Access to Health

Access to Health

Health Literacy

Health Literacy
Access to Health
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We are committed to improving health literacy as part of our mission to improve health.

Health literacy is vital to achieving the best possible results from medical care, medicines and vaccines. We must partner with patients to promote their understanding of their medical condition or disease, the reasons they are being treated, and the appropriate use of their medications and other treatments. Doing so will result in minimizing safety issues and maximizing the benefit of using our medicines.

Since its inception in 1891, our company has pushed the boundaries of science with the hope and expectation that advancing scientific knowledge will lead to major advances in health.1 We believe one way to improve global health care outcomes is to make medical and health information accessible to health care professionals and patients around the world.2 Our commitment to improving patient health outcomes extends to our commitment to health literacy. We shared this perspective, that communication is indeed part of the cure, in the Journal of Health Communication.

Health economists estimate that low health literacy costs the American health care system $73 billion per year and the Swiss health care system between CHF1.5 and CHF2.3 billion per year.

Health literacy can affect a person’s ability to access health care services, use services appropriately, adopt health-promoting behaviors, manage chronic conditions, navigate the health care system, and act on health-related news and information.3

Health literacy challenges can affect people of all ages, races, incomes and educational levels. Some population groups are more vulnerable to low health literacy. They include the elderly, people with less than a high school education, people living in poverty, racial and ethnic minorities, and people with limited English proficiency.4

Those with limited health literacy are more likely to have chronic conditions and are less able to manage them effectively.5

In 2012, about one out of every two adults (117 million Americans) had at least one chronic condition.

Health literacy is essential in efforts to:

  • Encourage use of appropriate preventive measures, e.g., health screenings, mammograms, recommended vaccinations
  • Teach patients about health benefits, risk factors, and adherence to treatment plans
  • Inform and alert the public about important health recommendations6,7

KEY DEFINITIONS

Health literacy (U.S. definition): The degree to which individuals have the capacity to obtain, communicate, process and understand basic health information and services to make appropriate health decisions.

Health literacy (EU definition): Health literacy is linked to literacy and entails people’s knowledge, motivation and competences to access, understand, appraise, and apply health information in order to make judgments and take decisions in everyday life concerning health care, disease prevention and health promotion to maintain or improve quality of life during the life course.7

POOR HEALTH LITERACY IS A SERIOUS CHALLENGE

Health literacy challenges exist in all parts of the world. According to WHO Europe, people with strong health literacy skills enjoy better health and well-being, while those with weaker skills tend to engage in riskier behavior and have poorer health.8 Health literacy also has an impact on the efficient use of health care resources. Health economists estimate that low health literacy costs the American health care system $73 billion per year and the Swiss health care system between CHF1.5 and CHF2.3 billion per year.9 According to more recent research, low health literacy has been estimated to cost the U.S. economy between $106 billion and $236 billion annually.3

Our company recognizes the potential we have to help improve millions of lives by improving how we communicate as we shepherd discoveries from the lab to the marketplace. We also know it will take a multifaceted effort focused on public policy, engaging diverse stakeholders and new ways of communicating. Consequently, we are calling for collaboration among government agencies, health care providers, patient advocacy groups and health care companies to do more, together, to increase patient understanding of health care and treatment plans.

At a time when patients and family members are increasingly involved in their own care, clear communication at every point along the patient journey, from researching symptoms to seeking diagnosis to managing disease, is a crucial adjunct to the medicines we discover.

KEY HEALTH LITERACY PRIORITIES

Our company is committed to ensuring diversity in clinical trials, championing health literacy across countries and divisions, and proposing new solutions to improve health care equity around the globe. In the U.S., our goal is to create and model patient-centered innovative programs that foster health literacy. We publicly share best practices with other pharmaceutical companies and other stakeholders, demonstrating our commitment to improving patient health outcomes. We proudly participate in both the National Academies Health Literacy Roundtable and the Roundtable on the Promotion of Health Equity and the Elimination of Health Disparities.

Our vision in Europe is to ensure citizen- and patient-centered health systems. Health literacy is a key enabler for citizens and patients to take an active role with regard to their health. In addition, health literacy activities lead to better “readable” health systems where patients can easily navigate and receive the care needed.10 Empowered citizens and readable health systems contribute to better health and more efficient health care.

We have been engaging in Europe with various stakeholders such as the European Commission, the European Parliament and patient, physician, pharmacy and nurse associations toward those goals. In July 2015, the European Parliament Science and Technology Options Assessment (STOA) Committee hosted a seminar, “Health Literacy in Europe: Empowering patients—How can technology contribute to improving health literacy?” In September 2015, European Parliament member Françoise Grossetête was invited to a lunch debate on health literacy and personalized medicines.

Health literacy has gained attention among policy makers across Europe. The Council of the European Parliament refer to the importance of health literacy in the context of personalized medicines.11 The “Riga Roadmap”—a joint declaration by industry, civil society and patient organizations—launched during the Latvian EU Presidency—calls for a regular EU health literacy survey across all EU member states to collect comparative data, and for investing in health literacy interventions.12

Finally, many affiliates of our company have translated health literacy into programs to improve the health of citizens and patients in high-priority areas such as diabetes or HIV/AIDS. We highlight some of our U.S. and global health-literacy initiatives in the next two tabs.

1 Merck & Co., Inc., Kenilworth, NJ, USA. Corporate videos. Accessed: June 22, 2016.
2 Merck & Co., Inc., Kenilworth, NJ, USA. “Helping the World Be Well”. Corporate presentation. Accessed: June 22, 2016.
3 U.S. Department of Health and Human Services (HHS). Quick Guide to Health Literacy. http://health.gov/communication/literacy/quickguide/Quickguide.pdf. Accessed June 22, 2016.
4 U.S. Department of Health and Human Services (HHS). Office of Disease Prevention and Health Promotion. National Action Plan to Improve Health Literacy. Washington, DC: Author. 2010.
5 U.S. Department of Health and Human Services (HHS). Quick Guide to Health Literacy and Older Adults. http://health.gov/communication/literacy/olderadults/literacy.htm. Accessed: June 22, 2016.
6 Berkman, ND, Sheridan, SL, Donahue, KE, et al. Health Literacy Interventions and Outcomes: An Updated Systematic Review. Evidence Report/Technology Assessment No.199. AHRQ Publication Number 11-E006. Rockville, MD. Agency for Healthcare Research and Quality. March 2011.
7 Sorensen, K, et al. (2012), “Health literacy and public health: A systematic review and integration of definitions and models.” BMC Public Health, 12:80.
8 WHO Europe (2013), Health literacy: The solid facts; edited by Ilona Kickbusch, Jürgen M. Pelikan, Franklin Apfel and Agis D. Tsouros; http://www.euro.who.int/en/publications/abstracts/health-literacy.-the-solid-facts (31/12/2015).
9 Friedland, RB, O’Neill, G (1998), Understanding Health Literacy: New Estimates of the Costs of Inadequate Health Literacy; Fact Sheet of the National Academy on an Aging Society; see: http://www.agingsociety.org/agingsociety/publications/fact/fact_low.html; Spycher S (2006), Ökonomische Aspekte der Gesundheitskompetenzen. Konzeptpapier im Auftrag des Bundesamtes für Gesundheit, Berne; see: http://www.bag.admin.ch; Gesundheitsförderung Schweiz, Merck Sharp & Dohme-Chibret AG (Ed.) (2008), Die volkswirtschaftliche Bedeutung von Gesundheitskompetenz. Eine Studie, ein Gespräch am runden Tisch und drei Interviews, Berne, Zurich. 10 See: http://rigahealthconference2015.eu/wp-content/uploads/2015/08/Riga-Roadmap-download-FINAL.pdf. Accessed: May 13, 2016.
11 AHRQ 2012 Health Disparities Report (page 5). http://archive.ahrq.gov/research/findings/nhqrdr/nhdr12/2012nhdr.pdf.
12 Henry J. Kaiser Family Foundation. “Disparities in Health and Health Care: Five Key Questions and Answers.” December 2012.
U.S. Initiatives

SHAPING THE EXTERNAL ENVIRONMENT—HEALTH CARE PROVIDERS

While the skills of individual patients and caregivers are an important part of health literacy, there is also a need to reduce the complexity of the health care system. Poor health literacy and health care disparities may negatively impact quality, adherence and patient safety. Many payers, integrated health systems and large medical groups share our commitment to addressing these issues. Individuals with limited health literacy have a lower quality of communication with health professionals.1 Patient-centeredness, cultural competency and health literacy may all play a role in reducing health disparities. By taking a systematic approach to promoting health literacy, medical practices and other health care organizations may help to improve the quality of patient care.

We have created and shared many resources about health literacy, and updated several of them this year. These updates reflect the widespread understanding across the health care system of the need to address health literacy. We updated background materials and speaker presentations, with a greater emphasis on actionable recommendations to foster health literacy and on cultural competency to improve the health care consumer experience.

SHAPING THE EXTERNAL ENVIRONMENT—PATIENTS / HEALTH CARE CONSUMERS

Patients require health literacy skills in order to understand and navigate the health care system, talk to providers, engage in self-management, exercise basic numeracy skills, adopt healthy behaviors, and act on news and information.2 Our consumer-engagement platform, available in the U.S., provides unbranded health-literate content in support of our pharma and vaccine brands. This multi-channel health and wellness program is designed to improve engagement and adherence, to help U.S. consumers strive to meet their goals for a healthy lifestyle, and to provide a platform to educate patients on real-time health-related issues.

Since 2014, we have had a leadership role in the Multi-Regional Clinical Trials Center (MRCT) Return of Results working group. This multi-stakeholder group, including representatives from patient advocacy, industry and academia, worked collaboratively to develop a health-literate template and supporting guidance document for returning results to clinical trial participants. In 2015, two of our employees were invited to participate in an EMA task force on lay summaries, in advance of an EU requirement to publish lay summaries by 2018. Again, patient representatives were part of this task force. The draft EU guidance issued in June 2016 features health literacy principles, numeracy, and clear examples. The EMA taskforce and the MRCT Center of Brigham and Women’s Hospital and Harvard are aligned to create global, health-literate guidance and templates.

SHAPING THE EXTERNAL ENVIRONMENT–BEST PRACTICES FOR INDUSTRY

We continue to partner with academia to create a new approach to the development and testing of patient product labeling for new molecules. The purpose of the collaboration is to demonstrate improved patient understanding and use by optimizing the development and testing processes. The collaboration is between leaders in the field of health literacy at Northwestern University and Emory University and a cross-divisional team at our company, and addresses labeling, legal and regulatory policy. Best practices from the field of health literacy and patient feedback are incorporated throughout the development of patient labeling for new molecules. Patient input is provided several times: in focus groups during the initial development, and later to confirm comprehension of the final draft label for FDA submission.

Notably, our past approach included conducting market research across a broad range of education levels; however, few of the respondents who presented had limited health literacy. Such candidates are harder to locate, are less likely to participate and are not represented adequately in the databases of market research agencies serving the pharmaceutical industry. Northwestern University and Emory University helped us apply best practices from the field of health literacy to secure these respondents. This process has consistently achieved strong comprehension in respondents with both limited and adequate health literacy (90 percent or better in both groups in qualitative research). In March 2016, we published this innovative approach in Quirks, a magazine for market researchers. This was the first article ever in Quirks about health literacy, and generated significant interest. Our commitment to health literacy in patient labeling is also highlighted on the National Academies Health Literacy Roundtable website in a member spotlight here.

We received the 2016 health literacy research award from the Institute for Health Advancement for our patient labeling work. This was a noteworthy achievement, as it indicated a best practice not just for the industry, but also for the field of health literacy.

Importantly, we had our first two health-literate patient labels approved by the FDA, a key milestone both for patients, and as a model for others in the industry.

SHAPING OUR INTERNAL ENVIRONMENT

Health literacy is about the ability to deliver patient communications in an understandable and actionable way. We work to integrate health literacy principles into our patient-education materials. We launched an internal training program in late 2014, providing clear instructions to the creators of materials on how to implement health-literacy best practices. These best practices are derived from recent research in the field of health literacy, as well as from feedback we have already received from health care providers and patients themselves. Although this training was designed for creators of patient education in the U.S., it was widely used by employees in other divisions and countries in 2015.

We lead the industry in our commitment of resources to health literacy, with a full-time position dedicated to it; a special assignee working as a health literacy reviewer for patient education nearly full-time; and a market researcher spending about half her time on health literacy. There are many other champions across the company who have embraced health literacy and lead efforts within their own departments, including our manufacturing and research divisions. Although many pharmaceutical companies recognize the importance of health literacy, and have professionals who focus on health literacy as part of their responsibilities, we are one of only two companies in the pharmaceutical industry with a person fully dedicated to health literacy, working both inside and outside of our company to effect change.

DEMONSTRATING SCIENTIFIC EXCELLENCE

In 2013, we launched the Investigator Studies Program (MISP), focused on health literacy, diversity and adherence. This was the first program of its kind at our company that was not specific to a therapeutic area. Additional studies were funded in 2015, demonstrating our strong commitment to this subject.

In 2013, we partnered with Northwestern Medicine, Walgreens and Alliance of Chicago community health centers to collaborate on a study with a deceptively simple goal: to provide clear instructions on prescription medicine labels so patients don’t make mistakes or overcomplicate taking their daily medications. In 2014, the electronic health record (EHR) and pharmacy systems were designed to support the study, and pharmacists and prescribers were trained. Patient enrollment began in 2015 and continued into 2016. It is a three-arm, physician-randomized “pragmatic trial” using usual care (control); UMS with EHR tools; and UMS, EHR tools and SMS text reminders for the first seven days following a new or changed prescription. The primary outcomes include self-management knowledge, prescription adherence, and measures of blood sugar control and blood pressure. Initial results are anticipated in late 2016.

To advance key discussions in health literacy, we were part of a small group of NAM Health Literacy Roundtable members who authored two perspective papers in early 2016, “Strategies to Enhance Numeracy Skills” and “Considerations for a New Definition of Health Literacy.” They were well received, and by mid-2016 ranked among the top 15 most popular perspective papers ever published by the Institute of Medicine/National Academies.

1 Koh HK, et al. “New Federal Policy Initiatives to Boost Health Literacy Can Help the Nation Move Beyond the Cycle of Costly ‘Crisis Care.’” Health Affairs. 2012;31(2):434–443.

2 U.S. Department of Health and Human Services (HHS). “Quick Guide to Health Literacy.” Fact Sheet. Basics. Available at https://health.gov/communication/literacy/quickguide/factsbasic.htm. Accessed: June 1, 2013.
Global Initiatives

We collaborate with various stakeholders in policy development for health literacy and support programs that improve the health literacy levels of citizens and patients.

In the EU, we do so together with European associations of physicians, pharmacists, nurses, patients and policy makers from the European Parliament and other EU institutions.1 Our vision in Europe is to ensure citizen- and patient-centered health systems. Health literacy is a key enabler for citizens and patients to take an active role with regard to their health. In addition, health literacy activities lead to better “readable” health systems where patients can easily navigate and receive the care needed.2 Empowered citizens and readable health systems contribute to better health and more efficient health care.

We have been engaging in Europe with various stakeholders such as the European Commission, the European Parliament, patients, physicians, and pharmacy and nurse associations toward those goals. Health literacy has gained attention among policy makers across Europe. Both the conclusions of the Council of the European Union and the “Riga Roadmap”—a joint declaration by industry, civil society and patient organizations refer to the importance of health literacy.2,3


Austria

Make the Good Choice—Fight Diabetes

Unlike many other diseases, diabetes is complex and therefore difficult to manage for patients. Managing diabetes consists of many components such as nutritional management, physical activity, medication, glucose monitoring, and psychosocial adjustment. In the fall of 2014, MSD Austria and the Austrian Pharmacist Association set up a program to enhance diabetes awareness, prevention and scaling-up of treatment. In collaboration with the Austrian Diabetes Society, a scientific guidance for screening and counselling for pharmacists was developed.

In May 2015, all customers in pharmacies were invited to monitor their glucose levels. People with pre-diabetes levels (34.8 percent) received a free consultation and advice materials, and were encouraged to increase their physical activity and improve their nutritional habits. People with a stage of clinically manifested type-2-diabetes (9.5 percent) were encouraged to see a physician. Follow-up meetings with all identified-risk patients were arranged after three months.

Eighty-five percent showed up and had their HbA1c levels monitored again. Nearly half of the risk population (45.6 percent) had reduced their glucose levels to normal as a result of their lifestyle modifications. To enhance the existing data quality and improve the screening options, the project will be adopted and rolled out by the Austrian Social Insurance Authority for Business (SVA) in 2016.

Health Literacy Migrant Survey Austria 2015

Improving health literacy is one of the health targets of Austria in the context of the Federal Framework of Health Objectives. However, despite that recognition, there were still knowledge gaps in 2015. Little to no reliable data were available on the health literacy of important immigrant groups in Austria, whereas important findings from the education and health sectors indicated that immigrants in general, and non-EU immigrants in particular, had to be considered as vulnerable groups. That was one of the reasons for initiating the Health Literacy Migrant Survey in Austria, of which we were a part.

The objectives of the study were to collect qualitative and quantitative health-literacy data on immigrant groups in Austria, and to compare the health literacy of non-EU immigrants with each other and with the general Austrian population. A project-advisory board had been created in addition to the Project Steering Committee, comprising representatives from the Federal Ministry of Health; the Ministry of Labour; Social Affairs and Consumer Protection; the State Secretariat for Integration; City of Vienna; Volkshilfe Austria; and immigrant groups. The Project Steering Committee consisted of the Austrian Social Security Body, the Austrian Health Institute (MoH) and MSD Austria. The successful collaboration and the data generated provided relevant information for decision makers and stakeholders in the health sector and health policy, and have gained increasing importance with regard to the current migrant crisis in the European Union.

Belgium

Well Done–MSD Health Literacy Awards 2015

The Well Done–MSD Health Literacy Awards recognize and reward projects in Belgian and Luxembourg that make a significant contribution to the health literacy of citizens. This project involves close collaboration between MSD and key stakeholders, including patients and health care practitioner (HCP) associations, sick funds, members of parliament, and the National Institute for Health and Disability Insurance.

The 2015 edition resulted in 52 health-literacy projects (an increase of more than 40 percent since 2014) that were analyzed, from which three were selected for the First Line, Specialty Care and Community Awards of €3,000 each. This initiative opened up a lot of opportunities for collaborating with important stakeholders and showed MSD’s commitment to health literacy, a topic that is high on the Belgian political agenda. See more information on this initiative here.

Belgian Health Literacy Survey 2015

MSD Belgium initiated a survey in 2015 to assess the perception of the health literacy level of chronic patients with hypertension, diabetes or asthma. For this survey, conducted by Professor Stephan Van den Broucke, a renowned health-literacy expert from the Université Catholique de Louvain, 450 patients and 360 HCPs were interviewed.

It concluded that patients have a better perception of their health literacy levels than do HCPs. The pharmacist, after the physician, is a very important source of information for the patient. Thirty-four percent of the patients interviewed also report consulting other information sources (e.g., internet), but to a much lesser extent than physicians think. The study also reveals that patients with a better health literacy level are more compliant with the advice and guidelines they receive from their physician.

Germany

MiMi Diabetes

MSD has been supporting the migrants project MiMi (“With Migrants for Migrants”), founded by the Ethno-Medical Center in Hannover, Germany, since 2012. The MiMi project builds on two pillars: German-speaking migrants are trained on health care issues and learn to teach other migrants in their mother tongue, and the organization publishes multilingual guides (e.g., in Arabic, Russian, Turkish, English) on those topics. MSD and the Ethno-Medical Center started cooperating on diabetes and broadened its focus to maternal health in 2014. In 2015, in an initiative by the MSD sales forces, MSD and the Ethno-Medical Center organized an informational event for physicians titled, “Diabetes in Different Cultures.” Ramazan Salman, founder of the Ethno-Medical Center, spoke at various MSD events about the importance of culture-specific health care and a healthy integration of migrants.

In 2015, the Ethno-Medical Center opened its first office in the metropolitan region Rhein-Neckar (including the cities of Mannheim, Ludwigshafen, Heidelberg)—a region notable for its high number of migrants and refugees. In November 2015, the organization started training German-speaking migrants on the topic of maternal health. Most of the participants already work as health care professionals, teachers or coaches, and many of them are also engaged in German refugee aid—some of them on a voluntary basis, others full-time. After their training, these coaches will start to teach other migrants in their mother tongue about maternal health.

Scabies Outbreaks: Providing Access to STROMECTOL®

In 2015, Europe, and especially Germany, faced a huge number of refugees seeking asylum who were at increased risk for easily spreadable diseases such as scabies. In this context, German authorities asked MSD to provide people with access to STROMECTOL®. MSD Germany not only helped to make the product accessible—it was only approved in the Netherlands and France—but also provided product-specific and patient-relevant information which was translated into several languages (including Turkish, Farsi, English). Consequently, refugees were granted access to important health care information.

Drug Safety in Oncology

In recent years, major breakthroughs have been achieved in the field of oncology—offering cancer patients and their families new hope. Nevertheless, these innovations also require adequate education. MSD created educational materials that were discussed with patient organizations and physicians’ associations. In addition, the materials were translated into English, Russian and Turkish.

Patient-Friendly Package Inserts

Since 2009, MSD Germany has been cooperating with patient and senior organizations to adjust its package inserts for better comprehensibility, readability and patient-friendliness in order to enhance patients’ adherence and health outcomes. In 2015, MSD entered a dialogue with the Minister of Social, Health, Women, and Family in the German state of Saarland on the importance of adjusting package inserts. While MSD shared its experience on the process of adjusting, Minister Bachmann called for a corresponding initiative in the upper German parliamentary chamber, the Bundesrat.

German Coalition for Patient Safety

MSD has been a member of the German Coalition for Patient Safety since 2010. The coalition aims at improving safety in health care, and collaborates with professional and patient associations, societies, insurance organizations, self-governmental bodies, and research institutions. The Federal Ministry of Health is one of the organization's sponsors, and the German Minister of Health, Hermann Gröhe, has offered his patronage. In 2015, the organization celebrated two special occasions: its 10th anniversary and the first International Day of Patient Safety, which focused on “Hygiene and the Prevention of Infections.” MSD supported this day of action with an awareness campaign for its employees.

Hungary

HLS.HU

One out of two Hungarians has insufficient health literacy levels, according to industry-supported health literacy research. Under the leadership of MSD, the Association of International Pharmaceutical Manufacturers (AIPM) created a separate working group on health literacy with the purpose of replicating the European Health Literacy Survey (HLS.EU). The data were presented in Brussels in late autumn 2015 and in a subsequent large press event in Budapest. As a next step, the working group is providing education on the findings and engaging with stakeholders across governmental and professional bodies, as well as patient associations.

In addition, health literacy appears not to be on the public health agenda, nor does the term “health literacy” exist in Hungarian. To close this gap, a reference group has been initiated consisting of representatives from all relevant stakeholders to help guide future activities and initiatives. Building on experience from Belgium, a Health Literacy Award was announced by AIPM in late May 2016, and health literacy topics will be introduced at all relevant professional congresses.

Ireland

Accredited Health Literacy–Friendly Pharmacies and General Practices

In 2015, MSD in Ireland launched the Crystal Clear Mark and Audit Programme, the first independent accreditation for “health literacy–friendly” general practices and pharmacies. MSD, the National Adult Literacy Agency (NALA), the Irish Pharmacy Union and the Irish Department of Health partnered to launch the Crystal Clear Pharmacy and GP Audit Programme, which allows pharmacies and general practices to apply for a quality mark recognizing their health care setting as health literacy–friendly. The program includes online education for health care professionals and an online self-completion audit that is subsequently assessed by NALA health literacy experts.

Following successful completion of the audit, the health care setting is awarded the Crystal Clear Mark. Feedback from customers on this program has been very positive, as it puts patients’ needs at the very center of how their service is delivered. The program also encourages continuing education and helps pharmacies differentiate their business. The NALA plans to extend this program to other setting such as hospitals, social welfare offices and citizen advice bureaus.

Italy

Volere Non Basta (“Asking for Something Is Not Enough”)

In 2015, the Fondazione MSD, in partnership with Rome Sapienza University and Milan Engineering School, designed and sponsored a long-term educational plan to train patients to communicate in an effective way and to be able to use empowerment tools appropriately. The program is based on patient associations’ emerging needs to be heard more clearly through media and to act as protagonists in their own “patient journey” as well as in the policy decision-making process.

The 2016 edition will be implemented in partnership with the Italian Observatory of Narrative Medicine (OMNI) and the Center for Digital Health Humanities, under the aegis of National Institute of Health. Its focus will be digital narrative medicine as a way to exploit digital technologies to improve patient-physician communication and to reach better health results.

Il Sole per Amico (“The Sun as a Friend”) and Meglio Smettere (“Stop smoking is better”)

Both are important awareness campaigns, supported by MSD, in collaboration with scientific society and patient associations to promote primary prevention. The first, promoted by The Italian Melanoma Intergroup under the patronage of the Ministries of Health and Education, is on melanoma’s primary prevention and involves 130 schools throughout Italy, a major event at the parliamentary level, a national press conference, and seven regional press conferences resulting in impressive media coverage (>130 million contacts).

The second, in partnership with the Italian Association of Medical Oncology (AIOM) under the aegis of the Ministries of Health, is aimed at making the younger population aware of the risks to health posed by cigarettes. The campaign, featuring a famous testimonial by the 2015 U.S. Open winner Flavia Pennetta, will be launched at an institutional event, and includes a social media plan to better address the target population.

Ora Che Mi Ci Fai Pensare (“Now That You’ve Got Me Thinking”)

“Ora Che Mi Ci Fai Pensare” focuses on the impact of therapy on patients suffering from inflammatory bowel disease (IBD) and on their quality of life. It was launched in February 2015 and developed by Italian and European patients’ associations, the Italian Scientific Society for Gastroenterology (IG-IBD) and MSD Italy. It consists of a short movie made up of patients’ self-shot videos. There have been over 10,000 views on YouTube/Vimeo and Facebook (Amici Onlus and IG-IBD Facebook accounts) and more than 500 “likes”. The short movie “Now That You’ve Got Me Thinking” will be presented in several short-movie festivals throughout Italy in 2016.

“LOVE IT”

Education through information was the objective of “LOVE IT,” a 360-degree cross-media campaign with the Italian Society of Gynecology and Obstetrics (SIGO), leveraging Italian “The Pill Without a Pill” campaign actions and aimed at creating a cultural movement on contraception.

Portugal

Women’s Choice

The latest Portuguese report on pregnancy interruptions showed that 97 percent of abortions occur as a result of women’s choice and are not due to medical-related issues. Having no contraception or the wrong contraception is a circumstance that largely contributes to these statistics. Oral contraceptives are used by 58 percent of women, but 60 percent of them admit forgetting to take it at least once in the last three months, showing that a daily contraceptive is not suitable for all women. The report also revealed that the Internet is the third source where women seek information about contraception, after primary-care physicians and gynecologists.

This was the first website exclusively for contraception in Portugal, created to reflect MSD´s vision of women´s health: contraceptive choices adapted to each woman’s lifestyle. It is part of a digital patient education program of the Contraception Medical Society and Family Planning Association. The website is for women to learn about the pros and cons of contraceptive methods, and includes quizzes, videos and interactive tools. In 2015 alone it generated 10 million visits.

Prevent and Optimize Diabetes Treatment

Knowledge is a powerful tool to prevent and optimize diabetes treatment. But knowledge is relevant not only for people living with diabetes, their families and their informal caregivers, but also for people with little or no current link to diabetes. This site was developed to inform people about how to prevent and manage the disease. It serves as a tool for empowerment, which is a critical component of diabetes management.

Switzerland

Action Guide on Health Literacy

In 2015, the Swiss Health Literacy Alliance developed an “Action Guide” (in both German and French) to support health care stakeholders in putting health literacy into practice. The “Action Guide” presents key facts and figures about health literacy in a reader-friendly way, describes some best-practice projects, and closes with a list of success factors for implementing such initiatives. In addition, the Alliance, of which MSD Switzerland is a founding member, published a report on the status of and perspectives on health literacy in Switzerland in collaboration with the Swiss Academy of Medical Sciences (SAMW). Both publications were presented at a Health Literacy Symposium in December 2015 organized by the Alliance and the SAMW.

KOMEKON

KOMEKON provides comprehensive health-related services to physician networks. The program consists of compelling health literacy courses and events for diabetes patients, combining an integrated treatment approach with interactive patient care. The program was jointly developed by PizolCare, a local physician network, and MSD Switzerland. Networks across Switzerland are now following the example of PizolCare, with MSD Switzerland facilitating implementation of the project. KOMEKON has gained the support of one of the health insurance systems, and others will hopefully follow suit.

1 European Health Forum Gastein: EHFG 2013: New Consensus Paper calls for EU action on health literacy; Bad Hofgastein 2013; http://www.ehfg.org/health-literacy.html. Accessed: March 16, 2015.
2 http://rigahealthconference2015.eu/wp-content/uploads/2015/08/Riga-Roadmap-download-FINAL.pdf. Accessed: May 13, 2016.
3 http://data.consilium.europa.eu/doc/document/ST-14393-2015-INIT/en/pdf. Accessed: May 13, 2016.