Peggy W. Flowers, GlaxoSmithKline

Chronic conditions are on the rise, U.S. obesity numbers continue to grow, and health care costs are spiraling upward. Medications are prescribed, but over 50% are not filled or taken as instructed. Health goals and News Year’s resolutions often fall by the wayside. What can be done? 

For years, like other leading pharmaceutical manufacturers, GlaxoSmithKline (GSK) has provided high quality disease management programs that were therapeutically aligned with our products and could be customized to the individual patient. When program users inquired about treating the “whole patient” we showed them how to create a customized program by combining resources across the programs, but it wasn’t easy and it wasn’t enough. It became clear that we needed a new “whole patient” approach to care management.

	Health coaching is an increasingly popular method of guiding individuals to discover and address their own uncertainty about health behavior changes and it helps build their capacity to achieve short- and long-term health goals. Health coaching is based on the “whole person” approach. A health coach helps identify the motivation needed to get excited about working on health, and provides encouragement to address the obstacles along the way.

GSK recently launched an interactive consumer website, HealthCoach4Me.com, to make health coaching available to a broad audience. HealthCoach4Me.com helps users take charge of their health emphasizing intrinsic motivation, small steps and progress tracking. Users identify a health goal in an area of wellness or a chronic condition, and the virtual coach helps break the goal down into small achievable steps. Each user is provided a customized dashboard for tracking progress, and every goal includes a step focusing on adherence to treatment as prescribed by a healthcare provider.

	HealthCoach4Me.com helps users develop an intrinsic motivational statement that appears on their customized website pages. Understanding the motivation is an important factor in improving adherence and helping patients achieve their health goals. This is simple to understand if we look at our own successes and struggles. Most of us have issues in our lives that we know we should address more rigorously. Maybe your doctor has suggested that you lose weight, exercise more, or reduce stress, and you have agreed. Good intentions surround us as we sit in the doctor’s office. We agree to take action immediately. But if we’re honest, we admit that the “should” word makes us feel guilty, even a little embarrassed. It’s easier to allow that commitment to wane. Being told you should do something is an extrinsic motivator. It usually isn’t going to stick because it makes you feel bad, and who wants that? Not us, not the patients who take our medications. 

Intrinsic motivation used in health coaching has a much better chance of success. For example, if you decide it is really important for you to dance at your daughter’s wedding; you have identified an intrinsic motivator. Visualizing yourself actually achieving your goal provides positive motivation to stay focused. 

This is a simple example to which we can all relate. Medication adherence is much more complicated. Taking medications for a chronic condition is a constant reminder for patients that they have a disease they don’t want. Denial of their condition, confusion about why they should take medications, forgetfulness and other barriers get in the way of medication adherence. Health coaching may make a difference. 

Although research on this is just beginning, the findings are encouraging. A literature review revealed 16 randomized controlled studies on health coaching. While many of the studies were small, positive results in improving health outcomes and medication adherence were documented. Health coaching is different from the disease management of the past where call centers provided reminders to patients about things they “should” do. No wonder the results were disappointing! 

At GSK, we believe that health coaching provides support “beyond the pill” by addressing the needs of the “whole patient” and setting them up for success in achieving their health goals. A new health-coaching culture shows promise of making a positive difference in health outcomes and medication adherence.

	Peggy W. Flowers is Senior Director of the Care Management Solutions department at GlaxoSmithKline and leads a team that develops care management resources for health plans, providers and patients. She completed the coaching program at the Hudson Institute of Santa Barbara and received her MSPH from the University of North Carolina at Chapel Hill. 

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