Mintzes et al's Influence of DTC Pharmaceutical and Patients' Requests on Prescibing Decisions-Two S

Mintzes et al's Influence of DTC Pharmaceutical and Patients' Requests on Prescibing Decisions-Two S

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Influence of direct to consumer pharmaceutical advertising and patients’ requests on prescribing decisions: two site cross sectional survey Barbara Mintzes, Morris L Barer, Richard L Kravitz, Arminée Kazanjian, Ken Bassett, Joel Lexchin, Robert G Evans, Richard Pan, Stephen A Marion Only the United States and New Zealand allow adver- tising of prescription drugs directed at patients. US spending on such advertising grew rapidly during the 1990s, reaching $2.47bn (£1650m) in 2000. 1 The dramatic increase in investment by the US pharmaceu- tical industry is evidence of an expected effect on sales. On the rationale that such advertising provides impor- tant information to consumers and patients who may benefit from advertised products, pharmaceutical manufacturers have campaigned in the European Union 2 and Canada 3 for the relaxing of current regula- tory restrictions. We examined the relation between direct to consumer advertising and patients’ requests for prescriptions and the relation between patients’ requests and prescribing decisions. Participants, methods, and results We carried out a cross sectional survey of a cluster sample of primary care patients in Sacramento, California, from March to June 2001 and in Vancouver, British Columbia, from June to August 2000. We used questionnaires to determine the frequency of patients’ requests for prescriptions and of prescriptions resulting from requests. Seventy eight physicians participated in the study, 40 in Vancouver (all family physicians) and 38 in Sacramento (14 general internists and 24 family physicians). Patients were all 18 years and over, spoke English, and provided informed consent. The unit of analysis was a matched set of patient-physician questionnaires covering a single consultation. We estimated adjusted odds ratios using a generalised estimation equation. We classified drugs as advertised to consumers if they were among the 50 drugs with the highest US advertis- ing budgets 4 or were described as advertised to consumers in Canadian media reports 5 in 1999-2000, or both. Sixty one per cent of patients attending physicians’ offices on preset study days participated (1431 total; 683 in Sacramento and 748 in Vancouver). Patients in the two cities had similar demographic characteristics, socioeconomic status, and attitudes toward the doctor- patient relationship. In both settings, income was higher than average, and 80% were of European descent. Patients requested prescriptions in 12% of sur- veyed visits. Of these requests, 42% were for products advertised to consumers. The table provides details of factors associated with requests. Physicians prescribed the requested drugs to 9% (128) of patients and requested advertised drugs to 4% (55) of patients. The prescribing rate was similar for advertised and non-advertised drugs (about 74%). After we controlled for health status, demograph-
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This note was uploaded on 04/13/2010 for the course PSYCH 101 taught by Professor Gabbart during the Spring '08 term at Union College.

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Mintzes et al's Influence of DTC Pharmaceutical and Patients' Requests on Prescibing Decisions-Two S

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