title: Simple heuristics in over-the-counter drug choices: a new hint for medical education and practice.
abstract: BACKGROUND
  Over-the-counter (OTC) drugs are widely available and often purchased by consumers without advice from a health care provider. Many people rely on self-management of medications to treat common medical conditions. Although OTC medications are regulated by the National and the International Health and Drug Administration, many people are unaware of proper dosing, side effects, adverse drug reactions, and possible medication interactions.
  
  
  OBJECTIVE
  This study examined how subjects make their decisions to select an OTC drug, evaluating the role of cognitive heuristics which are simple and adaptive rules that help the decision-making process of people in everyday contexts.
  
  
  METHODS
  By analyzing 70 subjects' information-search and decision-making behavior when selecting OTC drugs, we examined the heuristics they applied in order to assess whether simple decision-making processes were also accurate and relevant. Subjects were tested with a sequence of two experimental tests based on a computerized Java system devised to analyze participants' choices in a virtual environment.
  
  
  RESULTS
  We found that subjects' information-search behavior reflected the use of fast and frugal heuristics. In addition, although the heuristics which correctly predicted subjects' decisions implied significantly fewer cues on average than the subjects did in the information-search task, they were accurate in describing order of information search. A simple combination of a fast and frugal tree and a tallying rule predicted more than 78% of subjects' decisions.
  
  
  CONCLUSIONS
  The current emphasis in health care is to shift some responsibility onto the consumer through expansion of self medication. To know which cognitive mechanisms are behind the choice of OTC drugs is becoming a relevant purpose of current medical education. These findings have implications both for the validity of simple heuristics describing information searches in the field of OTC drug choices and for current medical education, which has to prepare competent health specialists to orientate and support the choices of their patients.
authors.affiliation: Department of Psychology, Catholic University of the Sacred Heart of Milan, Milan, Italy ; Department for Adaptive Behaviour and Cognition, Max Planck Institute for Human Development Berlin, Germany ; Department of Medicine and Medical Specialities, ABB Centre, University of Milan and IRCCS Ca' Granda Foundation, Maggiore Hospital, Milan, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Riva
authors.forename: Marco
authors.initials: M
authors.lastname: Monti
authors.forename: Alessandro
authors.initials: A
authors.lastname: Antonietti
keywords: OTC drugs; decision making; decision-tree; fast and frugal heuristics treatment