How advertising to patients affects prescribing

Reported by Susan Aldridge, PhD, medical journalist

A study using actors showed that doctors are influenced by patients who request a medication by name.
Direct-to-consumer (DTC) advertising has been increasing in recent years. Its critics say that this leads to over-prescribing while advocates point out that this is a useful opportunity for patient education. Researchers at the University of California sought to assess the impact of DTC on prescribing by using actors to play various patient roles.

They simulated either depression or 'adjustment disorder' and either asked for paroxetine by name, made a general request for medication, or did not ask for antidepressants at all. The doctors were more likely to prescribe for depression rather than adjustment disorder. And they were clearly influenced by the nature of the patient's request. Of those asking for paroxetine by name, 55 per cent received an antidepressant prescription. If they just asked for medication, 39 per cent received a prescription and if they did not ask for medication, only ten per cent received a prescription.

Given that depression is often said to be under-treated, it may be that the patient taking the initiative in this way is a good thing. However, it may be that there should be more emphasis on patient education in DTC and that physicians need extra training to learn how to respond appropriately to patient medication requests.

Source
Journal of the American Medical Association 27th April 2005 Volume 293 pages 1995-2002