Direct-to-consumer advertising and the patient-physician relationship

Shah, Mansi B.; Bentley, John P.; McCaffrey, David J.; Kolassa, E. Mick

doi:10.1016/j.sapharm.2005.03.008

« Previous Next »Research in Social and Administrative Pharmacy
Volume 1, Issue 2 , Pages 211-230, June 2005

Direct-to-consumer advertising and the patient-physician relationship

Mansi B. Shah, M.S.
- Department of Pharmacy Administration, The University of Mississippi, Faser Hall, University, MS 38677, USA
- Corresponding author. Tel.: +1 662 915 5948; fax: +1 662 915 5262.
John P. Bentley, R.Ph., M.B.A., Ph.D.
- Department of Pharmacy Administration, The University of Mississippi, Faser Hall, University, MS 38677, USA
- Research Institute of Pharmaceutical Sciences, School of Pharmacy, The University of Mississippi, University, MS 38677, USA
- Tel.: +1 662 915 7114.
David J. McCaffrey III, R.Ph., Ph.D.
- Department of Pharmacy Administration, The University of Mississippi, Faser Hall, University, MS 38677, USA
- Research Institute of Pharmaceutical Sciences, School of Pharmacy, The University of Mississippi, University, MS 38677, USA
- Tel.: +1 662 915 5490.
E. Mick Kolassa, Ph.D.
- Medical Marketing Economics (MME), LLC, 1223 Jackson Ave, Suite #301, Oxford, MS 38655, USA

Abstract

Background

Differences in attitudes of patients and physicians toward direct-to-consumer advertising (DTCA) of prescription medications may influence the patient-physician relationship, which may in turn influence health care outcomes.

Objective

The objective of this study was to provide empirical evidence to show how the patient-physician relationship may be influenced by DTCA.

Methods

The study used a cross-sectional research design. Pharmacists at 71 pharmacies were asked to distribute self-report survey instruments to patients who used either a proton-pump inhibitor or a nonsedating antihistamine by prescription. Data were collected between March and June 2003. Hierarchical multiple regression was used to assess the research propositions.

Results

A usable response rate of 7.3% (n=326) was obtained. About 95% of the sample had seen an advertisement for either a proton-pump inhibitor or a nonsedating antihistamine. Response to DTCA was significantly related to the patient's satisfaction with the physician and the patient's evaluation of communication, even after controlling for demographic variables and length of the patient-physician relationship. Other outcome variables (trust, relationship commitment, and average visit time) were not significantly related to DTCA response. Post hoc analyses revealed that DTCA responders, who asked their doctor to prescribe a specific product after seeing its advertisement, rated satisfaction and communication lower than the DTCA nonresponders. Additional follow-up analyses showed that these findings were largely attributed to patients in the proton-pump inhibitor group.

Conclusion

The findings suggest that response to DTCA may be significantly related to patients' evaluation of communication quality and their satisfaction with the physician. However, these findings may not generalize to all medical conditions or types of patient. Furthermore, DTCA response does not appear to be related to other patient-physician relationship outcome variables. Given these findings, key variables to explore in future DTCA research with respect to its effect on the patient-physician relationship include patient expectations and disease/condition type.

Keywords: Direct-to-consumer advertising, Patient-physician relationship, Trust, Communication, Satisfaction