NDLI: Lack of impact of direct-to-consumer advertising on the physician-patient encounter in primary care: a SNOCAP report.

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Lack of impact of direct-to-consumer advertising on the physician-patient encounter in primary care: a SNOCAP report.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Parnes, Bennett Smith, Peter C. Gilroy, Christine Quintela, Javan Emsermann, Caroline B. Dickinson, L. Miriam Westfall, John M.
Description	Country affiliation: United States Author Affiliation: Parnes B ( Department of Family Medicine, University of Colorado School of Medicine, Aurora, Colorado 80045, USA. Bennett.Parnes@uchsc.edu)
Abstract	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.
File Format	HTM / HTML
ISSN	15441709
e-ISSN	15441717
DOI	10.1370/afm.870
Journal	The Annals of Family Medicine
Issue Number	1
Volume Number	7
Language	English
Publisher	Annals of Family Medicine Inc
Publisher Date	2009-01-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Family Medicine Advertising As Topic Patient Participation Physician-patient Relations Physician's Practice Patterns Primary Health Care Adolescent Child, Preschool Cross-sectional Studies Drug Industry Infant Observation Prescription Drugs Administration & Dosage Socioeconomic Factors Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Family Practice

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