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Respondent demographics, n ¼ 427 (%) n (%)
Source publication
A 68-question Internet survey was used to determine the impact of televised direct-to-consumer advertising (DTCA) on consumer-initiated medication changes for the treatment of gastroesophageal reflux disease (GERD) and social anxiety disorder (SAD). Of the 427 respondents, 10% that viewed DTCA for GERD and 6% that viewed DTCA for SAD reported that...
Context in source publication
Context 1
... to this survey were broadly reflective of the population of Internet-mediated health seekers in that they are more likely to be female, educated, and affluent compared with the general population ( Dutta-Bergman, 2004;Spooner, Meredith, & Rainie, 2003). Full demographic data are shown in Table 1. ...
Citations
... One study estimates that up to 10% of survey respondents who had viewed DCTA for GERD initiated a conversation that often resulted in a change of therapy. 25 This form of advertising also has direct impacts on health literacy. One study evaluated the impact of DCTA advertising on public knowledge of GERD, during which a mock advertisement about GERD and proton pump inhibitors was shown to participants in public venues. ...
Objective
To assess for differences of intended meaning in the description of reflux‐related symptoms among otolaryngology patients and clinicians.
Study Design
Cross‐sectional survey‐based study.
Setting
Five tertiary, academic otolaryngology practices.
Methods
Between June 2020 and July 2022, a questionnaire consisting of 20 common descriptors of reflux‐related symptoms within four domains (throat‐, chest‐, stomach‐, and sensory‐related symptoms) was completed by patients. Attending otolaryngologists at five academic medical centers then completed the same survey. The primary outcome was to assess differences in patient and clinician perceptions of reflux‐related symptoms. Differences based on geographic location was a secondary outcome.
Results
A total of 324 patients and 27 otolaryngologists participated. Patients selected a median of six terms compared with 10.5 for otolaryngologists (p < .001). Otolaryngologists were more likely to select sensory symptoms (difference: 35.8%; 95% confidence interval [CI]: 19.2%, 52.4%), throat‐related symptoms (32.4%; 21.2, 43.6%), and chest‐related symptoms (12.4%; 8.8, 15.9). Otolaryngologists and patients were equally likely to consider stomach symptoms as related to reflux (4.0%, −3.7%, 11.7%). No significant differences were identified based on geographic location.
Conclusion
There are differences between otolaryngologists and their patients in the interpretation of the symptoms of reflux. Patients tended to have a narrower interpretation of reflux with symptoms primarily limited to classic stomach‐related symptoms, while clinicians tended to have a broader definition of reflux that included extra‐esophageal manifestations of disease. This has important counseling implications for the clinician, as patients presenting with reflux symptoms may not comprehend the relationship of those symptoms to reflux disease.
... Third, social desirability bias may have influenced our findings as respondents may have been reluctant to report they successfully convinced their provider to prescribe them their requested drug. Additionally, we reported a slightly higher rate of respondents seeing an advertisement for the fictitious medication than previously reported (up to 5.6%), but the rate was still overall low [20,21].This could potentially reflect a small error rate in recognizing other medications such as the biologic agents and/or a component of acquiescence response bias. Finally, IBD providers were not surveyed in our study. ...
IntroductionWith an increasing number of available therapies for inflammatory bowel disease (IBD), little is known about patients’ attitudes regarding IBD-related direct-to-consumer advertising (IBD-DTCA) and its impact on treatment decisions in clinical practice.Methods
We administered a 58-item, mailed questionnaire to patients with IBD receiving Gastroenterology subspecialty care at a large academic health system. The survey assessed patient awareness and perception of IBD-DTCA and its effect on IBD treatment discussions and decisions. We used bivariate analysis to evaluate patient-level factors associated with awareness and favorable perception of IBD-DTCA.ResultsWe achieved a response rate of 15.2% (n = 226 of 1486). Most patients (93.3%) reported awareness of IBD-DTCA, with adalimumab receiving the most exposure. A majority of respondents reported IBD-DTCA made them more aware of treatments they otherwise would not know about (53.6%), provided information in a balanced manner (63.5%), and taught them about new potential risks and side effects (64.5%). Patients without a college degree and those with a household income less than $75 k per year perceived IBD-DTCA more favorably. However, IBD-DTCA rarely changed IBD management, with only 7.6% of respondents having a discussion with their provider about the advertised drug and only two (0.9%) being initiated on the advertised drug.ConclusionIBD patients were aware of IBD-DTCA and perceived it favorably; however, IBD-DTCA rarely led to patient-provider discussions or changes in treatment regimen.
... Of these patients, 39% asked for a specific brand of drug, and of these, about half reported that they received the drug they had asked about (Aikin et al., 2004). More than half of respondents in the previously described study by Murray et al. (2004) reported having requested at least one medical intervention from their Aikin et al., 2004;Allison-Ottey et al., 2002;Allison-Ottey et al., 2003;Avorn, Chen, & Hartley, 1982;Bell, Kravitz, & Wilkes, 1999;Bell et al., 2010;Bhanji et al., 2008;Brodie, 2001;DeLorme, Huh, & Reid, 2006;Dens, Eagle, & De Pelsmacker, 2008;Deshpande, Menon, Perri, & Zinkhan, 2004;Dieringer, Kukkamma, Somes, & Shorr, 2011;Duckwitz & Yuan, 2002;Fortuna et al., 2008;Green et al., 2017;Herzenstein et al., 2004;Hoek & Maubach, 2007;Huh et al., 2005;Kelly et al., 2013;Khanfar, Polen, & Clauson, 2009;Krezmien, Wanzer, Servoss, & LaBelle, 2011;Lee, Salmon, & Paek, 2007;Lee & Begley, 2010;Lipsky & Taylor, 1997;Mintzes et al., 2003;Murray et al., 2004;Parnes et al., 2009;Paul et al., 2002;Robinson et al., 2004;Singh & Smith, 2005 Aikin et al., 2004;Bell et al., 1999;Brodie, 2001;DeLorme et al., 2006;Deshpande et al., 2004;Dieringer et al., 2011;Hoek & Maubach, 2007;Huh et al., 2005;Khanfar et al., 2009;Krezmien et al., 2011;Lee et al., 2007;Lee & Begley, 2010;Murray et al., 2004;Robinson et al., 2004;Singh & Smith, 2005;Sumpradit et al., 2002;Weissman et al., 2003 Aikin et al., 2004;Allison-Ottey et al., 2002;Avorn et al., 1982;Bhanji et al., 2008;Dens et al., 2008;Duckwitz & Yuan, 2002;Fortuna et al., 2008;Kelly et al., 2013;Kravitz et al., 2005;Lipsky & Taylor, 1997;Mintzes et al., 2003;Parnes et al., 2009;Paul et al., 2002;Robinson et al., 2004;Tentler et al., 2008;Weissman et al., 2004 Other prescribers (nurse practitioners) Aikin et al., 2004;Avorn et al., 1982;Bell et al., 1999;Deshpande et al., 2004;Dieringer et al., 2011;Herzenstein et al., 2004;Lee et al., 2007;Lee & Begley, 2010;Murray et al., 2004;Robinson et al., 2004;Sumpradit et al., 2002;Weissman et al., 2003 physicians as a result of DTCA; most requests were for changes in medications, followed by tests and referrals to specialists for conditions that were described in the DTCA. Of those who made requests, 55% reported receiving the intervention they requested. ...
... Of these patients, 39% asked for a specific brand of drug, and of these, about half reported that they received the drug they had asked about (Aikin et al., 2004). More than half of respondents in the previously described study by Murray et al. (2004) reported having requested at least one medical intervention from their Aikin et al., 2004;Allison-Ottey et al., 2002;Allison-Ottey et al., 2003;Avorn, Chen, & Hartley, 1982;Bell, Kravitz, & Wilkes, 1999;Bell et al., 2010;Bhanji et al., 2008;Brodie, 2001;DeLorme, Huh, & Reid, 2006;Dens, Eagle, & De Pelsmacker, 2008;Deshpande, Menon, Perri, & Zinkhan, 2004;Dieringer, Kukkamma, Somes, & Shorr, 2011;Duckwitz & Yuan, 2002;Fortuna et al., 2008;Green et al., 2017;Herzenstein et al., 2004;Hoek & Maubach, 2007;Huh et al., 2005;Kelly et al., 2013;Khanfar, Polen, & Clauson, 2009;Krezmien, Wanzer, Servoss, & LaBelle, 2011;Lee, Salmon, & Paek, 2007;Lee & Begley, 2010;Lipsky & Taylor, 1997;Mintzes et al., 2003;Murray et al., 2004;Parnes et al., 2009;Paul et al., 2002;Robinson et al., 2004;Singh & Smith, 2005 Aikin et al., 2004;Bell et al., 1999;Brodie, 2001;DeLorme et al., 2006;Deshpande et al., 2004;Dieringer et al., 2011;Hoek & Maubach, 2007;Huh et al., 2005;Khanfar et al., 2009;Krezmien et al., 2011;Lee et al., 2007;Lee & Begley, 2010;Murray et al., 2004;Robinson et al., 2004;Singh & Smith, 2005;Sumpradit et al., 2002;Weissman et al., 2003 Aikin et al., 2004;Allison-Ottey et al., 2002;Avorn et al., 1982;Bhanji et al., 2008;Dens et al., 2008;Duckwitz & Yuan, 2002;Fortuna et al., 2008;Kelly et al., 2013;Kravitz et al., 2005;Lipsky & Taylor, 1997;Mintzes et al., 2003;Parnes et al., 2009;Paul et al., 2002;Robinson et al., 2004;Tentler et al., 2008;Weissman et al., 2004 Other prescribers (nurse practitioners) Aikin et al., 2004;Avorn et al., 1982;Bell et al., 1999;Deshpande et al., 2004;Dieringer et al., 2011;Herzenstein et al., 2004;Lee et al., 2007;Lee & Begley, 2010;Murray et al., 2004;Robinson et al., 2004;Sumpradit et al., 2002;Weissman et al., 2003 physicians as a result of DTCA; most requests were for changes in medications, followed by tests and referrals to specialists for conditions that were described in the DTCA. Of those who made requests, 55% reported receiving the intervention they requested. ...
We systematically reviewed the research on patients’ and prescribers’ perceptions of, and self-reported behaviors prompted by, exposure to direct-to-consumer advertising (DTCA) (For ease of reading we use the term “advertising” to encompass advertising and promotional labeling. Broad use of this term does not imply endorsement by FDA) of prescription drugs that occurs in the context of a clinical encounter. This research offers an important perspective on the broader goal of incorporating patient and prescriber voices in decision-making. Outcomes included patient information seeking, medication adherence, patient requests for DTCA-promoted prescription drugs, prescribing behaviors, and perceptions of the patient–prescriber relationship and interactions. We searched PubMed and other databases from 1982–2017 and identified 38 studies meeting our study criteria. Of these, 24 studies used patient-reported outcomes and 18 used prescriber-reported outcomes (four used both). Studies suggested some potential benefits of exposure to DTCA, including patients’ enhanced information-seeking, increased patient requests for appropriate prescriptions (when addressing potential underuse) and patients’ perceptions of higher-quality interactions with prescribers. Most prescribers perceived a neutral influence on the quality of their clinical interactions with patients regarding DTCA. Harms included patients receiving prescriptions for drugs that were not appropriate for them or that the patients did not need, and the potential for DTCA to interfere with medication adherence in some populations, such as those with mental illness. The potential benefits of DTCA on the patient–provider encounter must be balanced with the potential for harms.
... 6 Despite misgivings, many physicians accede to a patient's medication request. [7][8][9] Whether this varies by patient attributes (such as gender, race/ethnicity and socioeconomic status), physician characteristics (such as gender and years of clinical experience), organizational or practice setting influences remains poorly understood. Research to date is almost entirely observational--usually surveys of patients and physicians with respect to the outcome of a medication request. ...
Background:
Because of internet searches, advice from friends, and pharmaceutical advertising, especially direct-to-consumer advertising, patients are increasingly activated to request medications during a physician encounter.
Objectives:
To estimate the effect of patient requests for medications on physician-prescribing behavior, unconfounded by patient, physician, and practice-setting factors.
Research design:
Two experiments were conducted among 192 primary care physicians, each using different video-based scenarios: an undiagnosed "patient" with symptoms strongly suggesting sciatica, and a "patient" with already diagnosed chronic knee osteoarthritis. Half of patients with sciatica symptoms requested oxycodone, whereas the other half requested something to help with pain. Similarly, half of knee osteoarthritis patients specifically requested celebrex and half requested something to help with pain.
Subjects:
To increase generalizability and ensure sufficient numbers were available, we recruited 192 primary care physicians from 6 US states.
Measures:
The primary outcome was whether physicians would accede to a patient's request for a medication. Alternative pain medications prescribed were secondary outcomes.
Results:
19.8% of sciatica patients requesting oxycodone would receive a prescription for oxycodone, compared with 1% of those making no specific request (P = 0.001). Fifty-three percent of knee osteoarthritis patients requesting celebrex would receive it, compared with 24% of patients making no request (P = 0.001). Patients requesting oxycodone were more likely to receive a strong narcotic (P = 0.001) and less likely to receive a weak narcotic (P = 0.01). Patients requesting celebrex were much less likely to receive a nonselective nonsteroidal anti-inflammatory drugs (P = 0.008). No patient attributes, physician, or organizational factors influenced a physician's willingness to accede to a patient's medication request.
Conclusions:
In both scenarios, activated patient requests for a medication substantially affected physician-prescribing decisions, despite the drawbacks of the requested medications.
... The majority of DTCA communication research focuses on whether DTCA influences patients to inquire specifically about an advertised drug or to request a prescription for the medication from their providers (Aikin et al., 2004; An, 2007; Bell, Wilkes, Kravitz, & others, 1999; Deshpande et al., 2004; Herzenstein et al., 2004; Khanfar, Polen, & Clauson, 2009; A. L. Lee, 2009; Liu et al., 2005; Mendonca, McCaffrey, Banahan, Bentley, & Yang, 2011; Murray et al., 2004). This line of research has important implications for clinical practice because it informs various stakeholders including regulators and health professionals concerned with adverse changes in patientphysician relationships or undue pressure leading to inappropriate prescribing; patients who are exposed to DTCA and receiving prescription treatments they may not need; and advertisers who wish to know if the advertising campaign was effective in generating drug sales. ...
Direct-to-consumer advertising (DTCA) of prescription medications and healthcare facilities has generated much debate over the potential benefits and adverse consequences for the public at large, patients, clinician-patient relationships, and the overall healthcare system. This dissertation is aimed at contributing to this debate through studying the impact of DTCA in the context of cancer treatment. Study 1 assessed the reliability and validity of three candidate measures of patient-reported exposure to cancer-related DTCA across seven criteria. The study found that all three measures performed well in terms of convergent, nomological, discriminant, and face validity. Findings from this study offer support for utilizing these survey measures in future studies targeting cancer patients. Next, Study 2 examined the prevalence and correlates of cancer-related DTCA exposure in a sample of patients in Pennsylvania diagnosed with breast, prostate, or colorectal cancers. On average, patients reported modest exposure to such DTCA (median exposure was once per week). Significant correlates of exposure included cancer type, age, stage of disease, and ethnicity. Study 3 investigated the relationships between DTCA exposure and subsequent information seeking behaviors. The analyses detected a significant association between DTCA exposure and cancer patients' subsequent information engagement with their clinicians at one-year follow-up. Exposure to DTCA was marginally significant in predicting information seeking from non-clinician (lay media and interpersonal) sources. Based on the Integrative Model of Behavioral Prediction, a focused analysis showed a significant indirect path between DTCA exposure and subsequent information seeking from non-clinician sources, mediated through attitudes and intention to seek from these sources. Study 4 was guided by the Structural Influence Model of Communication to explore disparities in health information seeking behaviors arising from DTCA exposure. The study found that the associations between DTCA exposure and active information seeking behaviors were not moderated by patients' age, educational level, race/ethnicity, or cancer type. To conclude, these studies would likely inform the ongoing debate and future research regarding the impact of cancer-related DTCA exposure on communication outcomes and disparities.
... (12) The authors concluded that the average television viewer is exposed to more than 30 hours of direct-toconsumer pharma advertisements per year, far surpassing any exposure to other forms of health communication (12). And, sure enough, the results are clear: The ads have been found to make a positive difference in sales, in requests for specific agents, and in the quality of encounters between doctors and patients (8,11,13). Indeed, about half of primary care physicians and an equal number of patients report that a new prescription had been influenced by a television advertisement (8,11). It is no surprise then that by 2006, the American Medical Association and the American College of Physicians had come out for a complete moratorium or for tighter regulation of the ask-your-doctor advertisements (8). ...
Die weitreichenden Entwicklungen der technischen, ökonomischen und rechtlichen Rahmenbedingungen erhöhen den Kosten- und Innovationsdruck auf das allgemeine Geschäftsmodell der Pharmaindustrie (Kap. 1). Diese richtet sich daher in den Bereichen der Forschung und Entwicklung, der Markteinführung und des Vertriebs neu aus (Kap. 1 und 6 ff.; Camacho 2014, S. 426).
SANDRA ZWIER & ANDRE BOEKHORST Ask your doctor: From prescription drug advertising to physician's prescription Ongoing proposals by the European Commission to adapt the current ban on direct-to-consumer advertising of prescription drugs (DTCA) are generating much public debate. This article reviews the mainly US based empirical evidence for the effects of DTCA on a) consumers' exposure, b) consumers' requests for advertised drugs, and c) physicians' reactions to these requests, and discusses how the Dutch and broader European context can impact upon these effects. It is concluded that there is empirical evidence for DTCA's impact on American consumers and physicians, but also that the European context is likely to reduce the strength of these effects.
Advertisements and other marketing communications extensively discuss food and nutrition, tobacco, alcohol, and prescription drugs. In addition to mass media advertising and public service announcements (PSAs), messages are placed on product labels and in television shows and social media. Research indicates that these health-related communications can have significant and measurable effects on consumer cognitions, emotions, and behaviors. Some messages enhance health by discouraging unhealthy or risky consumption; others do the opposite. While many messages have their intended effects, other messages are discounted or even counterproductive. The specific effects often depend on message content and/or execution in combination with consumer characteristics. Therefore, it is important to tailor the communications to the target consumers, and to test for intended and unintended effects.
