Table 1.

Summary of Hypotheses Tested, Dependent Variables Used to Test Each Hypothesis, Total Number of Respondents Experiencing Each Outcome, and Association with Socioeconomic Status

Hypothesis*: That DTCA would result in:DVN (% of Total Population) [95% CI]Significant Associations (see text for details)
Clinical benefits and harms
 More patients attending physicians for preventive health care.Respondent requested preventive care from a health professional Respondent attended physician or other health professional for a check-up203 (6.3%)[5.3–7.5%] 189 (5.9%)[5.0–6.9%)Low education, Hispanic, chronic disease Low education, Hispanic, chronic disease
 Increased diagnoses of currently under-diagnosed conditions.Respondent diagnosed with, or told at risk of, condition mentioned in advertisement during or after consultation28 (0.9)[0.6–1.3%]Being in managed care, no SES association
 Improved treatments of currently under-treated conditions.Respondent given medication mentioned in advertisement and doctor said it would benefit patient.67 (2.1%)[1.6–2.8%]Low education, low income, not proactive about health information
 Worsened treatmentRespondents given medication requested but doctor said it would not benefit patient26 (0.8%)[0.5–1.2]Age 18–24
Psychosocial benefits
 Increased sense of confidence and control by patient during physician visit.Respondent felt more confident during visit as a result of DTCA142 (4.4%)[3.7–5.4%]No SES association
Respondent felt more in control during visit as a result of DTCA168 (5.2%)[4.4–6.2%]Women, not proactive about health information
Effect on doctor-patient relationship
 Enhanced disclosure of health concerns to doctorRespondent disclosed health concerns to physician as a result of DTCA455 (14.2%)[12.8–15.8%]Low income, nonwhite, chronic disease, proactive about health information
 Changed global rating of relationshipRespondent’s assessment of effect of discussing information from DTCA on doctor-patient relationship Improved        51 (1.6%)[1.2–2.2%]       Change in relationship associated with SES.
Neutral163 (5.1)[4.3–6.0%]
Worsened11 (0.3)[0.1–1.0%]Worsened relationship associated with the request’s not being filled.
 Failure by patient to acknowledge doctor’s expertise or doctor experiencing difficulty with knowledgeable/activated patientDoctor acted challenged30 (0.9%)[0.6–1.4%]Low education
 Serious dissatisfaction by patientRespondent sought 2nd opinion, changed doctor or health plan)46 (1.4%)[1.0–2.2%]Low SES, no relationship with having request filled.
Effects on health care system
 Increased costs, without commensurate health gains.Number of respondents who scheduled visit to physician to discuss ad Number of respondents who made specific requests Number of respondents who received what they asked for55 (1.7%)[1.2–2.4%]     161 (5.0%)[4.2–5.9%]     89 (2.8%)[2.2.–3.5]Low education, being in managed care        High SES
  • * See previous article15 for full description of hypotheses.

  • Outcomes are presented as a percentage of the total population of respondents to allow a comparison of the various effects on a population.

    SES, socioeconomic status.