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Annals of Family Medicine 7:41-46 (2009)
© 2009 Annals of Family Medicine, Inc.
doi: 10.1370/afm.870
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Lack of Impact of Direct-to-Consumer Advertising on the Physician-Patient Encounter in Primary Care: A SNOCAP Report

Bennett Parnes, MD1,2, Peter C. Smith, MD1,4, Christine Gilroy, MD5, Javan Quintela, BS1, Caroline B. Emsermann, MS1, L. Miriam Dickinson, PhD1 and John M. Westfall, MD, MPH1,3

1 Department of Family Medicine, University of Colorado School of Medicine, Aurora, Colorado
2 Colorado Research Network (CaReNet), Aurora, Colorado
3 High Plains Research Network (HPRN), Aurora, Colorado
4 Building InvestiGative practices for better Health Outcomes Research Network (BIGHORN), Aurora, Colorado
5 Department of Medicine, Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, Colorado

CORRESPONDING AUTHOR: Bennett Parnes, MD, Department of Family Medicine, 12631 E 17th Ave, AO1 L15, 3rd Floor, F-496, PO Box 6511, Aurora, CO 80045, Bennett.Parnes{at}uchsc.edu

PURPOSE Direct-to-consumer advertising (DTCA) has increased tremendously during the past decade. Recent changes in the DTCA environment may have affected its impact on clinical encounters. Our objective was to determine the rate of patient medication inquiries and their influence on clinical encounters in primary care.

METHODS Our methods consisted of a cross-sectional survey in the State Networks of Colorado Ambulatory Practices and Partners, a collaboration of 3 practice-based research networks. Clinicians completed a short patient encounter form after consecutive patient encounter for one-half or 1 full day. The main outcomes were the rate of inquiries, independent predictors of inquiries, and overall impact on clinical encounters.

RESULTS One hundred sixty-eight clinicians in 22 practices completed forms after 1,647 patient encounters. In 58 encounters (3.5%), the patient inquired about a specific new prescription medication. Community health center patients made fewer inquiries than private practice patients (1.7% vs 7.2%, P<.001). Predictors of inquiries included taking 3 or more chronic medications and the clinician being female. Most clinicians reported the requested medication was not their first choice for treatment (62%), but it was prescribed in 53% of the cases. Physicians interpreted the overall impact on the visit as positive in 24% of visits, neutral in 66%, and negative in 10%.

CONCLUSIONS Patient requests for prescription medication were uncommon overall, and even more so among patients in lower income groups. These requests were rarely perceived by clinicians as having a negative impact on the encounter. Future mixed methods studies should explore specific socioeconomic groups and reasons for clinicians’ willingness to prescribe these medications.

Key Words: Practice-based research networks • direct-to-consumer advertising (DTCA) • physician-patient relationship




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TRACK Comments:

Read all TRACK Comments

DTCA helpful, but not the key. So what does cause people to seek care?
Richard E Allen
Annals of Family Medicine, 15 Jan 2009 [Full text]
So Why Does DTCA Stir Us Up So Much?
Howard Brody
Annals of Family Medicine, 15 Jan 2009 [Full text]
Response to Drs Allen and Brody
Bennett L Parnes
Annals of Family Medicine, 15 Jan 2009 [Full text]
The health service burden of "low-impact" Direct-to-Consumer Advertising
Peter F. Cronholm, MD MSCE, et al.
Annals of Family Medicine, 22 Jan 2009 [Full text]
Lack of impact of DTCA or consistent effect on prescribing decisions?
Barbara J Mintzes
Annals of Family Medicine, 10 Feb 2009 [Full text]
Response to Dr Mintzes
Bennett Parnes
Annals of Family Medicine, 22 Feb 2009 [Full text]

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