RT Journal Article
SR Electronic
T1 Lack of Impact of Direct-to-Consumer Advertising on the Physician-Patient Encounter in Primary Care: A SNOCAP Report
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 41
OP 46
DO 10.1370/afm.870
VO 7
IS 1
A1 Bennett Parnes
A1 Peter C. Smith
A1 Christine Gilroy
A1 Javan Quintela
A1 Caroline B. Emsermann
A1 L. Miriam Dickinson
A1 John M. Westfall
YR 2009
UL http://www.annfammed.org/content/7/1/41.abstract
AB 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.