Summary
India's most unique pain measuring tool- PAIN-SMART- If patients could measure pain, they could track improvement leading to improved adherence.
Challenge
Chronic Pancreatitis patients preferred quick acting pain killers over the safe antioxidant therapy like Antoxipan. *Italian Consensus Guidelines 2010, IAP - APA - JPS - EPC Consensus Guidelines 2017 & 2018, ACG Clinical Guideline 2020, and NEJM Clinical Practice Guideline 2022
Objective
CHRONIC PANCREATITIS – A PAIN THAT NEVER LEAVES Pain is a prominent and often debilitating symptom of chronic pancreatitis. Patients often describe it as excruciating, stabbing or gnawing kind of pain. ~97% of patients suffer from it and is the main reason for hospitalization. Nearly 60% of these patients suffer from persistent pain which affects their quality of life. Even eating seems like a big challenge! They often avoid regular meals for fear of the pain associated with something as basic as eating! ANTIOXIDANT THERAPY - WIDELY RECOMMENDED, BUT NOT WIDELY ADOPTED! Several leading international guidelines* recommend antioxidant therapy to treat pain. It is the oxidative stress and prolonged inflammation that lead to intense frequent episodes of pain and antioxidants primarily work on the root cause. They are proven to be safe and effective for long-term use. However, it is a much slower therapy, and it takes a few months to see visible and lasting results. And the pain in chronic pancreatitis is so unbearable that the patients get impatient and seek a quick fix with fast-acting painkillers.
Strategy
THE FACTS THAT WE WERE WORKING WITH: Today's world prioritizes immediate relief over treating root cause and thus opted for fast acting painkillers Pain is the most individual and subjective symptom! It differs from person to person, time-to-time Antioxidants work on the root cause of pain but nobody believed it as it was slow acting There was no proof of concept that the Antioxidant therapy is working ! OUR INSIGHT: THE MOST CHALLENGING PART OF PAIN MANAGEMENT WAS ACTUALLY ‘MEASURING PAIN' We took inspiration from the old proverb- See it to believe it. People will start believing in a therapy when they see it's benefits. We knew that if patients could measure pain we could improve their adherence to antioxidant therapy. In order to create trust in the antioxidant therapy (Antoxipan), we needed to enable patients to make pain tangible and quantifiable. We needed to document the decreasing pain levels so that patients adhere to Antoxipan!
Data
The most challenging part of pain management was actually ‘measuring pain' as pain is a very subjective symptom.
Solution
Results
Antioxidants independently has a huge market size and enjoys usage across multiple indications. However, 'Pancreatic Pain Management Antioxidants'- specific to pain association was seeing only incremental increase YoY. This meant, doctors were not really adopting antioxidants as a choice of drug for managing pain in pancreatitis. We looked at how this PainSMART tool shaped the category, how it influenced the prescription behaviour of doctors, how sales of Antoxipan were postively affected and lastly but most importantly, how doctors associated Antoxipan whenever they thought of PAIN. This tool really helped in redefining the Pancreatic Pain Management category and role of antioxidants.
