Henry N. Young, Ph.D.,1 Earlene E. Lipowski, Ph.D.

,2
and Richard L. Kravitz, MD, MSPH1
1. University of California, Davis; 2. University of Florida
 How does DTCA affect patient behavior?
 Encourage active patient role
 Promote intrusive behavior and patient demand
 Patient behavior and health care
relationships
 Participatory relationships
 Relational conflict
 To examine the difference between
consumers’ intentions to 1) seek additional
information and 2) request a prescription for
an advertised drug in response to a direct-to-
consumer advertisement.
 Study design
 Cross-sectional survey
 Participants
 Women college students
▪ Women of child-bearing age
▪ Medical, nursing, and pharmacy students were excluded
 Procedure
 Exposed to fictitious ad, surveyed, and debriefed
 Fictitious prescription drug advertisement
 Prescription oral contraceptive medication …
Unigyne
▪ One pill per month
 Based upon an ad for Ortho Tri-Cyclen
 Redesign of the advertisement
▪ Focus groups
▪ Ad credibility ratings
 Variables
 Information-seeking
▪ Consumers’ intentions to ask their physicians for
more information regarding an advertised
prescription drug.
▪ 4 items measured on an 11-point scale: 0 “not at all
likely” to 10 “extremely likely”
▪ Mean score
 Variables
 Information-seeking items
▪ I would ask my doctor if the advertised drug really
works.
▪ I would ask my doctor for more information about
the advertised drug.
▪ I would ask my doctor if the advertised drug is
appropriate for me.
▪ I would ask my doctor about the side effects
associated with the use of the advertised drug.
 Variables
 Requesting
▪ Consumers’ intentions to ask for or demand a
prescription for an advertised prescription drug from
their physicians.
▪ 2 items measured on an 11-point scale: 0 “not at all
likely” to 10 “extremely likely”
▪ Mean score
 Variables
 Requesting items
▪ I would ask my doctor to prescribe the advertised
drug for me.
▪ I would insist that my doctor prescribe the
advertised drug for me.
 Reliability
 Information-seeking ( = .90)
 Requesting ( = .83)
 Confirmatory Factor Analysis
 Supported the two factor distinction
 Participants characteristics
 N = 107
 Mean Age = 20.64(2.41), Range 18-33
 48% White
 26% Family income > $90,000
 69% Sexually Active
 65% Contraceptive Users
 Means
 Information-seeking
▪ M = 8.6, SD = 2.0
 Requesting
▪ M = 4.7, SD = 3.0
 Testing the difference between means
 Dependent samples t test
 t(106) = 14.75, p < .01
 Similar results found in sexually active and
contraceptive user groups
 Participants’ responses
 93.5% of people were more likely to seek
information than a prescription
 3.7% of people were more likely to seek a
prescription than information
 2.8% of people were about the same
 Participants’ responses
 Information-seeking
▪ I would ask my doctor if the advertised drug really
works (M = 8.85, SD = 1.80).
▪ I would ask my doctor about the side effects
associated with the use of the advertised drug (M =
8.85, SD = 2.16).
▪ I would ask my doctor if the advertised drug is
appropriate for me (M = 8.49, SD = 2.51).
▪ I would ask my doctor for more information about
the advertised drug (M = 8.14, SD = 2.73).
 Participants’ responses
 Requesting
▪ I would ask my doctor to prescribe the advertised
drug for me (M = 5.92, SD = 3.19).
▪ I would insist that my doctor prescribe the
advertised drug for me (M = 3.48, SD = 3.22).
 Moderate intentions to seek information
from additional sources
 Pharmacist (M = 5.56, SD = 3.41)
 Toll-free number (M = 5.36, SD = 3.47)
 Website (M = 6.85, SD = 3.05)
 Use of students
 Generalizability to general population
 Use of fictitious oral contraceptive
 Curiosity may inherently motivate participants to
want to find out more info
 Promotes shared decision making process
 Increase information exchange
 Patient involvement
▪ Initiation of discussions about treatment options,
efficacy, appropriateness, and risks
 Identify characteristics of DTCA that promote
constructive patient involvement
 Use to set standards for the delivery of DTCA
 Quality of alternative information sources?