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Working together to go ‘beyond the pill’: building a virtuous network of collaborators
  1. David Halpin1,
  2. Lisa Banks2,
  3. Andrew Martello3
  1. 1Royal Devon and Exeter Hospital, Exeter, UK
  2. 2AstraZeneca, Shanghai, China
  3. 3Spoonful of Sugar—A UCL Business Company, London, UK
  1. Correspondence to Professor David Halpin, Royal Devon and Exeter Hospital, Barrack Road, Exeter EX2 5DW, UK; d.halpin{at}

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Successful management of long-term conditions requires patients to commit to lifestyle changes and may require the prolonged use of medication. Although a patient will spend more than 8000 h/year self-managing their disease, only a small proportion of this time is spent interacting directly with their healthcare team. Prescribing medications and making lifestyle recommendations are fundamental to disease management, but optimising patients’ adherence to medication and supporting lifestyle changes are key challenges. Indeed, it is estimated that half of the people with chronic conditions do not take their medication as instructed.1

Patient behaviour is one of the primary barriers in achieving optimal treatment outcomes, including adherence,2 ,3 and is fundamentally driven by beliefs relating to health, illness and treatment.4 These psychological barriers—combined with a multitude of practical barriers—influence their ability, capacity, resources and motivation to start and continue treatment.2 To overcome these barriers, healthcare professionals (HCPs) need to rigorously and systematically apply their understanding of behavioural medicine. Technological advances combined with an improved understanding of behaviour patterns offer a unique opportunity to re-evaluate how to address these beliefs and provide better support to patients.1

Following a consultation, patients are routinely left to self-manage their condition on a day-to-day basis. However, future healthcare paradigms must augment the consultation with key elements such as interactivity, feedback and sustained personalised support. The internet, smartphones and tablet computers offer opportunities to collect and share data and provide a huge potential to engage with patients at their convenience. Pharmaceutical companies, healthcare providers, healthcare entrepreneurs and technology companies have recognised this potential and are exploring …

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  • Funding Medical writing support was provided by David Finch of Complete Medical Communications, funded by AstraZeneca PLC. AstraZeneca was given the opportunity to review the manuscript to ensure scientific and medical accuracy, regulatory compliance and protection of intellectual property.

  • Competing interests DH has received sponsorship to attend international meetings and honoraria for lecturing, attending advisory boards and preparing educational materials from Almirall, AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Novartis and Pfizer. His department has received research funding from AstraZeneca. He is a member of the GOLD Board of Directors & Science Committee. LB is a full-time employee of AstraZeneca. AM was a full-time employee and shareholder in Spoonful of Sugar, a UCL Business company at the time this manuscript was developed. Andrew has previously worked, or is currently working, as a consultant for the following pharmaceutical companies: Pfizer, AstraZeneca, Merck Serono, GlaxoSmithKline, Merck Sharpe & Dohme, Roche, Shire and Otsuka.

  • Provenance and peer review Commissioned; internally peer reviewed.