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DIABETES
Addressing the overpromotion of intensive therapy in elderly Type 2 diabetes patients
Problem
Pharmaceutical manufacturers of insulin and other antidiabetic medications influenced professional medical associations to lower A1c targets for type 2 diabetes patients to less than 7% – an approach called treatment intensification. This shift, combined with aggressive promotion to healthcare professionals and direct-to-consumer advertising, convinced doctors and patients that intensive treatment was necessary to meet these new targets. What followed was a rise in emergency room admissions due to drug-induced hypoglycemia-related falls and fractures, particularly among older, frail adults.
Strategy
RxBalance and our VA team partners, with the input from three highly respected, independent medical professors, arrived at a simple and direct communication strategy to combat the problem: For many patients aged 65 and older, intensifying therapy, particularly with insulin or sulfonylureas, may do more harm than good.
Creative Solution
RxBalance created a series of powerful ads, highlighting the dangers of treatment intensification in elderly patients. Our approach was to highlight those sections of the clinical guidelines recommending more conservative treatment for vulnerable patient populations — information clinicians were less familiar with.
Results
The VA conducted qualitative testing of the RxBalance ads with medical residents, followed by rigorous testing with two groups: 75 clinicians recruited through Medscape and 75 patients with type 2 diabetes. Overall, VA staff physicians were both receptive to and influenced by these ad units. They expressed an intention to be more selective in their use of treatment intensification for Type 2 diabetes, recognizing that it wasn’t desirable for everyone. An unexpected outcome of the campaign was increased media attention on the issue, with a leading news outlet publishing a story that spotlighted the problem, further amplifying the impact of our work.
“RxBalance brought a unique perspective to the project and helped us reframe our strategy, producing content that was hard-hitting and memorable, yet based on best evidence. Moreover, RxBalance was able to mediate between opinionated physicians who didn’t always see eye to eye. Lydia and the RxBalance creative team were easy to establish rapport with and it was great fun and very productive.”
—David Arons, MD, Member of the VA/ Defense Department Diabetes Clinical Practice Guidelines Committee
