4Japan10 -11Peru6 NAPakistan5â7Total22â29

Communication Assessment Tool (CAT)The Communication Assessment Tool (CAT), developed by Makoul et al, assesses patient perceptions of physicians’ interpersonal and communication skills.The CAT is a 15-item survey that is easily administered in a paper-and-pencil format, via the phone or Internet. The CAT asks respondents to rate different dimensions of the communication and interpersonal skills of the physician using a 5-point rating scale (1=poor, 2=fair, 3=good, 4=very good, 5=excellent). Makoul et al found that scoring the CAT based on the proportion of items rated as excellent was more meaningful than summarizing the scores using means. Their psychometric analysis of response scales indicated that “a rating of ‘excellent’ was akin to ‘yes’, while even ‘very good’ was closer to ‘no’ than ‘yes.’” Data for the present study were analyzed using the sum of the items scored as excellent divided by the number of items answered.* *Source: http://www.stfm.org/fmhub/fm2010/September/Linda567.pdf (2010)

Q. Thinking of your most recent visit, please rate the doctor’s communication with you.

**

In 2010, 23 countries participated in the survey. IN 2011,

39

countries participated in the survey of which only

15

were recurrences from 2010. Slide9

9

High CAT scores

Citizens in

Armenia, Australia, Bosnia, Canada, Chile, Columbia, France, Germany, Greece, Ireland, Lebanon, Macedonia, Saudi Arabia, Sweden, Switzerland, and the USA

are very satisfied with their communication with their doctors with CAT scores above average

.

Low CAT scores

Citizens in

China, Hong Kong, India Japan, Kenya, Pakistan, Palestine, Peru, Poland and are

the least satisfies with their doctor with below average CAT scores.

Average CAT scores

Respondents in

Austria, Brazil, Bulgaria, Czech republic, Denmark, Finland, Iceland, Italy, Korea, Lithuania, Romania, Russia, South Africa and Tunisia have

average CAT scores.

5

. Global

Communication Assessment Tool (CAT) Summary Summer 2010

Doctor-Patient

Relationship around the world

*The data for this graph is based on questions presented on slides

12.

For the definitions of

CAT

(communication Assessment Tool) please refer to

slide 12.

Key Finding:Slide10

10

39%

of individuals currently have a medication that was prescribed by a doctor.

Just over half (57%) of respondents take the medication exactly according to the doctor’s directions and another 31% take the medication according to the doctor’s direction most of the time.

While Bulgarians are most likely to take prescription medication exactly according to direction (91%), citizens of Peru and Czech Republic are the least likely to do so with 29% who answered that they only some of the time or rarely take the medication according to direction. Key Finding:Just over half (57%) of citizens on prescribed medication take it exactly according to the doctor’s directions.

10

6. Medication

Usage

Q.

Do you currently have a medication that was prescribed by the doctor with whom you most recently met?

Q. How often would you say you have taken this prescription medication exactly according to the doctor’s direction?

Yes

%

All the

time

%

Most of the

time

%

Only some of the

time/Rarely

%

China

80

43

55

3

Korea

68

36

54

10

USA

63

70

21

8

Australia

62 67303Palestine58 342838Canada57 72235Austria57 68321South Africa55 582517Bosnia53 8479France5373

23

3

Bulgaria

52

91

6

3

Colombia52 701514Romania50 75187Denmark50à 79183Germany50 64323Sweden49 75186Czech Rep.48 442629Japan48 55423Italy48 76203Poland47 77192Ireland4778139Macedonia47 85104Lithuania46 72198Hong Kong4441

4314Brazil

43

à

78

14

8

Tunisia

41

50

27

23

Switzerland

40

68

23

8

Iceland

39

61

34

6

Armenia

39

43

18

38

Pakistan

38

41

47

11

Lebanon

38

74

16

10

Saudi Arabia

37

58

20

20

Finland

37

73

24

3Greece

35

 68725Chile35 

652113Russia32 50

427

Peru

31 531829India26 

443422Kenya

24 

60

19

20

Total39

573112Of those on prescribed medicaton, taken medication according to doctor's direction