pan european health study 2009 insites consulting
TRANSCRIPT
Pan-European Health Study 2009
InSites Consulting, Taking Health Research Forward
Magali Geens, Director Health Research
[email protected], T +32 9 269 16 04, M +32 497 523 526
May 2009
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PAN-EUROPEAN HEALTH STUDYPATIENT STUDY in 7 EUROPEAN COUNTRIES, 2ND EDITION
Edition 2008:
1.400 consumers (18+), representative total country population.Data collected on proprietary research panels from InSites Consulting, field in the summer of 2008.
Edition 2009:
2.800 consumers (18+), representative total country population.Data collected on proprietary research panels from InSites Consulting, field in the spring of 2009.
Online data collection
on proprietary
research panels by
InSites Consulting
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2008 EditionContent – freely available on request
Do we manage to control our
weight? What happened to sports?
How many suffer chronic pain? Is
depression a problem in Europe?
How healthy are we actually? ...
Patients have massively discovered
the internet as a source for health-
related information. Do patients act
as doctor now with the help of
Doctor Google? ...
I have stress, you have stress, we
all have stress!!!!!!!!!! And we
mainly blame our jobs. How close is
Europe to a total burn-out? What do
people do to relax these days? ...
Are we on prescription drugs? What
about generic alternatives? What
medication do we keep in our
home pharmacy? Which medication
do we pack to go on holiday? ...
Are we too fat? Or are some too
skinny maybe? And if people face
weight problems, are they also
acknowledged? Learn about popular
diets across Europe and more ...
„And me‟ is all about personal
hygiene. What products do we
use, do we buy them in the
supermarket or the pharmacy, how
much do we spend on them ...
Do you want us to tell the story live?
Have we raised certain questions
you would like to ask us? Our
contact details are included and
we are happy to pay you a visit.
Do we all have a personal general
physician? What is (s)he like?
How often do visit them? Do
Europeans trust their GP? And how
well do GP‟s know their patients? ...
2008
Pan-European Health Study, © InSites Consulting, 2008.
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Obviously not all patients are alike.
By means of factor analysis and a
three-dimensional segmentation, 4
distinct patient segmentswere brought alive. We present...
2009 EditionContent of this report2
009
89% of the 2.841 participants report
having been ill during the past year.
What is the prevalence of
various acute and chronic disorders
across Europe? In which countries...
When people get sick, they can do
different things: look in the home
pharmacy, visit the GP, address an
SP, go to the pharmacy, etc. Learn
about the patient action flow...
The obvious first step for patients is
to look for information. The
internet, friends and family, health
encyclopedia... The sources are
diverse and usage differs between...
On average 1 in 5 patients does not
follow any kind of treatment.
Mostly treatment also involves
medication. Also diets are adapted
and physical exercise increased....
What is the relationship with the
physician like? Do different patient
segments have a different level of
confidence in their GP?
Do patients follow the advice?...
When do patients go the pharmacy?
How do they make choices? What is
the influence of a pharmacist?
Do patients ask for the pharmacist‟s
advice? Do pharmacists actively...
What are drivers and barriers for
compliance to treatment?
Does compliance differ between
patient segments? What is the
influence of health professionals...
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2009 Edition More on the methodology
Fieldwork
Countries: UK, Germany, France, Italy, Spain, Netherlands, Belgium
Online quantitative survey
Data collection period: March 2009
Sample size
+/- 400 respondents per country
Recruited from the InSites Consulting consumer panel (TalkToChange Panel, > 2.5 million consumers)
Error margin results: 4%
Sample composition
Screener criteria: adults
Quota criteria: representative for the total population in terms of gender and age per country
Word version of the questionnaire (English version):
Icon legend used throughout the report
Significant difference (95% confidence):
Be careful with interpretation: counts in a sub-cell are below 30:
2009
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Obviously not all patients are alike.
By means of factor analysis and a
three-dimensional segmentation, 4
distinct patient segmentswere brought alive. We present...
2009 EditionHow healthy is the European?2
009
89% of the 2.841 participants report
having been ill during the past year.
What is the prevalence of
various acute and chronic disorders
across Europe? In which countries...
When people get sick, they can do
different things: look in the home
pharmacy, visit the GP, address an
SP, go to the pharmacy, etc. Learn
about the patient action flow...
The obvious first step for patients is
to look for information. The
internet, friends and family, health
encyclopedia... The sources are
diverse and usage differs between...
On average 1 in 5 patients does not
follow any kind of treatment.
Mostly treatment also involves
medication. Also diets are adapted
and physical exercise increased....
What is the relationship with the
physician like? Do different patient
segments have a different level of
confidence in their GP?
Do patients follow the advice?...
When do patients go the pharmacy?
How do they make choices? What is
the influence of a pharmacist?
Do patients ask for the pharmacist‟s
advice? Do pharmacists actively...
What are drivers and barriers for
compliance to treatment?
Does compliance differ between
patient segments? What is the
influence of health professionals...
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WE ARE NOTSO HEALTHY
Less than 50% says to have a HEALTHY life-style
At least 40% admits to have OVERWEIGHT
On average 30% indicates CHRONIC PAIN
Around 20% is DEPRESSED occasionally
Up to 10% is DIABETIC
2008 In 2008 we have learned that...
Pan-European Health Study, © InSites Consulting, 2008.
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N Europe = 2841 / Filter = None
89%of all participants has been
sick during the past year
In 2009 we have measured that...
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PrevalenceAcute and chronic / recurrent 2
009
89%of all participants has been
sick during the past year
16% 66% 6%
CHRONIC /
RECURRENT ACUTE
CHRONIC /
RECURRENT
AND
ACUTE
Headache 22%
Hypertension 17%
Stress 14%
Allergy 19%
Sleeping disorder 13%
Muscle ache 13%
Obesity 12%
Migraine11%
Depression 10%
Influenza 10%
Heartburn 9%
High cholesterol 9%
Anxiety 8%...
Headache 27%
Influenza 14%
Muscle ache 14%
Allergy 12%
Stress 12%
Heartburn 10%
Sleeping
disorder 11%
Migraine 9%
High blood
pressure 7%
Stomach problems 7%
Herpes labialis 6%
N Europe = 2841 / Filter = None
...
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82%
CHRONIC /
RECURRENT
Headache 22%
High blood pressure 21%
Depression 20%
Stress 19%
Asthma 17%Headache 13%
Allergy 22%
High blood pressure 22%
Influenza 16%
Stress 15%
Heartburn 17%
Headache 16%
Allergy 15%
High blood pressure 12%
Obesity 12%
Headache 25%
Heartburn 20%
Allergy 17%
Sleeping disorder 16%
Muscle ache 16%
Allergy 21%
Muscle ache 18%
Obesity 16%
Heartburn 16%
Sleeping disorder 16%
Headache 22%
Allergy 22%
Influenza 16%
Muscle ache12%
High blood pressure 11%
Allergy 23%
High blood pressure 19%
Influenza 15%
High cholesterol 14%
Headache 13%
N Belgium
= 405
N Netherlands
= 401
N Italy
= 417
N France
= 408
N Germany
= 400
N Spain
= 409
N United Kingdom
= 401
N Europe = 2841 / Filter = None
2009
Overview
chronic
diseases
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72%ACUTE
Headache 24%
Stress 11%
Muscle ache 8%
Sleeping disorder 8%
Heartburn 8%
N France
= 1073
N Europe = 2841 / Filter = None
Headache 22%
Heartburn 20%
Stress 17%
Muscle ache 15%
Allergy 13%
Headache 35%
Heartburn 22%
Muscle ache 19%
Sleeping disorder 15%
Stress 13%
Headache 25%
Influenza 20%
Muscle ache17%
Allergy 13%
Stress 10%
Headache 33%
Influenza 19%
Stress 13%
Allergy 13%
High blood pressure 10%
Influenza 29%
Headache 20%
Muscle ache 14%
Migraine 12%
Allergy 10%
Muscle ache 24%
Heartburn 23%
Allergy 19%
Headache 19%
Stress 16%
2009
N Belgium
= 405
N Netherlands
= 401
N Italy
= 417
N France
= 408
N Germany
= 400
N Spain
= 409
N United Kingdom
= 401
Overview
acute diseases
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Obviously not all patients are alike.
By means of factor analysis and a
three-dimensional segmentation, 4
distinct patient segmentswere brought alive. We present...
2009 EditionAre all patients alike?2
009
89% of the 2.841 participants report
having been ill during the past year.
What is the prevalence of
various acute and chronic disorders
across Europe? In which countries...
When people get sick, they can do
different things: look in the home
pharmacy, visit the GP, address an
SP, go to the pharmacy, etc. Learn
about the patient action flow...
The obvious first step for patients is
to look for information. The
internet, friends and family, health
encyclopedia... The sources are
diverse and usage differs between...
On average 1 in 5 patients does not
follow any kind of treatment.
Mostly treatment also involves
medication. Also diets are adapted
and physical exercise increased....
What is the relationship with the
physician like? Do different patient
segments have a different level of
confidence in their GP?
Do patients follow the advice?...
When do patients go the pharmacy?
How do they make choices? What is
the influence of a pharmacist?
Do patients ask for the pharmacist‟s
advice? Do pharmacists actively...
What are drivers and barriers for
compliance to treatment?
Does compliance differ between
patient segments? What is the
influence of health professionals...
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BUT ARE THEY
ALL ALIKE?
2009
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Different patient segmentsFactor analysis: 3 important segmentation dimensions2
009
What is it?Factor analysis is a procedure for data simplification through reducing the rating scales to a smaller set of factors or
composite variables by identifying dimensions underlying the data.
How was it measured?In the survey we asked each respondent to rate 11 statements regarding health on a scale from 1 to 5. Via factor
analysis, we reduced the total set of over 11 statements to 3 underlying factors.
How to interpret?On the next slide you will see the extracted factors and the different items belonging to each factor. The “alpha-
scores” assess the reliability of the different items that measure each underlying factor. The α-scores are values
between 0 and 1. The higher the α-scores, the more reliable the underlying factor is.
Factor analysis
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Different patient segmentsFactor analysis: 3 important segmentation dimensions
Q :To what extent do you agree with the following statements?
I have a healthy lifestyle
I have healthy eating habits
I get sufficient physical exercise
Friends see me as a person who highly values a healthy way of life
Healthy life-style (alpha = .81)
Health involvement (alpha = .72)
Alternative viewpoint (alpha = .59)
I think natural products are better
I believe prevention is better than cure
I would more likely change my eating habits and lifestyle than take medication to tackle medical problems
I go to the doctor every year for a check-up
I regularly enquire about health-related matters
I collect health-related information
I influence my family and friends when it comes to health-related matters
2009
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Different patient segments 3-dimensional patient segmentation2
009
What is it?Cluster analysis is an explorative classification method to sort respondents into a limited number of groups (= clusters),
so that the degree of association is strong between members of the same cluster and weak between members of
different clusters. To determine the ideal number of groups, hierarchical cluster analysis (Ward‟s mean) was used. To
allocate each respondent to a cluster, we used K-Means clustering. Note that standardized scores were used. As they
are hard to interpret, color codes are reported instead.
How was it measured?As input for our segmentation we used the scores of all respondents on the 3 different factors (created via a factor
analysis on the 11 statements of health). The factors were standardized to eliminate the response behavior of the
respondents.
How to interpret?Via cluster analysis, we discovered 4 segments. On the next slide we mapped our 4 segments on the 3 factors that are
the most discriminating between the segments in a 3-dimensional field. Each bubble stands for a particular segment.
The percentage within the bubble indicates the segment size. On the next slides, we described the different segments
on their factor scores and other relevant variables (e.g. socio-demographic profile).
Clustering
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Different patient segments 3-dimensional patient segmentation
NonConfirmist
Health Conscious
Hedonist
Expert
Involvement
Alte
rnativ
e
24%
25%
21%
29%
2009
Non-Conformist
Healthy Laidback
Hedonist of life
Expert
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Different patient segments Meet the NON-CONFORMISTS
NonConfirmist
Health Conscious
Hedonist
Expert
Involvement
Alte
rnativ
e
24%
25%
21%
29%
N Non-Conformists= 634
24%
2009
Hedonist of life
Expert
Non-Conformist
Healthy Laidback
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NonConfirmist
Health Conscious
Hedonist
Expert
Involvement
Alte
rnativ
e
Meet ‘the’ patientMeet the NON-CONFORMISTS
24%
25%
21%24%
N Non-Conformists= 634
Meet ‘the’ patientMeet the NON-CONFORMISTS
Un-healthy life-style, bad eating habits, little to no physical exercise
No regular doctor‟s visit, no health reference for friends and family
They say they would rather change habits than take medication
29%
Gender 56% Female
Age <34
Country France / Italy
Income Lower Income
Household size Average
BMI Overweight
Smokers Smokers
Stress Level High
Visit Frequency GP Only if necessary
They are more likely ...
2009
Healthy Laidback
Hedonist of life
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Different patient segments Meet the HEALTY LAIDBACK
NonConfirmist
Health Conscious
Hedonist
Expert
Involvement
Alte
rnativ
e
24%
25%
21%
29%
N Healthy Laidback = 654
2009
Non-ConformistExpert
Healthy Laidback
21%
Hedonist of life
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Meet ‘the’ patientMeet the HEALTHY LAIDBACK
NonConfirmist
Health Conscious
Hedonist
Expert
Involvement
Alte
rnativ
e
24%
25%
21%
29%
Healthy life-style and eating habits and lots of physical exercise
But they are little involved in health because they have no need to worry
Prevent is better rather than cure and natural products are better
29%
2009
Non-Conformist
Healthy Laidback
21%
Hedonist of life
N Healthy Laidback = 654
Expert
They are more likely ...
Gender 59% Male
Age Equal Spread
Country Netherlands / France / UK
Income Higher Income
Household size Average
BMI Normal
Smokers Mix
Stress Level Low
Visit Frequency GP Only if necessary
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Different patient segments Meet the EXPERTS
NonConfirmist
Health Conscious
Hedonist
Expert
Involvement
Alte
rnativ
e
24%
25%
21%
29%
29%
N Experts = 835
2009
Non-Conformist
Expert
Healthy Laidback
Hedonist of life
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NonConfirmist
Health Conscious
Hedonist
Expert
Involvement
Alte
rnativ
e
25%
21%
29%
29%
N Experts = 835
Healthy life-style, healthy eating habits, physically active and go to the doctor for a yearly check-up
Highly involved in health, inquire about health and collect health information
Believe in prevention, but natural product are not necessarily better
Meet ‘the’ patientMeet the EXPERTS2
009
Expert
Healthy Laidback
Hedonist of life
24% Non-Conformist
They are more likely ...
Gender 58% Female
Age 55+
Country Germany / Spain / Italy
Income Higher Income
Household size Small
BMI Normal
Smokers Non Smokers
Stress Level Average
Visit Frequency GP Frequent
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Different patient segments Meet the HEDONISTS OF LIFE
NonConfirmist
Health Conscious
Hedonist
Expert
Involvement
Alte
rnativ
e
24%
21%
N Hedonists of Life = 714
2009
Expert29%
Non-Conformist
Healthy Laidback
Hedonist of life
25%
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Meet ‘the’ patientMeet the HEDONISTS OF LIFE
NonConfirmist
Health Conscious
Hedonist
Expert
Involvement
Alte
rnativ
e
21%
29%
They do not highly value a healthy way of living, but they do not feel particularly unhealthy either
They are not a health reference for their surroundings, but do search for health info when needed
They are not prevention-oriented and take medication whenever necessary to feel better
24%
2009
Non-Conformist
Healthy Laidback
Hedonist of life
25%
N Hedonists of Life = 714
ExpertThey are more likely ...
Gender Male/Female
Age <34
Country Netherlands/Germany
Income Lower Income
Household size Small
BMI Normal / Overweight
Smokers Smokers
Stress Level Average
Visit Frequency GP Only if necessary
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Different patient segments Distribution across the countries
21%
10%
27%
21%
25%
28%
23%
24%
37%
25%
16%
20%
16%
28%
29%
32%
20%
36%
19%
21%
24%
26%
20%
27%
28%
36%
35%
25%
Belgium
Netherlands
France
Germany
Span
Italy
UK
Nonconformist Health conscious Hedonist Health Expert
2
9
%
2009
Significant differences between the countries (95%).
NON-CONFORMISTS EXPERTSHEDONISTS OF LIFEHEALTHY LAIDBACK
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Different patient segments What is their typical profile?
Non-conformists
(24%)
Healthy laidback
(21%)
Experts
(29%)
Gender
Age
Country
Income
Household size
BMI
Smokers
Stress level
Visit frequency GP
56% Female
< 34
France / Italy
Lower income
Average
Overweight
Smokers
High
Only if necessary
59% Male
Equal spread
Netherlands / France / UK
Higher income
Average
Normal
Mix
Low
Only if necessary
Hedonists of life
(25%)
Equal spread
< 34
Netherlands / Germany
Lower income
Small
Normal / Overweight
Smokers
Average
Only if necessary
58% Female
55+
Germany / Spain / Italy
Higher income
Small
Normal
Non-smokers
Average
Frequent
Where are the
older people?
Where are the
smokers?...
Find out here:
2009
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NonConfirmist
Health Conscious
Hedonist
Expert
Involvement
Alte
rnativ
e
24%
25%
21%
29%
24%
29%
29%
NON-CONFORMISTS
HEALTHY LAIDBACK
EXPERTS
21%
25%
2009 Headache 30%
Muscle ache 19%
Stress 17%
Sleeping disorder 14%
Heartburn 14%
Headache 23%
Influenza 12%
Muscle ache 11%
Heartburn 10%
Allergy 9%
Allergy 23%
High blood pressure 21%
Headache 19%
Muscle ache 15%
Stress 12%
Headache 28%
Allergy 18%
High blood pressure 18%
Stress 16%
Migraine 16%
82%
CHRONIC /
RECURRENT N Non Conformist = 634
N healthy laidback = 654
N Hedonist of Life = 714
N Expert =835
F = No filter applied
HEDONISTS OF LIFE
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NonConfirmist
Health Conscious
Hedonist
Expert
Involvement
Alte
rnativ
e
24%
25%
21%
29%
24%
29%
29%
NON-CONFORMISTS
EXPERTS
HEDONISTS OF LIFE
21%
25%
2009 Headache 23%
Stress 19%
High blood pressure 18%
Obesity 18%
Allergy 17%
Headache 17%
Allergy 17%
High blood pressure 17%
Sleeping disorder 10%
Stress 9%
Allergy 23%
High blood pressure 21%
Headache 19%
Allergy 14%
Stress 12%
Headache 30%
Influenza 14%
Allergy 13%
Migraine 12%
Stress 12%
72%ACUTE
HEALTHY LAIDBACK
N Non conformist = 634
N healthy laidback = 654
N Hedonist of Life = 714
N Expert =835
F = No filter applied
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Obviously not all patients are alike.
By means of factor analysis and a
three-dimensional segmentation, 4
distinct patient segmentswere brought alive. We present...
2009 EditionWhat is the patient action flow?2
009
89% of the 2.841 participants report
having been ill during the past year.
What is the prevalence of
various acute and chronic disorders
across Europe? In which countries...
When people get sick, they can do
different things: look in the home
pharmacy, visit the GP, address an
SP, go to the pharmacy, etc. Learn
about the patient action flow...
The obvious first step for patients is
to look for information. The
internet, friends and family, health
encyclopedia... The sources are
diverse and usage differs between...
On average 1 in 5 patients does not
follow any kind of treatment.
Mostly treatment also involves
medication. Also diets are adapted
and physical exercise increased....
What is the relationship with the
physician like? Do different patient
segments have a different level of
confidence in their GP?
Do patients follow the advice?...
When do patients go the pharmacy?
How do they make choices? What is
the influence of a pharmacist?
Do patients ask for the pharmacist‟s
advice? Do pharmacists actively...
What are drivers and barriers for
compliance to treatment?
Does compliance differ between
patient segments? What is the
influence of health professionals...
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WHAT DO PATIENTS
DO FIRST WHEN
THEY ARE SICK?
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Flow of actionWhat do patients do?
Q : What were the consecutive actions you undertook after you discovered you suffered from your disorder?
2009
1
2
3
4
5
6
...
I waited some time without doing a thing
I looked for information myself
I looked in the home pharmacy
I went to the pharmacy
I went to the general physician (GP)
I went to the specialist physician (SP)
I did something else (I‟ll specify later)
I did nothing
Please drag and drop the consequent actions you undertook in the order you
undertook the actions. Of course it is possible to use the actions multiple times.
N Europe = 2841 / Filter = None
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Before undertaking any action, they
FIRST WAIT FOR A WHILE…
The large majority of patients waits!
In the action flows that are outlined
on the following pages, “waiting” is
not reported as it is not distinguishing
between segments, countries or ages.
Flow of actionWhat do patients do?2
009
N Europe = 2841 / Filter = None
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This flow shows – for each
step, the action with the
highest frequency.
We have considered on an
overall level all frequencies of
each action in each step, and
retained the action with the
highest frequency in each step.
E.g. “information search” received the
highest frequency score in step 1 if
„waiting‟ was not taken into account.
More information in the Excel file below:
Flow of actionWhat do patients do?
Looked for information
General Practitioner
Pharmacy
General Practitioner
Special Practitioner
Something Else
Q : What were the consecutive actions you undertook after you discovered you suffered from your disorder?
2009
Flow of actions
EU total
N Europe = 2841 / Filter = None
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Flow of actionWhat do patients do?
Home
Pharmacy
Looked for
information
General
Practitioner
Looked for
information/
Home Pharmacy
Special
Practitioner /
Pharmacy
General
Practitioner
General
PractitionerPharmacy
General
practitioner
Special
Practitioner /
Pharmacy
General
PractitionerPharmacy
Special
PractitionerPharmacy Pharmacy
General
Practitioner
Special
PractitionerSomething Else Something Else
Special
Practitioner
Something Else PharmacySpecial
PractitionerSomething Else
Home PharmacyLooked for
information
Looked for
information
PharmacySpecial
Practitioner
General
Practitioner
Special
PractitionerPharmacy
Looked for
information
Something ElseSpecial
Practitioner
Looked for
information
General
Practitioner
Special
PractionerPharmacy
Special
PractitionerSomething Else Something Else
Q : What were the consecutive actions you undertook after you discovered you suffered from your disorder?
2009
N Belgium = 405 / N Netherlands = 401/ N France = 408/ N Germany = 400 / N Spain = 409 / N Italy = 417 / N United Kingdom = 401
Flow of actions
Country split
36Pan-European Health Study, © InSites Consulting, 2009.© In
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N Europe = 2841 / Filter = None
Looked for
information
Looked for
information
Looked for
information
Looked for
information
Looked for
information
Looked for
information
General
Practitioner
General
PractitionerPharmacy
General
Practitioner
General
Practitioner /
Pharmacy
General
Practitioner
General
Practitioner
General
Practitioner
Pharmacy Pharmacy PharmacySpecial
practitionerPharmacy Pharmacy
General
practitioner
General
Practitioner PharmacySpecial
practitioner
Special
practitioner /
Pharmacy
General
Practitioner
General
Practitioner
General
Practitioner
Special
practitioner
I did something
else
Special
practitioner
Special
practitioner
Special
practitioner
Special
practitioner
Special
practitioner
Something
else
Special
practitionerSomething else Something else Something else Something else Something else
18-24 25-34 35-44 45-54 55-64 65+
Flow of actionWhat do patients do?
Flow of actions
Age split
37Pan-European Health Study, © InSites Consulting, 2009.© In
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Flow of actionWhat do patients do?
Looked for
information
Looked for
information
General
Practitioner
General
Practitioner
PharmacyGeneral
Practitioner
Pharmacy Pharmacy
Specialist /
Something ElseSpecialist
Specialist Specialist
Home Pharmacy Looked for information
Pharmacy /
General
Practitioner
General
Practitioner
PharmacyInformation / Pharmacy
/ Specialist
General
Practitioner
General
Practitioner
Specialist Specialist
Something Else Something Else
2009
N Europe = 2841 / Filter = None
Looked for
information
General
Practitioner
Pharmacy
General
Practitioner
Special
practitioner
Something
else
Flow of actions
Segment split
NON-CONFORMISTS EXPERTSHEDONISTS OF LIFEHEALTHY LAIDBACK
38Pan-European Health Study, © InSites Consulting, 2009.© In
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Home Pharmacy Home Pharmacy
General
Practitioner
General
Practitioner
General
Practitioner
General
Practitioner
Pharmacy Pharmacy
Something Else Something Else
Specialist Waited some time
Flow of actionWhat do patients do in France?2
009
General
practitioner
General
practitioner
General
practitioner
Pharmacy
Something else
Special
practitioner
TOTAL
Looked for
information
General
Practitioner
Pharmacy Pharmacy
Home PharmacyGeneral
Practitioner
Pharmacy Waited some time
Specialist Specialist
Something Else Something Else
N Non conformist = 116 / N Healthy Laidback =92 / N Hedonist of Life = 68 / N Expert = 130 / F = No filter applied
39Pan-European Health Study, © InSites Consulting, 2009.© In
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Home PharmacyGeneral
Practitioner
General
PractitionerHome Pharmacy
Something Else Something Else
General
PractitionerPharmacy
Specialist Specialist
Something Else Waited some time
Flow of actionWhat do patients do in Germany?2
009
Looked for
information/
Pharmacy
Pharmacy
Pharmacy
General
practitioner
Special
practitioner
Something else
TOTAL
Home PharmacyLooked for
information
Pharmacy Pharmacy
PharmacyLooked for
Information / Pharmacy
General
Practitioner
General
Practitioner
Looked for
informationSpecialist
Something Else Something Else
N Non conformist = 90 / N Healthy Laidback = 61 / N Hedonist of Life = 149 / N Expert = 100 / F = No filter applied
40Pan-European Health Study, © InSites Consulting, 2009.© In
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Looked for
informationHome Pharmacy
General
PractitionerPharmacy
Specialist Waited some time
General
Practitioner
General
Practitioner
Specialist Specialist
Pharmacy /
SpecialistWaited some time
Flow of actionWhat do patients do in Spain?2
009
Home Pharmacy
Pharmacy
Special
Practitioner
Something else
General
Practitioner
Special
Practitioner
TOTAL
Home Pharmacy Specialist
PharmacyGeneral Practitioner
/ Specialist
Looked for
informationSpecialist
Something Else Specialist
General
Practitioner
Looked for
information
Specialist Something Else
N Non conformist = 108 / N Healthy Laidback = 76 / N Hedonist of Life = 77 / N Expert = 149 / F = No filter applied
41Pan-European Health Study, © InSites Consulting, 2009.© In
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Looked for
information
Looked for
information
SpecialistGeneral
Practitioner
Pharmacy Pharmacy
Looked for
informationSpecialist
Something Else Specialist
Something Else Waited some time
Flow of actionWhat do patients do in Italy?2
009
Looked for
information
Special
Practitioner
Pharmacy
Special
Practitioner
Special
practitioner
Something else
TOTAL
Home PharmacyLooked for
information
General
PractitionerSomething Else
Pharmacy Specialist
General
Practitioner /
Something Else
Pharmacy
SpecialistLooked for
information
Something Else Something Else
N Non conformist = 116 / N Healthy Laidback = 57 / N Hedonist of Life = 96 / N Expert = 148 / F = No filter applied
42Pan-European Health Study, © InSites Consulting, 2009.© In
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Looked for
information
Looked for
information
SpecialistGeneral
Practitioner
Looked for
informationHome Pharmacy
Looked for
informationPharmacy
General
PractitionerSpecialist
Specialist Specialist
Flow of actionWhat do patients do in the UK?2
009
Looked for
information
General
Practitioner
Looked for
information
Looked for
information
Pharmacy
Something else
TOTAL
Looked for
information
Looked for
information
General
Practitioner
Looked for
information
Specialist Pharmacy
Specialist Something Else
Pharmacy Pharmacy
Looked for
informationSomething Else
N Non conformist = 232 / N health conscious = 299 / N Hedonist= 249 / N Expert = 268 / F = No filter applied
43Pan-European Health Study, © InSites Consulting, 2009.© In
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Looked for
information
Looked for
information
Home Pharmacy
Looked for
information /
Specialist
General
PractitionerSpecialist
PharmacyGeneral
Practitioner
Something Else
General
Practitioner /
Specialist
Pharmacy Specialist
Flow of actionWhat do patients do in the Netherlands?2
009
Looked for
information
General
Practitioner
Special
Practitioner/
Pharmacy
Pharmacy
Something else
Pharmacy
TOTAL
General
PractitionerHome Pharmacy
Looked for
information
General
Practitioner
Looked for
informationPharmacy
Pharmacy Something Else
Something ElseGeneral
Practitioner
Waited some time Pharmacy
N Non conformist = 39 / N Healthy Laidback = 149 / N Hedonist of Life = 130 / N Expert = 82 / F = No filter applied
44Pan-European Health Study, © InSites Consulting, 2009.© In
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Home PharmacyGeneral
Practitioner
Pharmacy Specialist
PharmacyGeneral
Practitioner
Something else Specialist
Specialist Something Else
Specialist Pharmacy
Flow of actionWhat do patients do in Belgium?2
009
Home
Pharmacy
Special
Practitioner/
Pharmacy
General
Practitioner
Special
Practitioner
Special
Practitioner
Something else
TOTAL
Home Pharmacy Home Pharmacy
PharmacyGeneral
Practitioner
General
Practitioner
General
Practitioner
Specialist Specialist
Something Else Something Else
Something ElseGeneral
Practitioner
N Non conformist = 80 / N Healthy Laidback = 99 / N Hedonist of Life = 100 / N Expert = 126 / F = No filter applied
45Pan-European Health Study, © InSites Consulting, 2009.© In
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Obviously not all patients are alike.
By means of factor analysis and a
three-dimensional segmentation, 4
distinct patient segmentswere brought alive. We present...
2009 EditionWhere do patients look for information?2
009
89% of the 2.841 participants report
having been ill during the past year.
What is the prevalence of
various acute and chronic disorders
across Europe? In which countries...
When people get sick, they can do
different things: look in the home
pharmacy, visit the GP, address an
SP, go to the pharmacy, etc. Learn
about the patient action flow...
The obvious first step for patients is
to look for information. The
internet, friends and family, health
encyclopedia... The sources are
diverse and usage differs between...
On average 1 in 5 patients does not
follow any kind of treatment.
Mostly treatment also involves
medication. Also diets are adapted
and physical exercise increased....
What is the relationship with the
physician like? Do different patient
segments have a different level of
confidence in their GP?
Do patients follow the advice?...
When do patients go the pharmacy?
How do they make choices? What is
the influence of a pharmacist?
Do patients ask for the pharmacist‟s
advice? Do pharmacists actively...
What are drivers and barriers for
compliance to treatment?
Does compliance differ between
patient segments? What is the
influence of health professionals...
46Pan-European Health Study, © InSites Consulting, 2009.© In
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47Pan-European Health Study, © InSites Consulting, 2009.© In
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Information searchInformation search in the flow of action
Looked for information
General Practitioner
Pharmacy
General Practitioner
Special Practitioner
Something Else
Q : What were the consecutive actions you undertook after you discovered you suffered from your disorder?
2009
N Europe = 2841 / Filter = None
48Pan-European Health Study, © InSites Consulting, 2009.© In
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Information searchWhere do patients look for information?
N total = 628 / Filter = If looked up information.
89%
26%
25%
20%
14%
12%
12%
6%
4%
4%
3%
2%
Internet
Friends / acquaintances
Family
Health encyclopaedia (book)
Health article(s) I collected
Magazines
Patient folder(s)
Newspapers
Fellow patients
Library
Other
Patient organisations
56%
58%
51%
6%
* Remark: the data were collected via an online
panel survey. The total use of the internet by
patients was 89% in the sample. To avoid over-
estimation of the internet usage by patients
(because the internet penetration in the sample
was 100%), the internet usage was corrected
based on the internet penetration in Europe.
2009
49Pan-European Health Study, © InSites Consulting, 2009.© In
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62%
38%
20%
24%
19%
27%
10%
23%
21%
36%
20%
15%
2%
1%
9%
3%
3%
Male
Female
25 - 34
35 - 44
45 - 54
55 - 69
70 or older
High blood pressure
High cholesterol
Overweight (Obesity)
Chronic pain
Depression
Look on Internet when feel smthg
Before doctor visit, look on Internet
When doctor diagnosis, look Internet for more info
When doctor diagnosis, check it based on online info
When taking medicine, look up info about it online
44%
56%
19%
22%
19%
28%
12%
29%
26%
41%
35%
20%
33%
30%
63%
34%
33%
Male
Female
25 - 34
35 - 44
45 - 54
55 - 69
70 or older
High blood pressure
High cholesterol
Overweight (Obesity)
Chronic pain
Depression
Look on Internet when feel smthg
Before doctor visit, look on Internet
When doctor diagnosis, look Internet for more info
When doctor diagnosis, check it based on online info
When taking medicine, look up info about it online
1%
3%
5%
4%
2%
5%
11%
4%
3%
8%
7%
7%
7%
7%
8%
9%
8%
10%
8%
14%
27%
60%
59%
55%
63%
59%
48%
37%
27%
26%
24%
16%
24%
27%
18%
Belgium
Netherlands
France
Germany
UK
Spain
Italy
Once a week or more A couple of times a month Every month A couple of times a year Never
1%
3%
5%
4%
2%
5%
11%
4%
3%
8%
7%
7%
7%
7%
8%
9%
8%
10%
8%
14%
27%
60%
59%
55%
63%
59%
48%
37%
27%
26%
24%
16%
24%
27%
18%
Belgium
Netherlands
France
Germany
UK
Spain
Italy
Once a week or more A couple of times a month Every month A couple of times a year Never
1%
3%
5%
4%
2%
5%
11%
4%
3%
8%
7%
7%
7%
7%
8%
9%
8%
10%
8%
14%
27%
60%
59%
55%
63%
59%
48%
37%
27%
26%
24%
16%
24%
27%
18%
Belgium
Netherlands
France
Germany
UK
Spain
Italy
Once a week or more A couple of times a month Every month A couple of times a year Never
INTERNET IS NOT
SOMETHING ONLY
FOR YOUNG USERS
2008
In 2008 we have learned that...
Those who DO and who DO NOT use
the internet for health-related
information have the same age
distribution. Above all, the 55 to 69
years old use it most intensively.
Pan-European Health Study, © InSites Consulting, 2008.
50Pan-European Health Study, © InSites Consulting, 2009.© In
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Information searchWhere do patients look for information?
56% 62% 72% 59% 46% 51% 45% 60%
26% 41% 15% 30% 34% 21% 17% 25%
25% 29% 22% 20% 21% 24% 47% 17%
20% 14% 11% 9% 18% 15% 33% 20%
14% 13% 7% 11% 22% 12% 11% 12%
12% 4% 7% 14% 16% 9% 9% 10%
12% 13% 18% 14% 22% 3% 8% 7%
6% 3% 3% 13% 11% 2% 2% 4%
4% 3% 9% 0% 4% 9% 3% 5%
4% 0% 4% 3% 4% 3% 4% 6%
3% 2% 2% 3% 2% 2% 4% 2%
2% 8% 7% 0% 1% 2% 0% 4%
89%
26%
25%
20%
14%
12%
12%
6%
4%
4%
3%
2%
Internet
Friends / acquaintances
Family
Health encyclopaedia (book)
Health article(s) I collected
Magazines
Patient folder(s)
Newspapers
Fellow patients
Library
Other
Patient organisations
N Europe = 628 / N Belgium = 55 / N Netherlands = 97 / N France = 50 / N Germany = 109 / N Spain= 81 / N Italy = 91 / N United Kingdom = 145
Filter: If searched for informationSig. Difference between countries (95%)
2009
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Information searchWhere do patients look?
56%
26%
25%
20%
14%
12%
12%
6%
4%
4%
3%
2%
89%
26%
25%
20%
14%
12%
12%
6%
4%
4%
3%
2%
Internet
Friends / acquaintances
Family
Health encyclopaedia (book)
Health article(s) I collected
Magazines
Patient folder(s)
Newspapers
Fellow patients
Library
Other
Patient organisations
N Europe = 628 / N Non Conformist = 141 / N Healthy Laidback = 115 / N Hedonist of Life = 147 / N Health Expert = 225
Filter: If searched for information
2
9
%58% 54% 50% 59%
23% 35% 23% 26%
29% 20% 24% 26%
12% 9% 22% 28%
13% 9% 6% 22%
13% 14% 9% 12%
12% 15% 7% 15%
6% 9% 5% 7%
4% 3% 5% 5%
3% 2% 5% 7%
2% 1% 4% 3%
1% 2% 2% 3%
2009
Sig. Difference between segments (95%)
NON-CONFORMISTS EXPERTSHEDONISTS OF LIFEHEALTHY LAIDBACK
52Pan-European Health Study, © InSites Consulting, 2009.© In
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Obviously not all patients are alike.
By means of factor analysis and a
three-dimensional segmentation, 4
distinct patient segmentswere brought alive. We present...
2009 EditionHow do patients get treated?2
009
89% of the 2.841 participants report
having been ill during the past year.
What is the prevalence of
various acute and chronic disorders
across Europe? In which countries...
When people get sick, they can do
different things: look in the home
pharmacy, visit the GP, address an
SP, go to the pharmacy, etc. Learn
about the patient action flow...
The obvious first step for patients is
to look for information. The
internet, friends and family, health
encyclopedia... The sources are
diverse and usage differs between...
On average 1 in 5 patients does not
follow any kind of treatment.
Mostly treatment also involves
medication. Also diets are adapted
and physical exercise increased....
What is the relationship with the
physician like? Do different patient
segments have a different level of
confidence in their GP?
Do patients follow the advice?...
When do patients go the pharmacy?
How do they make choices? What is
the influence of a pharmacist?
Do patients ask for the pharmacist‟s
advice? Do pharmacists actively...
What are drivers and barriers for
compliance to treatment?
Does compliance differ between
patient segments? What is the
influence of health professionals...
53Pan-European Health Study, © InSites Consulting, 2009.© In
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(HOW) DO THEYGET TREATED?
54Pan-European Health Study, © InSites Consulting, 2009.© In
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TreatmentKinds of treatment
63%
16%
15%
5%
5%
3%
3%
2%
2%
2%
1%
7%
19%
Medication
An adapted diet
Physical exercise / sports
A vitamin cure
Homeopathic products
Physiotherapy
Surgical operation
Acupuncture
Manual therapy
Psychotherapy
Osteopathy
Hypnosis
Other
I did not follow any sort of treatment
N Europe = 2.841 / Filter = None
2009
Treatment mostly involves
medication (63%).
In Germany patients followed a
treatment in 67% of the cases
(highest score).
In the Netherlands this is only
55% (lowest score).
19% did not follow any
treatment whatsoever.
In Italy non-treatmentis lowest (14%), in the
Netherlands highest (29%).
55Pan-European Health Study, © InSites Consulting, 2009.© In
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TreatmentKinds of treatment
63%
16%
15%
5%
5%
3%
3%
2%
2%
2%
1%
7%
19%
Medication
An adapted diet
Physical exercise / sports
A vitamin cure
Homeopathic products
Physiotherapy
Surgical operation
Acupuncture
Manual therapy
Psychotherapy
Osteopathy
Hypnosis
Other
I did not follow any sort of treatment
63% 59% 55% 64% 67% 63% 64% 59%
16% 16% 5% 12% 8% 28% 23% 17%
15% 12% 15% 8% 22% 20% 14% 9%
5% 11% 3% 6% 3% 1% 6% 5%
5% 6% 4% 5% 7% 3% 6% 2%
3% 3% 0% 1% 3% 3% 4% 4%
3% 5% 3% 3% 4% 3% 1% 2%
2% 1% 2% 1% 3% 2% 1% 2%
2% 2% 3% 1% 5% 2% 1% 2%
2% 1% 5% 1% 3% 2% 2% 2%
1% 3% 0% 2% 1% 1% 0% 1%
0% 0% 1% 0% 0% 0% 0% 2%
7% 9% 9% 6% 5% 6% 11% 8%
19% 26% 29% 21% 16% 17% 14% 23%
2009
Sig. Difference between countries (95%)
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TreatmentTop 5 chronic / recurrent diseases and their top 5 treatment
Q : What kind of treatment did you follow? If you were on a combination of treatment, you can select different options.
Headache Allergy Hypertension Stress Sleep disorders
70%
16%
10%
7%
7%
Medication
Physical exercise / sports
An adapted diet
A vitamin cure
Homeopathic products
71%
16%
13%
10%
8%
Medication
An adapted diet
Physical exercise / sports
Other (please specify)
Homeopathic products
78%
23%
22%
5%
4%
Medication
An adapted diet
Physical exercise / sports
Other (please specify)
Homeopathic products
56%
20%
16%
9%
9%
Medication
Physical exercise / sports
An adapted diet
Other (please specify)
Homeopathic products
64%
15%
14%
10%
9%
Medication
Physical exercise / sports
An adapted diet
Homeopathic products
Other (please specify)
N total = 2841 /F=None
2009
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TreatmentTop 5 acute diseases and their top 5 treatment
N total = 2841 /F=None
Q : What kind of treatment did you follow? If you were on a combination of treatment, you can select different options.
Headache Influenza Muscle ache Allergy Stress
64%
14%
12%
7%
7%
Medication
Physical exercise / sports
An adapted diet
Homeopathic products
Other (please specify)
71%
16%
14%
11%
10%
Medication
An adapted diet
Physical exercise / sports
Other (please specify)
A vitamin cure
60%
20%
17%
9%
8%
Medication
Physical exercise / sports
An adapted diet
Physiotherapy
A vitamin cure
71%
15%
12%
8%
6%
Medication
Physical exercise / sports
An adapted diet
Homeopathic products
A vitamin cure
50%
19%
14%
12%
9%
Medication
Physical exercise / sports
An adapted diet
Other (please specify)
Homeopathic products
2009
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TreatmentMedication – Prescription or not?
57%61%
67%
60%56%
45%
58%61%
32% 23%
27%
27% 39%
38%
27%
28%
12%16%
6%
13%
6%
17% 16%11%
57%
61%
67%
60%
56%
45%
58%
61%
32%
23%
27%
27%
39%
38%
27%
28%
12%
16%
6%
13%
6%
17%
16%
11%
My medication is only available on a doctor‟s prescription
My medication is freely available, also without a doctor‟s
prescription
I am not sure whether or not I needed a prescription
57%
61%
67%
60%
56%
45%
58%
61%
32%
23%
27%
27%
39%
38%
27%
28%
12%
16%
6%
13%
6%
17%
16%
11%
My medication is only available on a doctor‟s prescription
My medication is freely available, also without a doctor‟s
prescription
I am not sure whether or not I needed a prescription
57%
61%
67%
60%
56%
45%
58%
61%
32%
23%
27%
27%
39%
38%
27%
28%
12%
16%
6%
13%
6%
17%
16%
11%
My medication is only available on a doctor‟s prescription
My medication is freely available, also without a doctor‟s
prescription
I am not sure whether or not I needed a prescription
N Belgium = 405 / N Netherlands = 401/ N France = 408/ N Germany = 400 / N Spain = 409 / N Italy = 417 / N United Kingdom = 401
2009
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Treatment Medication – Who has most influence on the medication?2
009
Q Who had the most influence on the type/brand of medication you received? Typ
e o
f m
ed
icati
on
Average
Average
Brand of medication
The patient has
a relatively big
influence on the
type and brand
of medication
(s)he receives.
Me
Friends / family / acquaintances
The pharmacist
The GP
The SP
Someone else0%
10%
20%
30%
40%
0% 10% 20% 30% 40%
N Europe = 1.778 / Filter : If medication treatment
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Treatment Medication – Who has most influence on the medication in France?
Average
Average
Me
Friends / family / acquaintances
The pharmacist
The GP
The SP
Someone else (please specify)
Me -EU
Friends / family / acquaintances-EU
The pharmacist-EU
The GP-EU
The SP-EU
Someone else-EU
0%
10%
20%
30%
40%
0% 10% 20% 30% 40% 50%
N France = 270 / Filter : If medication treatment
Q Who had the most influence on the type/brand of medication you received? Typ
e o
f m
ed
icati
on
Brand of medication
2009
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Friends / family / acquaintances
The pharmacist
The GP
The SP
Someone else (please specify)
Me -EU
Friends / family / acquaintances-EU
The pharmacist-EU
The GP-EU
The SP-EU
Someone else-EU
0%
10%
20%
30%
40%
0% 10% 20% 30% 40% 50%
Treatment Medication – Who has most influence on the medication in Germany?
Average
Average
N Germany = 264 / Filter : If medication treatment
Q Who had the most influence on the type/brand of medication you received? Typ
e o
f m
ed
icati
on
Brand of medication
2009
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Me
Friends / family / acquaintances
The pharmacist
The GP
The SP
Someone else (please specify)
Me -EU
Friends / family / acquaintances-EU
The pharmacist-EU
The GP-EU
The SP-EU
Someone else-EU
0%
10%
20%
30%
40%
50%
0% 10% 20% 30% 40% 50%
Treatment Medication – Who has most influence on the medication in Spain?
Average
Average
N Spain = 257 / Filter : If medication treatment
Q Who had the most influence on the type/brand of medication you received? Typ
e o
f m
ed
icati
on
Brand of medication
2009
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Treatment Medication – Who has most influence on the medication in Italy?
Average
Average
Me
Friends / family / acquaintances
The pharmacist
The GP
The SP
Someone else (please specify)
Me -EU
Friends / family / acquaintances-EU
The pharmacist-EU
The GP-EU
The SP-EU
Someone else-EU0%
10%
20%
30%
40%
0% 10% 20% 30% 40% 50%
N Italy = 262 / Filter : If medication treatment
Q Who had the most influence on the type/brand of medication you received? Typ
e o
f m
ed
icati
on
Brand of medication
2009
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Friends / family / acquaintances
The pharmacist
The GP
The SP
Someone else (please specify)
Me -EU
Friends / family / acquaintances-EU
The pharmacist-EU
The GP-EU
The SP-EU
Someone else-EU0%
10%
20%
30%
40%
50%
0% 10% 20% 30% 40% 50%
Treatment Medication – Who has most influence on the medication in the UK?
Average
Average
N United Kingdom = 250 / Filter : If medication treatment
Q Who had the most influence on the type/brand of medication you received? Typ
e o
f m
ed
icati
on
Brand of medication
2009
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Friends / family / acquaintances
The pharmacist
The GP
The SP
Someone else (please specify)
Me -EU
Friends / family / acquaintances-EU
The pharmacist-EU
The GP-EU
The SP-EU
Someone else-EU
0%
10%
20%
30%
40%
0% 10% 20% 30% 40% 50%
Treatment Medication – Who has most influence on the medication in the Netherlands?
Average
Average
N Netherlands = 224 / Filter : If medication treatment
Q Who had the most influence on the type/brand of medication you received? Typ
e o
f m
ed
icati
on
Brand of medication
2009
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Friends / family / acquaintances
The pharmacist
The GP
The SP
Someone else (please specify)
Me -EU
Friends / family / acquaintances-EU
The pharmacist-EU
The GP-EU
The SP-EU
Someone else-EU
0%
10%
20%
30%
40%
50%
0% 10% 20% 30% 40% 50%
Treatment Medication – Who has most influence on the medication in Belgium?
Average
Average
N Belgium= 251 / Filter : If medication treatment
Q Who had the most influence on the type/brand of medication you received? Typ
e o
f m
ed
icati
on
Brand of medication
2009
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Treatment Medication – Branded or generic?
Q To what extent would you agree with the following statement:
„I know the difference between generic medication and branded medication‟?
71% knows the difference between branded and generic
those who know the difference are / have more likely...
MaleHigher income
Higher educatedNon Conformist
Expert45+
80%
74%73% 79%
>80%
Acute disorder72%
>80%
2009
71%
29%
Yes No
N Europe = 2841 / Filter = No filter applied
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71%
80%
26%
87%
60%
87%
81%
56%
Total
Belgium
Netherlands
France
Germany
Spain
Italy
United Kingdom
Sig. Difference between countries (95%)
Q To what extent would you agree with the following statement: „I know the difference between generic medication and branded medication‟?
% top 2 scores: I fully agree + I agree
2009 Treatment
Medication – Branded or generic?
N Europe = 2841/N Belgium = 405 / N Netherlands = 401/ N France = 408/ N Germany = 400 / N Spain = 409 / N Italy = 417 / N United Kingdom = 401
Fact that scores are surprisingly low in the Netherlands (and also in Germany) can be explained in 2 ways. Firstly, language issues: different terms
are used to refer to generics by consumers and they might have misunderstood the wording used in the survey (i.e. „generic medication‟). A second
explanation: the generics‟ markets are maturing in some countries and names of active components are mistakenly thought of a being brand names.
71%
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Medication – A view on generic medication
83%
17%
Top 2 Bottom 3
89%
11%
Yes No
56%44%
Top 2 Bottom 3
89% of those who know generics have ever used generics. However, almost
44% doesn’t believe they contain the same active ingredient
as branded medication. On the other hand, 83% agrees they are as effective as
branded medication.
Ever used Same active ingredient As effective
N Europe = 1960 / F= If aware of generics
Q Have you ever used generic medication?
Q I believe generic contains the same active ingredient as branded medication. Top 2: I fully believe / I believe.
Q I believe generic medication is as effective as branded medication. Top 2: I fully believe / I believe.
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56%44%
Top 2 Bottom 3
N Europe = 1960 / F= If aware of generics
Q : I believe generic medication contains the same active ingredient as the original formulation.
2009 Treatment
Medication – A view on generic medication
Non ConformistExpert
Acute Disease18-24
Chronic DiseaseHealthy Laidbacks
62%
59%
63%
58%
58%
61%
56% believes generic medication contains the same
active ingredient as the original formulation...
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Changing habitsWho changes eating habits?2
009
No differences between
men and women!
13% of the
young
19% of the
elderlyfollow a diet.
A typical reflex of the
Healthy
Laidback(20% diets).
63%
16%
15%
5%
5%
3%
3%
2%
2%
2%
1%
7%
19%
Medication
An adapted diet
Physical exercise / sports
A vitamin cure
Homeopathic products
Physiotherapy
Surgical operation
Acupuncture
Manual therapy
Psychotherapy
Osteopathy
Hypnosis
Other
I did not follow any sort of treatment
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Obviously not all patients are alike.
By means of factor analysis and a
three-dimensional segmentation, 4
distinct patient segmentswere brought alive. We present...
2009 EditionHow is the relationship with the physician?2
009
89% of the 2.841 participants report
having been ill during the past year.
What is the prevalence of
various acute and chronic disorders
across Europe? In which countries...
When people get sick, they can do
different things: look in the home
pharmacy, visit the GP, address an
SP, go to the pharmacy, etc. Learn
about the patient action flow...
The obvious first step for patients is
to look for information. The
internet, friends and family, health
encyclopedia... The sources are
diverse and usage differs between...
On average 1 in 5 patients does not
follow any kind of treatment.
Mostly treatment also involves
medication. Also diets are adapted
and physical exercise increased....
What is the relationship with the
physician like? Do different patient
segments have a different level of
confidence in their GP?
Do patients follow the advice?...
When do patients go the pharmacy?
How do they make choices? What is
the influence of a pharmacist?
Do patients ask for the pharmacist‟s
advice? Do pharmacists actively...
What are drivers and barriers for
compliance to treatment?
Does compliance differ between
patient segments? What is the
influence of health professionals...
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Flow of actionGP visit
Looked for information
General Practitioner
Pharmacy
General Practitioner
Specialist Practitioner
Something Else
Q : What were the consecutive actions you undertook after you discovered you suffered from your disorder?
2009
N Europe = 2841 / Filter = None
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Flow of actionGP visit
Q : What were the consecutive actions you undertook after you discovered you suffered from your disorder?
2009
N Europe = 2841 / Filter = None
STEP 1
STEP 2
STEP 3
STEP 4
STEP 5
STEP 6
14%
28%
41%
47%
50%
52%
STEP 7 52%
has visited In
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GP loyaltyWent to see the fixed GP
Q For your disorder, did you go to the same GP you usually visit?
Europe= 975 / Belgium = 147 / Netherlands = 136 / France = 138 / Germany = 131 / Spain = 144 / Italy = 104 / United Kingdom = 175 / Filter: If
went to GP
91%97%
94% 92% 95% 94%100%
78%
5%
3%3% 5% 3% 2%
12%
3% 3% 2% 2% 3%
6%
4%
91%
97%
94%
92%
95%
94%
100%
78%
5%
3%
3%
5%
3%
2%
12%
3%
3%
2%
2%
3%
6%
4%
Yes
No, my regular GP was not available at that time
No, I saw another GP at that time (please specify
why)
I do not have a regular GP
2009
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GP advise / prescriptionTreatment
Q Did your GP advise / prescribe a specific treatment?
73%
77%
69%
84%
66%
74%
74%
69%
14%
14%
13%
7%
21%
17%
17%
12%
13%
10%
19%
9%
13%
9%
9%
19%
Medication
No medication
Nothing
Europe= 975 / Belgium = 147 / Netherlands = 136 / France = 138 / Germany = 131 / Spain = 144 / Italy = 104 / United Kingdom = 175 / Filter: If
went to GP
2009
Sig. Difference between countries (95%)
73%77%
69%
84%
66%
74% 74%69%
14%14%
13%
7%
21%
17% 17%
12%
13%10%
19%
9%13%
9% 9%
19%
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GP advise / prescription % of treatments WITH MEDICATION for the most common disorders
Q Did your GP advise / prescribe a specific treatment?
Europe= 975 / Belgium = 147 / Netherlands = 136 / France = 138 / Germany = 131 / Spain = 144 / Italy = 104 / United Kingdom = 175 / Filter: If
went to GP
2009
84%
76%
75%
70%
61%
Hypertension
Sleep disorder
Allergy
Stress
Headache
79%
71%
70%
70%
70%
Influenza
Headache
Allergy
Muscle ache
Stress
% medication for chronic / recurrent disorders % medication for acute disorders
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24%
29%
29%
NON-CONFORMISTS
HEALTHY LAIDBACK
EXPERTS
21%
25%
DO THEY ALL TRUST THE DOCTOR?
2009
HEDONISTS OF LIFE
GP relationshipConfidence
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24%
29%
29%
NON-CONFORMISTS
HEALTHY LAIDBACK
EXPERTS
HEDONISTS
21%
25%
YES THEY DO
Pan-
They are more likely to...
Have complete confidence in their GP
Believe what the GP says
Agree that the GP is well-informed about
new treatments / medication
2009 GP relationship
Confidence
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24%
29%
29%
NON-CONFORMISTS
EXPERTS
HEDONISTS
21%
25%
NO THEY DON’T
They are less likely to...
Have complete confidence in their GP
Believe what the GP says
Agree that the GP is well-informed about
new treatments / medication
2009
HEALTHY LAIDBACKGP relationshipConfidence
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Confidence in GP Not completely Completely Not completely Completely
Interaction with GP No interaction No interaction No interaction Interaction
Believe what GP says Not always Most of the time Not always Most of the time
Prefer Second Opinion Preference No preference No preference Preference
GP well informed of new
treatment methods Less informed Well informed Less informed Well informed
GP well informed of new
medication Less informed Less informed Less informed Well informed
GP makes right
diagnosis Not always Not always Not always Mostly
GP makes time for me No No No Yes
More confidence in my
GP than other GP's Less/Equal confidence Less/Equal confidence Less/Equal confidence More confidence
29%
21%24% 25% 29%
NON-CONFORMISTS HEALTHY LAIDBACK HEDONISTS OF LIFE EXPERTS
2009
N Non Conformist = 634 /N Healthy Laidback = 654 / N Hedonist of Life = 714 / N Expert =835 F = No filter applied
GP relationConfidence
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Conversation with the GPPatient conversations: model definition
Q To what extent do you agree with the following statements about your interaction with the doctor?
Europe= 975 / Belgium = 147 / Netherlands = 136 / France = 138 / Germany = 131 / Spain = 144 / Italy = 104 / United Kingdom = 175
Filter: If went to GP
2009
I suggested to the doctor the disorder I
thought I suffered from.
I suggested to the doctor a specific treatment.
I asked the doctor for a specific (brand) of
medication
The doctor took my input into account when
making the diagnosis
The doctor took my input into account when
formulating/prescribing the treatment
The doctor showed empathy
There was a mutual respect between the
doctor and me.
Do you agree with... (on a 5 point scale)
Average
Average
Average
Active input from patient
Impact of patient input
Empathy by doctor
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Conversation with the GP Input versus impact of patient
Europe= 975 / Belgium = 147 / Netherlands = 136 / France = 138 / Germany = 131 / Spain = 144 / Italy = 104 / United Kingdom = 175 / Filter: If
went to GP
2009
Active input of patient
Impact
of patient
2
3
4
1 32
highlow
The input given by patients and the impact they have in a
conversation with their GP largely differs across countries. In
The Netherlands for example, patients have clearly a more
important role in the conversation with the doctor than in Italy.
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Conversation with the GP Empathy by the physician versus impact of the patient
Europe= 975 / Belgium = 147 / Netherlands = 136 / France = 138 / Germany = 131 / Spain = 144 / Italy = 104 / United Kingdom = 175 / Filter: If
went to GP
2009
Empathy by doctor
Impact
of patient
2
3
4
1 32
highlow
The empathy shown by the doctor in the dialog
with the patient largely varies as well.
In Italy a doctor‟s visit is clearly a one-way relationship.
Germans have more open conversations with their doctor.
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2,8
2,9
3,0
3,2
3,1
3,0
3,1
3,0
3,0
3,1
2,9
2,9
3,1
3,2
3,0
3,0
3,0
3,1
18-24
25-34
35-44
45-54
55-64
65 or older
Male
Female
Lower educated
Higher educated
Non conformist
Healthy laidback
Hedonists of Life
Expert
No
Yes
No
Yes
2,2
2,3
2,1
2,3
2,0
2,1
2,2
2,2
2,1
2,1
2,1
1,9
2,3
2,3
2,1
2,2
2,0
2,3
18-24
25-34
35-44
45-54
55-64
65 or older
Male
Female
Lower educated
Higher educated
Non conformist
Healthy laidback
Hedonists of Life
Expert
No
Yes
No
Yes
Conversation with the GPInput and impact of target groups
Q To what extent do you agree with the following statements about your interaction with the doctor?
Europe= 503/ Filter: If went to SP
Age
Sig. Difference (95%)
2009
Gender
Education
Segment
Chronic/recurrent
Acute
Active input from patient Impact of patient input
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Flow of actionSP visit
Looked for information
General Practitioner
Pharmacy
General Practitioner
Specialist Practitioner
Something Else
Q : What were the consecutive actions you undertook after you discovered you suffered from your disorder?
2009
N Europe = 2841 / Filter = None
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25%
23%
27%
45%
39%
32%
11%
32%
32%
33%
31%
28%
38%
31%
33%
36%
30%
20%
34%
23%
37%
Belgium
Netherlands
France
Germany
Spain
Italy
United Kingdom
18-44
45+
Male
Female
Lower
Higher
Non conformists
Healthy Laidback
Hedonists of Life
Expert
No
Yes
No
Yes
SP visitFirst to the GP or directly to the SP?
Europe= 503
Filter: If went to SP
Age
2009
Gender
Education
Segment
Chronic/recurrent
Acute sick
Directly to SP32%
First to GP68%
Country
Sig. Difference between patients (95%)
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SP visitReferral by the GP
84%
80%
91%
76%
82%
94%
85%
82%
Total
Belgium
Netherlands
France
Germany
Spain
Italy
United Kingdom
Sig. Difference between countries (95%)
Europe= 343 / Belgium = 45/ Netherlands = 49 / France = 40/ Germany = 35/ Spain = 66 / Italy = 52 / United Kingdom = 56
Filter: If went to GP and afterwards to SP
Q You first went to the GP and then to the specialist. Did your GP refer to the specialist?
2009
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Europe= 160 / Filter: If went to SP immediately
Q you immediately went to specialist without visiting your GP first. Which of the following statements applies to your situation?
31%
26%
23%
21%
10%
I estimated that my condition was so specific that my GP would not
be able to help me
This is the specialist I always go to
I had visited that specialist before for something similar and it was a
natural response to make an appointment there
This specialist was recommended to me
None of the above
2009
Drivers to go to SP
straight away
SP visitNo GP referral
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Obviously not all patients are alike.
By means of factor analysis and a
three-dimensional segmentation, 4
distinct patient segmentswere brought alive. We present...
2009 EditionThe role of the (home) pharmacy2
009
89% of the 2.800 participants report
having been ill during the past year.
What is the prevalence of
various acute and chronic disorders
across Europe? In which countries...
When people get sick, they can do
different things: look in the home
pharmacy, visit the GP, address an
SP, go to the pharmacy, etc. Learn
about the patient action flow...
The obvious first step for patients is
to look for information. The
internet, friends and family, health
encyclopedia..., the sources are
diverse and usage differs between...
On average 1 in 5 patients does not
follow any kind of treatment.
Mostly treatment also involves
medication. Also diets are adapted
and physical exercise increased....
What is the relationship with the
physician like? Do different patient
segments have a different level of
confidence in their GP?
Do patients follow the advice?...
When do patients go the pharmacy?
How do they make choices? What is
the influence of a pharmacist?
Do patients ask for the pharmacist‟s
advice? Do pharmacists actively...
What are drivers and barriers for
compliance to treatment?
Does compliance differ between
patient segments? What is the
influence of health professionals...
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The home pharmacy is not part
of the regular patient action flow.
Still it is the first reflex for one
segment: the Hedonists of Life.
2009
91
Lookedfor information
General Practitioner
Pharmacy
General Practitioner
Special Practitioner
Something Else
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The role of the home pharmacyMedication in the home pharmacy?
71%
78%
82%
74%
66%
69%
79%
68%
Total
Belgium
Netherlands
France
Germany
Spain
Italy
United Kingdom
N Europe = 531/ N Belgium = 80 / N Netherlands = 71 / N France = 92 / N Germany = 82 / N Spain= 72 / N Italy = 73/ N United Kingdom = 61 /
Filter: If looked in home pharmacy
Q Did you find what you were looking for in your home pharmacy?
Sig. Difference between countries (95%)
On average
7 in 10 patients find
what they are
looking for in
the home
pharmacy
2009
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The role of the home pharmacyMedication in the home pharmacy?
Those who find it in the home pharmacy
are more likely...
Non chronically sickAged 18 to 44
Families with children up to 17 years old
2009
Q Did you find what you were looking for in your home pharmacy?
79% 78%
74%
N Europe = 531 / Filter: If looked in home pharmacy
71%
29%
Yes No
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N Europe = 387 / Filter: If looked in home pharmacy and found what needed
Q Did you find what you were looking for in your home pharmacy? / Did you administer/apply what you found in the home pharmacy?
And those who find it in the home pharmacy
are very likely to administer it!
70%Of the total population
2009 The role of the home pharmacy
Administration / application of home pharmacy items
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The role of the home pharmacyAdministration / application of home pharmacy items
N Europe = 387 / Filter: If looked in home pharmacy
Population
Found in home
pharmacy 71%
Apply product from
home pharmacy
70%of the total
population
2009
82
82
74
74
78
75
65
65
79
79
66
66
69
69
Q Did you find what you were looking for in your home pharmacy? / Did you administer/apply what you found in the home pharmacy?
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The role of the home pharmacyThe instruction leaflet
N Europe = 387 / Filter: If administered / applied product
2009
43%
38%
9% 9%
1% 0%
Not read, taken before Read, followed instructions
Read, did not follow completely
Not read, not necessary Not read, no leaflet Read, not followed
47% first reads the instruction leaflet
before administering / applying something
Q Which of the following statements apply concerning the instruction leaflet?
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Going to the pharmacy is the
3rd step in the regular patient
action flow.
97
Lookedfor information
General Practitioner
Pharmacy
General Practitioner
Special Practitioner
Something Else
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The PharmacyLoyalty
Q To what extent do you always go to the same pharmacy?
38%
65%
75%
52%
36%
55%
14%
35%
44%
23%
16%
30%
46%
30%
72%
41%
17%12%
9%
18% 18%15% 13%
25%
Sig. Difference between countries (95%)
38%
65%
75%
52%
36%
55%
14%
35%
44%
23%
16%
30%
46%
30%
72%
41%
17%
12%
9%
18%
18%
15%
13%
25%
I always go to the same pharmacy if I can
I mostly go to the same pharmacy
I go to a number of pharmacies, depending
on where I am and
Europe= 307 / Belgium = 34 / Netherlands = 37 / France = 36 / Germany = 58 / Spain = 55 / Italy = 42 / United Kingdom = 45
Filter: If went to pharmacy yourself
2009
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The Pharmacy Product in stock?
Q Was the pharmacist able to give you the product / medication you needed at that time?
83%
80%
79%
88%
81%
88%
92%
66%
Total
Belgium
Netherlands
France
Germany
Spain
Italy
United Kingdom
Europe= 307 / Belgium = 34 / Netherlands = 37 / France = 36 / Germany = 58 / Spain = 55 / Italy = 42 / United Kingdom = 45
Filter: If went to pharmacy yourself
2009
Sig. Difference between countries (95%)
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The Pharmacy Interaction with the pharmacist
Q Did the pharmacist inquire about your health / condition?
49%
41%
37%
33%
54%
49%
40%
67%
Total
Belgium
Netherlands
France
Germany
Spain
Italy
United Kingdom
Europe= 307 / Belgium = 34 / Netherlands = 37 / France = 36 / Germany = 58 / Spain = 55 / Italy = 42 / United Kingdom = 45
Filter: If went to pharmacy yourself
2009
Sig. Difference between countries (95%)
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48%
78%
64%70%
53%
41%
31%
41%
13%
5%
3%
1%
13%
23%
16%
13%
11%
5%
12%
14%
11% 9%
9%
15%
17%
12%
14%
16%
18%16%
10%
26%
11%8% 7%
10%
34%
6%
The Pharmacy Interaction with the pharmacist
Q Which of the following statements applies best to the explanation given by the pharmacist
48%
78%
64%
70%
53%
41%
31%
41%
13%
5%
3%
1%
13%
23%
16%
13%
11%
5%
12%
14%
11%
9%
9%
15%
17%
12%
14%
16%
18%
16%
10%
26%
11%
8%
7%
10%
34%
6%
The pharmacist actively explained to me how I
needed to use
The pharmacist explained the use / the
regimen when I asked
The pharmacist did not explain because (s)he
estimated I had
The pharmacist did not explain because I
indicated I knew ho
The pharmacist did not explain and I don‟t know
why
Europe= 307 / Belgium = 34 / Netherlands = 37 / France = 36 / Germany = 58 / Spain = 55 / Italy = 42 / United Kingdom = 45
Filter: If went to pharmacy yourself
2009
Active explanation how to use
Explanation after asking
No explanation because taken before
No explanation/ I indicated I knew how
to use
No explanation without a reason
Sig. Difference between countries (95%)
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The Pharmacy Up-selling / cross-selling
Q Did you also take home other products / medicines from the pharmacy besides the one you needed / intended to purchase?
33%
32%
10%
53%
37%
27%
21%
37%
Total
Belgium
Netherlands
France
Germany
Spain
Italy
United Kingdom
Europe= 307 / Belgium = 34 / Netherlands = 37 / France = 36 / Germany = 58 / Spain = 55 / Italy = 42 / United Kingdom = 45
Filter: If went to pharmacy yourself
2009
Chronically sick people
Hedonist of Life
Healthy Laidback
Acute sick people
Very low for non conformists
Experts
39%
39%
38%
40%
12%
34%
2
9
%
Sig. Difference between countries (95%)
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The Pharmacy Impact of Point-Of-Purchase materials
Q Did you also take home other products / medicines from the pharmacy besides the one you needed / intended to purchase?
Europe= 95 / Filter: If take home other products
2009
48%
22%
10%
15%
Not linked to disorder
Visibly on display
Suggested by pharmacist
Asked for them
48% of the extra purchases are not intended for the current disorder (probably to re-fill the home pharmacy).
48%
22%
10%
15%
Not linked to disorder
Visibly on display
Suggested by pharmacist
Asked for them
Visible displaysare responsible for more extra sales than the active advice by the pharmacist.
48%
22%
10%
15%
Not linked to disorder
Visibly on display
Suggested by pharmacist
Asked for them
48%
22%
10%
15%
Not linked to disorder
Visibly on display
Suggested by pharmacist
Asked for them
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Obviously not all patients are alike.
By means of factor analysis and a
three-dimensional segmentation, 4
distinct patient segmentswere brought alive. We present...
2009 EditionCompliance to treatment2
009
89% of the 2.841 participants report
having been ill during the past year.
What is the prevalence of
various acute and chronic disorders
across Europe? In which countries...
When people get sick, they can do
different things: look in the home
pharmacy, visit the GP, address an
SP, go to the pharmacy, etc. Learn
about the patient action flow...
The obvious first step for patients is
to look for information. The
internet, friends and family, health
encyclopedia... The sources are
diverse and usage differs between...
On average 1 in 5 patients does not
follow any kind of treatment.
Mostly treatment also involves
medication. Also diets are adapted
and physical exercise increased....
What is the relationship with the
physician like? Do different patient
segments have a different level of
confidence in their GP?
Do patients follow the advice?...
When do patients go the pharmacy?
How do they make choices? What is
the influence of a pharmacist?
Do patients ask for the pharmacist‟s
advice? Do pharmacists actively...
What are drivers and barriers for
compliance to treatment?
Does compliance differ between
patient segments? What is the
influence of health professionals...
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Loyalty
Adherence (Compliance)
Persistence
Loyalty
A patient systematically takes a certain
brand of medicine according to the
prescribed regimen
Adherence or Compliance
A patient takes a medicine according to the
prescribed regimen
Persistance
A patient takes a medicine, but NOT
necessarily according to the
prescribed regimen
ComplianceWhat’s in a name?
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Compliance to treatmentImpact of a GP and SP visit
Europe= 975 / Filter: If went to GP
Q What happened after your visit to the GP / SP?
Europe= 503 / Filter: If went to SP
77%
24%
8%
6%
2%
1%
Started treatment
Adapted lifestyle
Other
Nothing
Changed treatment
Stopped treatment
74%
24%
7%
6%
5%
2%
Started treatment
Adapted lifestyle
Other
Nothing
Changed treatment
Stopped treatment
General Practitioner Special Practitioner
2009
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2%
7%
13%
37%
42%
Not at all
Rather not
Neutral
Rather well
Totally
Compliance to treatmentCompliance to treatment WITHOUT medication
Europe= 132 / Filter: If GP prescribed treatment without medication
Europe= 91 / Filter: If SP prescribed treatment without medication
Q: Did you follow the treatment exactly as prescribed?
5%
5%
11%
51%
29%
Not at all
Rather not
Neutral
Rather well
Totally
80% 79%
2009
General Practitioner Special Practitioner
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Europe= 724 / Filter: If GP prescribed medication
Europe= 357 / Filter: If SP prescribed medication
Q Please indicate which of the following descriptions applies best to the medication that was prescribed.
94%
2%
0%
3%
0%
0%
0%
Took exactly as prescribed
Lower dose
Higher dose
Shorter period
Longer period
Never started
Other
Compliance to treatmentCompliance to treatment WITH medication2
009
General Practitioner Special Practitioner
90%
4%
1%
3%
0%
2%
1%
Took exactly as prescribed
Lower dose
Higher dose
Shorter period
Longer period
Never started
Other
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Q What are reasons to deviate from what the doctor prescribed?
1
2
3
4
5
Top 5 reasons to deviate from the prescription Stressing the
importance of
continued use
once the
symptoms
disappear, seems
more important
than the
promotion of
compliance tools.
Europe= 144 / Filter: If not compliant to GP prescription; non-significant differences found for non-compliance to SP prescription, but counts too low.
Forgot to use it 9%
ComplianceReasons for non-compliance?2
009
109
Symptoms disappeared 21%
Do not like medication 10%
No short term effect 9%
Side effects in the leaflet 9%
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•THE END
2009
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Contact details
Magali GeensDirector Health Research
Tel. +32 9 269.16.04
Mobile +32 497.523.526
www.insites.eu Regus Rotterdam
[email protected] Brainpark
Evergemsesteenweg 195 Lichtenauerlaan 102-120
B-9032 Gent 3062ME Rotterdam
Belgium The Netherlands
Tel. +32 9 269 15 00 Tel. +31 10 204 56 71
Fax. +32 9 269 16 00 Fax. +31 10 204 55 55
2009
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Obviously not all patients are alike.
By means of factor analysis and a
three-dimensional segmentation, 4
distinct patient segmentswere brought alive. We present...
2009 EditionThank you2
009
89% of the 2.800 participants report
having been ill during the past year.
What is the prevalence of
various acute and chronic disorders
across Europe? In which countries...
When people get sick, they can do
different things: look in the home
pharmacy, visit the GP, address an
SP, go to the pharmacy, etc. Learn
about the patient action flow...
The obvious first step for patients is
to look for information. The
internet, friends and family, health
encyclopedia..., the sources are
diverse and usage differs between...
On average 1 in 5 patients does not
follow any kind of treatment.
Mostly treatment also involves
medication. Also diets are adapted
and physical exercise increased....
What is the relationship with the
physician like? Do different patient
segments have a different level of
confidence in their GP?
Do patients follow the advice?...
When do patients go the pharmacy?
How do they make choices? What is
the influence of a pharmacist?
Do patients ask for the pharmacist‟s
advice? Do pharmacists actively...
What are drivers and barriers for
compliance to treatment?
Does compliance differ between
patient segments? What is the
influence of health professionals...
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11 mio euro turnover
+2.5 mio panel members in +25 countries
80 employees
Projects in +35 countries
Offices in Belgium and the Netherlands
Yearly growth +40% last 7 years
Since 1997
Full-service
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Working for 40% of best global brands (2008)
In a nutshell
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We believe ...
in the power of new research methods
for better marketing decision making
InformationalProviding more depth to research insights
TransformationalDoing things that were previously not possible
AutomationalConducting research more efficiently
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We believe ...
in connected research
Everything we do is aimed at enhancing intimacy
between you, your market and us.
We believe ...
in sharing and co-creating
5% of our turnover is invested in R&D
10 ESOMAR papers over the last 2 years
Academic links all over the world
No black boxes
Co-development with clients Co-development with academia
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We believe ...
in giving back
Rewarding experiences for participants
Active involvement of panel members
Charity contributions
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We believe ...
in the power of our team
People make the difference
Open, forward thinking, dedicated, passionate
Specific knowledge centers
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Our health references
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