title: Direct-to-consumer advertising and the patient-physician relationship.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Pharmacy Administration, The University of Mississippi, Faser Hall, University, MS 38677, USA. mshah@olemiss.edu
authors.forename: Mansi B
authors.initials: MB
authors.lastname: Shah
authors.forename: John P
authors.initials: JP
authors.lastname: Bentley
authors.forename: David J
authors.initials: DJ
authors.lastname: McCaffrey
authors.forename: E Mick
authors.initials: EM
authors.lastname: Kolassa
mesh_terms: D000328:Adult; D000329:Advertising; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D003142:Communication; D005260:Female; D039563:Histamine H1 Antagonists, Non-Sedating / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D004364:Pharmaceutical Preparations; D010817:Physician-Patient Relations; D054328:Proton Pump Inhibitors; D011795:Surveys and Questionnaires; D035502:Trust
chemical_list: D000897:Anti-Ulcer Agents; D039563:Histamine H1 Antagonists, Non-Sedating; D004364:Pharmaceutical Preparations; D054328:Proton Pump Inhibitors