ABSTRACT
Background: Direct-to-consumer advertising (DTCA) is effective in promoting pharmaceutical products to consumers and may pose a challenge to providers in the delivery of care. This study examined advanced practice nurse prescriber (APNP) general views of DTCA and tested the effects of DTCA discussion between the patient and APNP in an office visit on efficiency of care, quality of care, and health outcomes.
Methods: A cross-sectional design was used to survey 1,163 APNPs in a single US Midwestern state. The final sample consisted of 316 participants (27.17%). Pearson's chi-squared and multinomial logistic regression analyses tested DTCA effects.
Results: Direct-to-consumer advertising disadvantages were increased costs of drugs (80%) and misled patients (75%). Direct-to-consumer advertising benefits included a balanced presentation of risks and benefits (60%) and patients getting treatments (51%). Direct-to-consumer advertising discussion was viewed as worsening time efficiency of visit (53%). Worsened efficiency was associated with worsened nurse-patient relationship. Direct-to-consumer advertising discussion had no effect on quality of care (86%) and health outcomes (89%). Worsened quality was related to inappropriate clinical requests and challenged prescriptive authority among other factors. The nurse doing what the patient wanted was related to worsened health outcomes.
Conclusion: The findings suggest training initiatives to maximize DTCA benefits in health care delivery.