Patient chart tracking studies are typically used when secondary prescription data is not available or when it does not contain the information needed.

• Secondary prescription data are not available
  Typically, if secondary prescription data is not available for a brand, it's because the product is not distributed to patients by a pharmacy. In this situation, a pharmaceutical company can turn to a tracking study using patient charts to monitor the performance of its brand in the marketplace over time.
• Prescription data does not contain the information needed
  Prescription data from pharmacies, managed care plans, and other sources can tell a company how much product it's sold; but when used exclusively, this information limits marketers' perspective of the market. By examining secondary prescription data in conjunction with patient charts, researchers gain a more comprehensive look into prescribing behavior. For example, patient charts can complement secondary data by providing data such as patient demographics, condition severity, patient requesting trends, specific diagnoses (not included in ICD-9 codes), etc. Among other things, this approach helps brand teams track the effectiveness of a promotional campaign and redirect efforts appropriately.

Common Methodologies:
One of the most pivotal decisions to be made for a patient chart tracking study is whether the charts will be examined through a prospective or retrospective approach. When researchers use a prospective methodology, physicians are asked to put aside patient charts from the time they are recruited for the study until their chart quotas are met. For example, a physician might be asked to put aside charts for the next five patients (s)he sees in the office that have a specific condition or were initiated on a specific brand. In contrast, researchers using a retrospective approach recruit physicians to pull charts for patients who have already been seen in the office. This means, physicians participating in a study using a retrospective approach are asked to pull charts for the most recent five patients that they saw in their office and had a specific condition or were initiated on a specific brand. There are merits to each of these methodologies, but a retrospective approach usually provides more accurate information for products that are already in the market, because:

• Physicians are likely to recall their thoughts at the time they made the decision to initiate the therapy.
• The decision to initiate a patient on the brand is not biased by the research.
• The type of clinical information that is gathered to make the prescribing decision is not influenced by the study.

Selection of a methodology will impact how to weight data appropriately to represent the actual market. For example, with a prospective view, physicians need to disclose how many patients they saw before they were able to complete their quota. Physicians who reach their quota faster should be weighted higher because they represent a larger portion of the market than physicians who took longer. Similarly, in a retrospective view, researchers need to know how many patients were seen during the time period in which participating physicians pulled charts.

Research participants for patient chart tracking studies are typically recruited using a phone-to-web methodology—similar to a strategic quantitative study. That is, qualified physicians are asked to reference a set number of patient records that meet a certain set of requirements, and they answer a battery of questions that reference those particular patients. Developing the right criteria for which patient charts to pull for the study is critical, as the quality of analysis and final results hinges on this description.

To ensure that physicians pull the correct patient charts for your study—and that specific quotas are met for the study—physicians are invited to call a toll-free number to be screened for study participation. A live person walks physicians through the screener questions to find out what charts each physician has available. Qualified physicians are assigned to pull specific charts for the study. A study "prep" sheet is then faxed or mailed to participating physicians to make sure that the right charts are being referenced. Physicians take the actual survey on a password-protected website.

G & S Research can help you determine the best approach for your specific research and business objectives.

Deliverables:
Typical with secondary data, the deliverable for a patient chart tracking study can monitor changes in use over time. It is common to have two types of deliverables for this type of study: a dashboard and a detailed report.

The detailed report will look similar to reports provided in other tracking studies, while a dashboard will be a custom-made summary of your market. Typically a dashboard is an Excel worksheet or a PowerPoint slide that provides the most important data being tracked over time. The dashboard can be populated and available a few days after data collection. A final report often takes several weeks to complete.

Application of Findings:
Findings from patient chart tracking studies can be used to monitor and test a business strategy's effectiveness in the field.