Article Figures & Data
Figures
- Figure 1.
Summary of testable hypothesis on the effects of DTCA.
- Figure 2.
- Figure 3.
Outcomes when patients brought information from DTCA to a visit (n = 395).
Tables
Unweighted N (%) Weighted N (%) Demographic and practice characteristics Age <39 222(22) 198(20) 40–49 360(36) 363(36) 50–59 248(25) 248(25) 60+ 169(17) 188(19) Gender Female 228(22) 223(22) Male 808(78) 812(78) 1999 Income from practice $100,000 or less 177(19) 179(19) $100,001–$150,000 298(31) 297(31) $151,001–$200,000 194(20) 195(20) $200,001–$250,000 128(13) 126(13) $250.001+ 162(17) 160(17) Geographic setting Urban 342(34) 346(34) Suburban 334(33) 333(33) Small town 275(27) 273(27) Rural 67(7) 66(7) Geographic Region East 288(27) 298(28) South 316(30) 310(30) Midwest 231(22) 230(22) West 215(21) 213(20) Type of medical specialty Primary care 404(39) 406(39) Medical specialty 350(33) 355(34) Surgical specialty 296(28) 289(28) Office- or Hospital-based Office 942(90) 937(89) Hospital 108(10) 113(11) Country of training US 946(90) 937(89) Foreign 104(10) 113(11) Unweighted Percentiles Weighted Percentiles 25th 50th 75th 25th 50th 75th Respondents’ best estimate of the percentage of their patients who were: Uninsured 3 5 13 3 5 13 On Medicaid 5 10 25 5 10 25 From a minority group 10 20 40 10 20 40 Had an annual household income of $20,000 or less 10 15 30 9 15 30 Respondents’ best estimate of: Number of hours spent per week in face-to-face contact with patients 24 32 40 24 32 40 Number of patients seen per week 50 80 105 50 80 104 Data were weighted to represent the national population of physicians on the MMS database who spend 20 or more hours per week on direct patient care using the MMS variables described in the text.
% Agreeing Gives patients confidence to talk to their doctor about their concerns 83 Drives up the cost of prescription drugs 81 Encourages people to follow treatment instructions or advice from their doctors 72 Promotes unnecessary fear of the side effects 59 Helps patients get treatments they would not otherwise get 55 Improves people’s understanding of medical conditions and treatments 54 Causes patients to take up more of their doctors’ time 53 Promotes unnecessary visits to doctors 45 Interferes with good relationships between doctors and patients 39 n % Improved % Neutral % Worsened p Multivariate Odds Ratio for Improved Relationship (95% CI)* Total 395 33 60 8 How relevant to the patient was the information in the ad? <0.001 Very/somewhat 309 37 58 5 Not very/not at all 82 16 66 19 How accurate was the information in the ad? <0.001 Very/somewhat 262 38 59 3 Not very/not at all 131 22 62 16 Why did the patient talk to you about the ad? 0.002 Wanted a test, medication change or referral 221 28 61 11 Wanted your opinion only 173 38 59 3 Did you do what the patient wanted?† <0.001 Yes, completely 75 44 55 1 5.7 (2.2–14.7) Yes, partially 244 35 57 7 3.7 (1.6–8.6) No 75 12 74 15 1.0 Did you have enough time to discuss the information? 0.031 Yes 258 36 59 5 2.0 (1.2–3.3) No 136 27 62 12 1.0 Did you feel the patient was taking responsibility? <0.001 Yes 279 38 56 6 2.4 (1.4–4.4) No 114 19 69 12 1.0 Did you feel the patient was challenging your authority? <0.001 Yes 49 28 39 33 No 343 33 63 4 Did you think that the patient’s request was not appropriate for their health? <0.001 Yes, not appropriate 143 25 56 19 No, appropriate 253 37 62 1 Did you feel you did not know the patient well enough to have good communication? <0.001 Yes 27 37 32 30 No 365 32 62 6 * For clarity, only significant odds ratios are shown. CI, confidence interval.
† Comparison of doing what the patient wanted completely versus partially revealed no significant difference in odds ratios.
- Table 4.
Factors Associated with Respondents Feeling That Their Authority Was Being Challenged during the Discussion about DTCA
n % Yes Univariate p Multivariate Odds Ratio (95% CI) Total 395 12 Practice characteristics % Patients with Medicaid 0.023 ≤25% 293 11 >25% 77 21 Physicians’ cognitive and emotional responses in the last visit where a patient talked about DTCA. How relevant to the patient was the information in the ad? 0.011 Very/somewhat 308 10 1.0 Not very/not at all 81 21 2.3 (1.1–4.8) How accurate was the information in the ad? 0.004 Very/somewhat 261 9 Not very/not at all 129 20 Why did the patient talk to you about the ad? 0.019 Wanted a test, medication change or referral 220 16 Wanted your opinion only 171 8 Did you do what the patient wanted? 0.004 Yes, completely 75 4 1.0 Yes, partially 241 12 3.0 (0.9–9.6) No 74 22 8.5 (2.5–29.2) Did you have enough time to discuss the information? <0.001 Yes 134 22 1.0 No 257 8 3.0 (1.6–5.8) Did you feel the patient was taking responsibility? 0.118 Yes 279 14 2.2 (1.0–5.1) No 112 8 1.0 Did you feel the patient’s request was not appropriate for their health? <0.001 Yes, not appropriate 139 30 No, appropriate 252 3 Did you feel you did not know the patient well enough to have good communication? <0.001 Yes 28 36 1.0 No 363 11 5.0 (1.9–12.6) The odds ratio of the doctor feeling challenged for not doing what the patient wanted compared with doing what the patient wanted partially was 2.8 (95% confidence interval, 1.3 to 6.1).
N % Helped % Neutral % Hurt Univariate p Multivariate Odds Ratio (95% CI) Total 392 13 48 39 Physicians’ background views on DTCA How accurate are drug ads? 0.003 Very/somewhat 298 16 49 35 Not very/not at all 93 4 44 51 How good are patients at assessing the relevance of ads? <0.001 Excellent/very good/good 75 23 56 21 Fair 216 13 49 38 Poor 100 6 39 55 Physicians’ cognitive and emotional responses in the last visit where a patient talked about DTCA How relevant to the patient was the information in the ad? <0.001 Very/somewhat 306 16 51 33 Not very/not at all 82 3 37 60 How accurate was the information in the ad? <0.001 Very/somewhat 259 18 52 29 1.0 Not very/not at all 130 2 40 58 1.9 (1.1–3.3) Why did the patient talk to you about the ad? <0.001 Wanted a test, medication change or referral 219 11 40 49 2.0 (1.2–3.4) Wanted your opinion only 172 16 58 26 1.0 Did you do what the patient wanted? <0.001 Yes, completely 74 15 58 27 Yes, partially 240 17 47 37 No 75 0 42 58 Did you have enough time to discuss the information? <0.001 Yes 255 16 55 29 1.0 No 134 7 34 59 3.0 (1.8–5.0) Did you feel the patient was taking responsibility? 0.040 Yes 276 16 47 37 No 114 6 50 44 Did you feel the patient was challenging your authority? <0.001 Yes 49 2 24 74 2.8 (1.2–6.3) No 338 15 51 34 1.0 Did you think that the patient’s request was not appropriate for their health? <0.001 Yes, not appropriate 142 3 35 62 1.0 No, appropriate 249 19 55 26 1.8 (1.1–3.1) CI, confidence interval.
