Pfizer's New Report Shows How Behavioural Science Can Help Boost Preventative Healthcare Measures

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PARIS, July 31, 2018 /PRNewswire=KYODO JBN/ --

Released today, a new report based on research by the Economist Intelligence

Unit (EIU) and sponsored by Pfizer Vaccines assesses why, despite the evidence

supporting the medical and cost-saving benefits of preventative healthcare

measures, consumers regularly choose not to adopt them.[1] Through interviews

with leading international experts, the report reviews the psychological

factors affecting consumer and patient decision-making, in relation to their

health. The report addresses what policymakers, public health campaigners and

healthcare professionals need to do to mitigate these influences, with a

particular focus on vaccination.

    Report key findings and recommendations  

    -Emotional and cognitive factors have an outsized influence on consumer

preventative healthcare decision-making

    -Policy makers, public health campaigners, and healthcare professionals

need to be aware of these influences when developing policy and devising public

health campaigns, and when making preventative healthcare recommendations

    -There is a significant opportunity for policy makers and healthcare

providers to draw on the information and tools provided by behavioural science

to improve the participation rate in key preventative healthcare measures.

    The Preventative care and behavioural science: the emotional drivers of

healthcare decisions report considers the many factors influencing vaccination

decision-making, as well as other preventative healthcare measures, through the

lens of behavioural science and behavioural economics - the application of

psychology to the decision-making processes of individuals and institutions.

Key principles of behavioural economics have been reported to benefit

healthcare management[2] and lend themselves to understanding and addressing

'non-rational' influences on vaccination decision-making.

    The report has been released on the back of a webinar hosted on the 4th

July by Economist Events. A panel of multi-disciplinary experts came together

to discuss the findings of the report and what needs to be done to ensure the

opportunities presented by behavioural economics are recognised and applied

across public health policy and campaigning, and during patient-doctor

consultations. The webinar is available at:

behaviouraleconomicsinhealthcare.economist.com.

    Action required on multiple levels

    The report concludes with what needs to happen to address the gap between

preventative healthcare theory and practice, and applies this specifically to

the challenge of increasing vaccination uptake.

    Prof Heidi Larson, Director of the Vaccine Confidence Project (VCP), London

School of Hygiene and Tropical Medicine (LSHTM), UK concluded, "There is no

single approach that will increase vaccination uptake among those who would

benefit from it - multi-level interventions are needed appealing to people

rationally, emotionally and taking into account prevailing cognitive biases. A

broad range of stakeholders need to drive this charge."

    Professor Bonanni, Professor of Hygiene in the Faculty of Medicine,

University of Florence, Italy said, "I would like to see a strong commitment

from health authorities to promote vaccination among the elderly, and support

healthcare professionals in their critical role. Healthcare professionals need

to be educated on the principles of behavioural economics so they are able to

apply them during their consultations with patients."

    Dr Douglas Hough, Associate Scientist & Associate Director, Master of

Health Administration Program, Health Policy and Management, John Hopkins

University, USA said, "If vaccinations do their job, no one notices - no one

says, 'thank you because I'm not dead from small pox.' Balancing data with

stories is key. Patients may be swayed by data but more likely a good story.

I'd suggest doctors show pictures... aim to really bring it home to the patient

or the patient's parent."

    Understanding cognitive bias  

    One of the key findings of the report is that cognitive biases have an

outsized influence on preventative healthcare decision-making. Amidst a daily

barrage of healthcare messages, consumers often are left confused.[1] Two

cognitive phenomena arising from the confusion are so-called 'omission bias'

and the 'nocebo effect'. Report interviewee Dr Alice Forster of University

College London describes 'omission bias' as 'the tendency to avoid making a

decision when confronted with complex and contradictory information.' She

describes a preference of patients, under conditions of uncertainty, to take no

action rather than risk making the wrong decision. She notes that this

phenomenon often influences parents' decisions about their children's

vaccination: Parents say they would feel more at fault if their child were to

have a negative reaction to a vaccination, than they would if their child were

to contract an illness, such as measles, due to omitting the vaccination.[3]

    The 'nocebo effect' (opposite of 'placebo effect'), is a tendency to

actually experience exaggerated side effects after having read or seen material

that creates negative expectations.[4]

    Commenting on omission bias in the context of vaccination, Professor Paolo

Bonanni says, "We need to help people understand that by making no decision,

they are in effect deciding, whether for themselves or their child, and they're

doing so in the least effective way."

    Emotional influences on decision-making

    Consumers often rely on the views of family and friends concerning medical

matters in preference to medical advisors who may be better informed.[1]

Research conducted by report interviewee Dr Chris Duke, Director, Center for

Consumer Choice in Healthcare, Altarum Institute, USA, shows that when parents

knew of families that had either positive vaccination experience or negative

experiences with the targeted disease, they were more likely to accept

vaccination for their own children.[1] The report concludes that one way to

acknowledge this influence is to balance data and anecdotes - "use clear

communication involving both data and anecdotes, and leave consumers room to

relate the information to their own circumstances." [1]

    Practical, emotional and cognitive influences on doctor's decision making

around vaccination  

    Prof Heidi Larson said, "doctors themselves are not immune to emotional and

cognitive influences on their decision-making. This is coupled with more

practical considerations such as minimal training around vaccination, and how

to deal with difficult patient conversations."

    Professor Bonanni said of the consequence of this lack of training,

"Clinicians may be more likely to be affected by negative publicity around

vaccination and can in turn, become part of the problem. If the clinician is

not convinced of the value of vaccination, the patient will pick up on it -

enter the power of non-verbal communication - a patient will respond

differently to a 'soft' recommendation of vaccination than a strong

recommendation. Doctors are not taught the principles of behavioural economics

which would help them both understand and communicate with their patients. They

learn on the job but it is difficult without being taught the foundations."

    NOTES TO EDITORS  

    Vaccination has greatly reduced the burdens of infectious diseases[5] and

offers cost-effective strategies[6]. Despite the evidence, there exists

'vaccination hesitancy' - the delay in acceptance or refusal of vaccines

despite availability of vaccination services.[7] Vaccination refusal is an

increasing challenge and threatens to jeopardize community protection against

infectious disease.[8] 'Vaccine hesitancy' has also been found to exist among

healthcare providers - their vaccine confidence and vaccination behaviour has

been found to affect their vaccination recommendations to others.[9]

    1. Preventative care and behavioural science: The emotional drivers of

healthcare decisions. The Economist Intelligence Unit. Available from:

https://eiuperspectives.com/healthcare/preventative-care-and-behavioural-science.

[Last accessed July 2018]

    2. Voyer B. 'Nudging' behaviours in healthcare: Insights from behavioural

economics. British Journal of Healthcare Management. 2015;21(3):130-135.

    3. Forster A, Rockcliffe L, Chorley A, et al. A qualitative systematic

review of factors influencing parents' vaccination decision-making in the

United Kingdom. SSM - Population Health. Volume 2, 2016. 603-612.

    4. Gupta A, Thompson D, Whitehouse A, et al. Adverse events associated with

unblinded, but not with blinded, statin therapy in the Anglo-Scandinavian

Cardiac Outcomes Trial-Lipid-Lowering Arm (ASCOT-LLA): a randomised

double-blind placebo-controlled trial and its non-randomised non-blind

extension phase. The Lancet. Volume 389, No. 10088, p2473-2481, 24 June 2017

    5. Vaccination greatly reduces disease, disability, death and inequity

worldwide. WHO. Available at:

http://www.who.int/bulletin/volumes/86/2/07-040089/en/. [Last accessed July

2018]

    6. Immunization. WHO. Available at:

http://www.who.int/topics/immunization/en/ [Last accessed July 2018]

    7. Addressing Vaccine Hesitancy. WHO. Available from:

http://www.who.int/immunization/programmes_systems/vaccine_hesitancy/en/. [Last

accessed July 2018]

    8. McKee C and Bohannon K. Exploring the Reasons Behind Parental Refusal of

Vaccines. J Pediatr Pharmacol Ther. 2016; 21(2): 104-109.

    9. Paterson P, Meurice F, Stanberry L, et al. Vaccine hesitancy and

healthcare providers. Vaccine 34 (2016) 6700-6706.

    For media enquiries please contact:  

    Dervila Keane  

    Media Relations, Pfizer Europe AfME

    Phone: +353-86-2110834

    Email: Dervila.keane@pfizer.com

SOURCE: Pfizer