Ensuring New Medical Devices Fit Into Patients’ Lives – A Case Study

By Joern Kleebach, Division Manager, and Miriam Maylaender, Senior Research Consultant

When new medical devices are developed, one key question our clients ask us to answer is: Will patients accept the new medical device?

A realistic picture of acceptance only develops over time

Acceptance of a new product does not happen immediately after first exposure, rather it is a long-term construct, influenced by many factors, that develops over days, weeks and sometimes even months. The initial interaction with a new device enables patients to assess it and even its potential acceptability, but it’s only the very first impression or the handling ability that can be captured at this time. True acceptance can only develop when patients have the possibility of becoming familiar with the new medical device, once it is built into their daily lives where it needs to prove itself. It is only with time that real acceptance will develop.

A single snapshot measurement is therefore too narrow, and we would miss relevant aspects that play a role when the device is incorporated into a patient’s daily life. To do justice to the construct of acceptance and in order to deliver a reliable answer to our clients, we, as market researchers, have to investigate how patients integrate a new device into their daily routines and whether and how they get used to it over time. This sheds light on how acceptance develops and uncovers the reasons for it.

Last year our research team was approached with such an acceptance question by a client: Will patients accept a new medical device to administer a daily medication?

Thinking beyond traditional approaches

Our research team’s first thought was that an ethnographical approach would be the methodology of choice to evaluate whether the new medical device really fits into patients’ routines. Ethnography allows researchers to observe and interview respondents in the context of their daily lives. It provides an in-depth understanding of beliefs, behaviors, needs and motivations and therefore a rich and meaningful picture of how patients build a new product into their lives and how acceptance takes shape.

From past experiences, the team estimated that an adequate time frame to assess real acceptance of a device patients use once or twice daily is 10 days. Ethnographers would have to accompany patients for this time period to get to the quintessence of the business question. In practice, however, this would be an expensive and elaborate procedure that also creates a tremendous intervention into respondents’ lives. Being observed by a person throughout the entire day might lead to a bias in behavior that misses spontaneous reactions and rather leads to socially desirable response patterns. Therefore, our research team realized that there is a need for a different methodological approach.

Nowadays, digital technologies can meet this need. The Internet has become a familiar environment that is used routinely and intuitively and accompanies many patients of all age groups throughout the day. Therefore, in close collaboration with our client, we created an innovative methodological approach by adapting traditional tools and by combining different methodologies and channels.

Robust data and real-life insights gathered in a qualitative multistep approach




Phase I - Initial Reaction: Our fieldwork kicked off with personal in-depth interviews with patients in central locations. This gave a sound foundation for our project as it provided an in-depth understanding of patients’ device history and the role of the current product used. Furthermore, patients were exposed to the new product for the first time to independently evaluate the handling and to assess the medical device. Neither active substance nor placebo was used at any time of the handling for legal reasons. The interview also served as a standardized training so that all patients had the same background when entering Phase II.

Phase II - “Real Life” Experience: After patients’ initial reactions were captured, the respondents were sent home equipped with everything they needed for a 10-day mock usage of the new medical device, which had to be used in addition to their regular medication administered with the current device. Patients used it once a day as per the medication’s envisaged label.

During this handling period, online bulletin boards, in which patients had to participate for 15 minutes every day, were used to capture practical experiences. Patients had to answer questions about daily usage routines and problems they encountered with the device, and had to explain how the new product was being integrated into their daily activities. Additionally, challenges were posted that put patients into different hypothetical situations with the medical device, e.g., usage in public, going on vacation, emergency situations. Moreover, patients could post pictures and exchange ideas with each other. The interactive bulletin boards proved to be a stimulating platform to develop great ideas for improving the device.

Some questions were answered by lively text accounts, others through posting of photos of daily situations, e.g., where the device is kept, how it is transported. Participants also uploaded illustrations depicting their suggestions for improvement or suggestions for easier storage. This mix of different exercises ensured high emotional involvement of the respondents and therefore provided the research team with a tangible and in-depth understanding of how the device was practically integrated into patients’ lives and whether and how patients became used to using it. The results provided rich in-depth insights that enabled the team to derive strategic recommendations and suggestions for improvement that mirrored patients’ needs.



Phase III - Feedback: Following the 10-day “real life” experience, all respondents were invited back to central locations to share and discuss their experiences in focus groups. The in-home usage of the device was assessed in detail and specific aspects uncovered during the OBBs were debated. At the end of the focus groups, participants had to return the test devices. This last research step gave additional insights into the level of attachment developed during the real-life experience.

The business question could thus be answered comprehensively: Patients would definitely accept the new medical device. Furthermore, we were able to track how acceptance developed over time and were able to illustrate this with many vivid examples. Some participants were hesitant about the new device at the beginning of the study, as they considered the handling to be complicated and time consuming. Over time, however, those patients got familiar with the product and integrated it into their daily activities. At the end they could easily use the device and at the same speed as their regular one. Other patients were enthusiastic at the beginning, but when the test device had to prove itself in daily situations they couldn’t see any difference compared with their current product. Overall, it could be observed that acceptance of the new device was balanced out and resulted in a daily routine. “The initial complicated procedure is getting easier and easier. It is as if I never used another device before.” – German patient.

High emotional involvement of all parties contributed to a rich outcome

For the business question our research team was facing, this approach was certainly the right choice. It not only delivered a snapshot but also more long-term data that tracks how acceptance develops. This methodology avoided the tremendous intervention into patients’ lives that often accompanies traditional ethnographic research approaches. Of course the responses were based on self-reporting and not on objective observations, but in OBBs participants were protected by pseudonyms that facilitated truthful responses.

The online platform could indeed deliver the qualitative insights that were required. Participants were engaged in different tasks that brought us into their world through vivid quotes and pictures describing challenges and triumphs with the new device. They could answer questions independently, but also engage in peer discussions, which was beneficial for idea generation. Questions and challenges in OBBs could be adapted every day in close collaboration with the client to react flexibly on findings. Through different questioning techniques and a new perspective on a familiar topic, this approach created high involvement among all stakeholders. For respondents, clients and researchers it was a valuable and fun project that generated a rich and meaningful outcome.

For us, the agency and the client, this study proved that it is worthwhile to think out of the box – to be encouraged to adapt existing, traditional methodologies to better meet the clients’ needs.

Add another perspective

Of course there are many possible ways to adapt and supplement this type of research approach according to clients’ demands. In our study we specifically added a second perspective – namely that of the physicians. Would they prescribe the new medical device?

In order to answer this question we added focus groups with doctors that complemented and added value to our approach. After a first group assessment of the device, physicians observed the patient group discussions we conducted. Then they went back to the focus group with colleagues to discuss and evaluate what they heard and how this would influence their prescribing. This additional step ensured that real patient feedback was taken into account in physicians’ decision processes. Listening to patient groups was a valuable experience for physicians. It increased their emotional engagement and they reported that they got something more out of their participation. Overall, it was a new perspective for physicians and researchers that helped bring to light some very interesting insights.