Many of you can probably identify with the following scenario. Mr. Jones arrives for his appointment with an encyclopedia of information from the Internet downloaded just before walking into your office. He has already diagnosed his condition and proceeds to inform you of the recommended treatment, including medications you should prescribe. He eventually pauses long enough to take a deep breath, looking to you for some sign of agreement. Your manner sends a clear message because he says, "But I could be wrong; that's why I came to see you."
Consumer Advertising and You
Direct-to-consumer advertising (DTCA) creates challenges and opportunities for nurse practitioners (NPs). Consumers are bombarded by advertisements placed by pharmaceutical companies, medical product manufacturers, entrepreneurs, and a host of others marketing an array of products and services. Some consumers intentionally scour the media for these ads while others avoid or ignore all advertising. Some in industry suggest that DTCA serves to educate consumers and raise awareness of the signs and symptoms of potentially serious medical conditions, alerting anyone experiencing the signs and symptoms mentioned to seek medical attention as soon as possible. Of course, they are encouraged to ask their healthcare provider whether the advertised product or service is right for them. And thus, patients present with very specific requests.
Is DTCA Helpful?
DTCA theoretically should facilitate earlier diagnosis secondary to earlier consumer awareness and access to care, thus decreasing the burden of treating more advanced or complicated disease because of patient delay. DTCA should also inform patients who are already diagnosed with a targeted condition of new treatment options, or simply remind them of recommended testing and monitoring protocols. But these advertisements often report signs and symptoms that are vague or common in so many health conditions that most individuals will have experienced them at some point. The big question is, "Does DTCA ultimately improve health outcomes?"
In a Harris Interactive (Poll) Inc., telephone survey of 3,000 consumers,1 35% had a discussion with a physician about a prescription drug or medical condition after exposure to DTCA-16% for the first time. Twenty-five percent received new diagnoses after these visits. The most common diagnoses were allergies, gastroesophageal reflux disease, high cholesterol, arthritis, hypertension, diabetes mellitus, anxiety, depression, heartburn, heart disease, and menopause symptoms. Physicians prescribed the DTCA drug for 43% of these patients. Of this group, 81% taking the prescription drug reported an improvement in their overall health following the DTCA visit; only 5% reported that their health had become worse. Patients who switched to the advertised drug were slightly more likely to report favorable outcomes (86%) than those who switched to a different drug (78%). Overall, however, there was no (statistically) significant difference in the proportion of those reporting an improvement in their health between the group taking the advertised drug and the group taking another drug.
A quick search revealed studies that related only to physicians as investigators or participants. A more intense search might uncover whether any queried DTCA and NP behaviors. Consumers today are more conscious of the wealth of information available to them. NPs are in a role to decipher and clarify this information to help patients become true partners in their own care.
Jamesetta Newland, APRN, BC, FNP, FAANP, FNAP, PhD
Editor-in-Chief, [email protected]
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