title: Advertisement-induced prescription drug requests: patients' anticipated reactions to a physician who refuses.
abstract: BACKGROUND
  Drug manufacturers increasingly encourage patient prescription drug demand through the use of direct-to-consumer (DTC) advertisements. We describe patients' forecasts of their reactions if their doctor were to deny an advertisement-motivated drug request and then identify significant predictors of these reactions.
  
  
  METHODS
  We conducted a random phone survey of 329 Sacramento adults (response rate = 69%). Key outcomes were respondents' perceived likelihood of reacting to the nonfulfillment of a prescription request by becoming disappointed, trying to persuade the physician to reconsider, seeking a prescription from a different physician, and changing physicians. We also assessed associations between the likelihood of these reactions and respondents' evaluations of their physician's communication skills; attitudes toward, assumptions about the regulation of, and past responses to DTC advertising; health status; and demographic characteristics.
  
  
  RESULTS
  Disappointment was the most likely reaction (46%). One fourth of the respondents anticipated resorting to persuasion and seeking the prescription elsewhere, while only 15% considered terminating their relationship with their physicians. Subjects who anticipated reacting in these 4 ways reported lower satisfaction with their physicians, evaluated DTC advertising more favorably, and possessed more confidence in the government's regulation of these advertisements.
  
  
  CONCLUSIONS
  A sizable fraction of patients believed they would react negatively if their physician refused to provide a prescription for a drug advertised in the general media. Avenues for dealing effectively with patients' advertising-induced requests for prescription drugs are needed.
authors.affiliation: Department of Communication, University of California-Davis, 95616-8500, USA. rabell@ucdavis.edu
authors.forename: R A
authors.initials: RA
authors.lastname: Bell
authors.forename: M S
authors.initials: MS
authors.lastname: Wilkes
authors.forename: R L
authors.initials: RL
authors.lastname: Kravitz
mesh_terms: D000293:Adolescent; D000328:Adult; D000329:Advertising; D000368:Aged; D001294:Attitude to Health; D002140:California; D003142:Communication; D004345:Drug Industry; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010358:Patient Participation; D004364:Pharmaceutical Preparations; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology; D016079:Refusal to Treat
chemical_list: D004364:Pharmaceutical Preparations