Providing our clients with robust and actionable segmentations forms the cornerstone of HRW: after all, our sister company (MMR) was founded on their use of attitudinal segmentations. We employ industry-recognised and proprietary segmentation techniques and statistical expertise which allow our segmentations to be based on both the rational and emotional drivers of behaviour. However, when thinking about patient segmentations we also know that uncovering both the rational and the emotional drivers can be more complex in some harder to reach patients.

The below uncovers some of the steps we took on a recent project where our client needed a segmentation for a patient population where psychosis and instability is commonplace. This meant that a direct approach of a qualitative phase followed by a quantitative survey with the population would be both unethical and immoral. This approach would also risk incomplete or unrepresentative data given this population’s desire to often remain closed off. A secondary challenge we faced was around the high individualisation of each patient both in terms of symptomology and treatment history: no one patient is the same and general themes and treatment algorithms are uncommon.

Qualitative interviews

Although we always recommend a qualitative phase to explore a therapy area landscape, for this project this phase was even more important. We conducted duo interviews with the patient population and their caregivers to explore how the disease impacts on their day-to-day life. Specifically, we explored the HCP-patient relationship, goals, unmet needs, treatment histories and much more.

Having the caregiver present allowed patients to feel safe: this was essential to maintain as this population are prone to feelings of paranoia. The presence of the caregiver and associated safety this brings allowed patients to open up about their experiences and allowed us to truly understand the condition through their own eyes.

We also conducted interviews with healthcare professionals (HCP) to ensure completeness in terms of treatment decisions, goals, unmet needs and the impact of the condition on the patient’s day to day life.

Online Bulletin Board

From prior work, we knew that some of the patient population suffer from social withdrawal and therefore a qualitative interview would not be suited to them. However, it was critical that this patient population’s voice was also heard during the initial exploratory phase of research. To capture this, we conducted an online bulletin board (OBB).

As respondents complete the OBB in their own time and most of the discussions are unmoderated it was important we ensured respondent safety was still upkept. We employed a psychiatrist to monitor responses and flag to our recruitment partners if they were concerned about potential decline in functioning or signs of relapse in the patients.

The OBB provided us to ample data and a window in the lives of this patient population. They were able to complete the tasks in the safety of their own home and we also received feedback from our recruiters that they enjoyed the experiences.

Quantitative survey

Once the qualitative phase completed, we were able to identify key differentiating themes from both the patient/ caregiver and HCP perspectives when helped to inform our questionnaire design. As mentioned, it would be unethical and immoral and risk data quality if we were to conduct a quantitative segmentation with the patient population. Recruiting caregivers would have also been tricky and slowed down the overall project timelines given the sample size we needed for a robust segmentation. For this reason, we opted to recruit healthcare professionals and get them to complete two patient record forms about patient’s they treat.

Of course, it was still important that the patient/caregiver perspective is reflected, so the combination of the qualitative interviews and the OBB allowed us to have a true and full picture of the patient’s voice and experiences even though they did not complete the survey.

Follow up qualitative interviews

To ensure the segments are reflective of the wider patient population this research had a ‘bolt-on’ third phase with patient, caregivers and healthcare professionals. During this phase, we showed respondents the segments and asked each to evaluate them on the extent to which they were reflective of themselves / the person they cared for/ their patient population.

This phase of research ensured that the profiles were refined and tailored. This was especially important given the heterogeneous nature of the patient population. We were able to make direct tweaks the segments to ensure they resonate in communications which will ultimately help with the potential uptake of our client’s product.

Behavioural science

Each phase of the research had consultancy from HRW SHIFT (our in-house behavioural science experts). Although HRW SHIFT will always be pivotal when conducting segmentations, for this research they were even more so.

Unconscious bias is even more important to unpick within this patient population as they themselves sometimes struggle to articulate how they are feeling and reasons behind their attitudes. Without the inclusion of behavioural science, we would have risked having surface level perceptions from patients and not fully understood their day to day lives through their own eyes.

At the end of the research, HRW SHIFT also identified behavioural biases associated with each segment and evidence-based recommendations on how to overcome these.

Concluding thoughts

Although the basis of this methodology is consistent with our ‘standard’ approach to segmentation (qual interviews followed up with a quantitative phase all overlaid with behavioural science), the complexities of this patient population meant that we had to think outside of the box during research design. Overall, this short case study (similar to many others we have conducted), sheds light on our wider capabilities in ensuring the patient voice is heard and incorporated into research even in the trickiest patient populations.

If you have any questions about the research, please do not hesitate to get in touch.


By Abigail Graham

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