Effects of conflicting prescription drug information from direct-to-consumer advertising and drug injury advertising on patients' beliefs and medication adherence.

BACKGROUND: Patients are often exposed to contradictory information about pharmaceutical products from various types of advertising. For example, direct-to-consumer advertising (DTCA) tend to emphasize a drug's benefits, while drug injury advertising emphasizes the worst side effects. Regarding DTCA as a drug information source, many researchers in pharmacy field focus on investigating the misinformation in DTCA and corrective advertising. However, no prior research has examined the effects of such contradictory advertising messages on patients' prescription medicine-related beliefs and medication adherence. This is a significant gap in the research literature on pharmaceutical advertising effects and medication adherence. OBJECTIVE: This is aimed to examine how exposure to DTCA and drug injury advertising would influence patients' chronic accessibility of drug-related beliefs and their medication adherence behavior. METHODS: An online survey was conducted with a sample of 213 patients taking prescription blood thinners. RESULTS: The findings from this study did not support the predicted relationship between exposure to DTCA and consumers' drug-related belief accessibility or their medication adherence. However, this study found a significant interaction effect of exposure to DTCA and exposure to drug injury ads on patients' medication adherence. The analysis results demonstrate that, for those who were exposed to drug injury ads, a significant negative relationship emerged between DTCA exposure and medication adherence. CONCLUSION: This study provides important empirical evidence of a negative interaction effect of exposure to DTCA and drug injury ads on patients' medication adherence, which demonstrates that the influence of DTCA and drug injury ad exposures on patients' medication adherence is not independent, separate process but an interactive process. A communication campaign with corrective advertising could alleviate the negative interaction effect of exposure to contradictory information from different types of pharmaceutical ads on patients' medication adherence.

Relationship Between Exposure to Direct-To-Consumer Prescription Drug Advertising (DTCA) and Patients' Belief Accessibility and Medication Adherence.

One of the most frequent and strong arguments for supporting direct-to-consumer prescription drug advertising (DTCA) as a positive influence on individuals and society is that DTCA could contribute to improving patients' medication adherence, but systematic empirical research testing this proposed effect is scant. To address this gap and provide an answer to the unresolved question about DTCA effects, this study examined the relationship between overall DTCA exposure and patients' medication adherence through the mechanism of media priming effect increasing medication-related belief accessibility. Results from a survey with a sample of prescription blood thinner takers revealed no significant relationships between DTCA exposure and patients' belief accessibility regarding their medical conditions and drug benefits and risks, and no support for the hypothesized relationship between DTCA exposure and medication adherence. The findings are discussed within the context of DTCA effect research literature, and theoretical and practical implications are presented.

Does Health Information in Mass Media Help or Hurt Patients? Investigation of Potential Negative Influence of Mass Media Health Information on Patients' Beliefs and Medication Regimen Adherence.

As an important public health issue, patient medication non-adherence has drawn much attention, but research on the impact of mass media as an information source on patient medication adherence has been scant. Given that mass media often provide confusing and contradicting information regarding health/medical issues, this study examined the potential negative influence of exposure to health information in mass media on patients' beliefs about their illnesses and medications, and medication adherence, in comparison with the effects of exposure to another primary medication information source, physicians. Survey data obtained from patients on blood thinner regimens revealed that the frequency of exposure to health information in mass media was negatively related to accuracy of patients' beliefs about their medication benefits and patient medication adherence. On the other hand, frequency of visits with physicians was positively associated with patients' beliefs about their medication benefits but had no significant relation to medication regimen adherence. The implications of the study findings are discussed, and methodological limitations and suggestion for future research are presented.

A Model of Consumer Response to Over-the-Counter Drug Advertising: Antecedents and Influencing Factors.

Given the importance of over-the-counter (OTC) drugs in the health care marketplace and lack of systematic research on OTC drug advertising (OTCA) effects, this study tested a theory-based, product category-specific OTCA effects model. Structural equation modeling analysis of data for 1 OTC drug category, analgesics, supported the proposed model, explaining the OTCA effect process from key consumer antecedents to ad involvement, from ad involvement to ad attention, from ad attention to cognitive responses, then to affective/evaluative responses, leading to the final behavioral outcome. Several noteworthy patterns also emerged: (a) Product involvement was directly linked to ad attention, rather than exerting an indirect influence through ad involvement; (b) ad attention was significantly related to both cognitive and affective/evaluative responses to different degrees, with stronger links to cognitive responses; and

Trust in prescription drug brand websites: website trust cues, attitude toward the website, and behavioral intentions.

Direct-to-consumer (DTC) prescription drug brand websites, as a form of DTC advertising, are receiving increasing attention due to the growing number and importance as an ad and a consumer information source. This study examined consumer trust in a DTC website as an important factor influencing consumers' attitude toward the website and behavioral intention. Applying the conceptual framework of website trust, the particular focus of investigation was the effect of the website trust cue factor on consumers' perceived DTC website trust and subsequent attitudinal and behavioral responses. Results show a significant relation between the website trust cue factor and consumers' perceived DTC website trust. Perceived DTC website trust, in turn, was found to be significantly associated with consumers' attitude toward the DTC website and behavioral intention.

Korean Americans' prescription drug information seeking and evaluation and use of different information sources.

This study examined Korean Americans' prescription drug information seeking, evaluation and use of different information sources, and communication with physicians, and compared the findings with those from the White American population. The results suggest that although Korean and White Americans were similar in extent of drug information seeking, Korean Americans tended to experience relatively greater difficulty finding information. Regarding perceived source usefulness, Korean Americans were significantly more likely to perceive higher usefulness in mass media and direct-to-consumer advertising sources than were Whites. Korean Americans were also more likely to use fewer sources, and less likely to use mass media and printed materials in drug information seeking. However, the hypothesized in-group source preference by Korean Americans was not found.

How Korean and White Americans Evaluate and Use Online Advertising and Non-advertising Sources for Prescription Drug Information.

This study examined Korean Americans' evaluation and use of online advertising and non-advertising sources of prescription drug information and compared the findings to those of white Americans. A mail survey was conducted with a disproportionate stratified sample of 600 adults (300 general population and 300 Korean Americans) who have ever taken or are currently taking prescription drugs regularly and reside in a metropolitan area in the Midwestern United States. While both Korean and white Americans evaluated online non-advertising sources more positively than advertising sources, the 2 groups were similar in their evaluation of both online advertising and non-advertising sources. White Americans tended to use more online advertising sources than did Korean Americans, but both groups were equally likely to use non-advertising sources. Evaluation and use of online advertising and non-advertising sources by Korean and white Americans were associated with different predictors.

Effects of anthropomorphic images and narration styles in promotional messages for generic prescription drugs.

BACKGROUND: Anthropomorphism is attribution of human characteristics to nonhuman objects or events. Marketers have used anthropomorphized characters to promote products and services. To promote use of generic drugs to save on prescription drug costs, health systems are in the process of developing informational materials to influence consumer's perceptions about generic prescription drugs. OBJECTIVES: To evaluate the effects of anthropomorphic images (control vs caring vs authoritative) and information narration styles (first person vs third person) on (1) social presence, (2) attitude toward the overall promotional message, (3) perceived informativeness of the message content, (4) attitude toward specific message, (5) intent to seek information, and (6) intention to switch to a generic prescription drug. METHODS: A 3×2 between-subject factorial design was used. Student participants were administered a mock promotional message regarding generic prescription drugs. Following the promotional message, they were asked to respond to items developed to measure the effects of the promotional message. Manipulation checks were conducted to test the desired effects of the independent variables. Pilot testing, exploratory factor analysis, and reliability testing of the item measures were conducted before their use in the study. Analysis of variance was used to analyze the data and test the proposed effects of the independent variables. RESULTS: Anthropomorphic images showed a positive effect on social presence and attitude toward the specific message. Narration styles had a positive effect on attitude toward the overall promotional message. Neither anthropomorphic images nor narration styles had a significant effect on perceived informativeness, intent to seek information, and intention to switch to a generic prescription drug. CONCLUSIONS: This research reveals that anthropomorphism of medications and narration styles could play a significant role in promotional messages for generic prescription drugs. These findings provide a new direction in developing educational materials for information about generic prescription drugs.

Source selection in prescription drug information seeking and influencing factors: applying the comprehensive model of information seeking in an American context.

This study investigates source selection in prescription drug information seeking and influencing factors on selection and seeking behaviors applying a modified Comprehensive Model of Information Seeking in an American context. Survey results suggest consumers engage in prescription drug information search before and after visiting a doctor, but search is not extensive. Consumers turn to the Internet, pharmacists, and doctors most frequently for prescription drug information. Information-seeking behaviors are rather universal across demographic and health-related characteristics; however, higher income consumers are more likely to search. Although our study shows some support for the modified Comprehensive Model of Information Seeking, the results indicate influencing factors vary by information source types examined, suggesting the model is more complex than predicted. The study advances research on health communication, information-seeking behaviors, and prescription drug decision making.

Direct-to-consumer prescription drug advertising: history, regulation, and issues.

Direct-to-consumer advertising has changed the way prescription drugs are marketed in the United States. This article traces the history of direct-to-consumer advertising of prescription and over-the-counter medications and describes how drug advertising is regulated and by whom. It also discusses the controversies that surround direct-to-consumer marketing of prescription drugs.

Evaluation, use, and usefulness of prescription drug information sources among Anglo and Hispanic Americans.

This survey was conducted to determine and compare how Anglo and Hispanic Americans evaluate and use interpersonal, advertising, and mediated sources of prescription drug information. Findings suggest the following: (1) Hispanics rely on doctors, Internet advertising sources, and direct-to-consumer advertising (DTCA), while Anglos frequently use health-related websites and health care professionals; (2) Anglos are more likely to use health-related websites such as WebMD, although Anglos and Hispanics do not appear significantly different in Internet source usefulness evaluation; (3) Hispanics rely on television (TV) and DTC TV advertising more than Anglos, and this tendency is stronger for strong than weak Hispanic identifiers; (4) Hispanics evaluate TV news stories and TV advertising as more useful than Anglos; (5) Hispanics evaluate DTCA more positively and with less skepticism than Anglos; and (6) Hispanic ethnic identification level is positively related to preferences for Spanish-language media and health care professionals.

Direct-to-consumer advertising skepticism and the use and perceived usefulness of prescription drug information sources.

This study investigates advertising skepticism in the context of consumers' prescription drug information seeking behavior. Results of a telephone survey found that: (a) the overall level of direct-to-consumer advertising (DTCA) skepticism among consumers was neutral; (b) DTCA skepticism was unrelated to age, positively related to education and income, and varied by race; (c) however, when all the antecedent variables were considered concurrently, only education emerged as a significant predictor (consumers with higher education were more skeptical of DTCA); (d) DTCA skepticism was not significantly related to perceived importance of prescription drug information; (e) DTCA skepticism was not associated with use of advertising and interpersonal sources of prescription drug information; and (f) DTCA skepticism was negatively related to perceived usefulness of advertising sources but unrelated to perceived usefulness of professional interpersonal sources (i.e., physicians and pharmacists). The article concludes with a discussion of findings and directions for future research.

Seniors' uncertainty management of direct-to-consumer prescription drug advertising usefulness.

This study provides insight into seniors' perceptions of and responses to direct-to-consumer prescription drug advertising (DTCA) usefulness, examines support for DTCA regulation as a type of uncertainty management, and extends and gives empirical voice to previous survey results through methodological triangulation. In-depth interview findings revealed that, for most informants, DTCA usefulness was uncertain and this uncertainty stemmed from 4 sources. The majority had negative responses to DTCA uncertainty and relied on 2 uncertainty-management strategies: information seeking from physicians, and inferences of and support for some government regulation of DTCA. Overall, the findings demonstrate the viability of uncertainty management theory (Brashers, 2001, 2007) for mass-mediated health communication, specifically DTCA. The article concludes with practical implications and research recommendations.

Age differences in how consumers behave following exposure to DTC advertising.

This study was conducted to provide additional evidence on how consumers behave following direct-to-consumer (DTC) advertising exposure and to determine if there are differences in ad-prompted acts (drug inquiry and drug requests) between different age groups (i.e., older, mature, and younger adults). The results suggest that younger, mature, and older consumers are all moved to act by DTC drug ads, but that each age group behaves in different ways. Somewhat surprisingly, age was not predictive of ad-prompted behavior. DTC advertising was no more effective at moving older consumers to behave than their younger counterparts. These results suggest that age does not matter that much when it comes to the "moving power" of prescription drug advertising, even though research indicates that older consumers are more vulnerable to the persuasive effects of communication.

Factors affecting trust in on-line prescription drug information and impact of trust on behavior following exposure to DTC advertising.

Despite growing concerns about the quality and accuracy of Internet-based prescription drug information, there has been very little empirical research on consumers' perceptions of the trustworthiness of on-line drug information. In this article, we report on a study modeled after that of Menon, Deshpande, Perri, and Zinkhan (2002) in Health Marketing Quarterly that reexamines how key demographic, predispositional, and media factors are associated with consumer trust in on-line prescription drug information and the impact of trust in on-line drug information on ad-promoted behavior following exposure to direct-to-consumer (DTC) advertising. Four major findings are reported: (1) on-line drug information is not highly trusted; (2) trust in on-line drug information is not differentially affected by consumer demographic or predispositional characteristics; (3) trust in the traditional media of DTC advertising is predictive of trust in on-line drug information; and (4) trust in on-line drug information is associated directly with specific types of ad-promoted behavior following exposure to DTC advertising. Implications and recommendations are offered based on the results.

Is the information "fair and balanced" in direct-to-consumer prescription drug websites?

This study applies the Food and Drug Administration's (FDA's) "fair-balance disclosure" provision to examine the content of prescription drug websites, specifically focusing on the quantity and quality of risk information. The results show that even though most prescription drug websites provide both risk and benefit information, the two types of information are presented differently. This study suggests directions for regulators to consider in writing a more specific rule to ensure that information on prescription drug websites is balanced.

Media credibility and informativeness of direct-to-consumer prescription drug advertising.

In this article, we report the results of a study conducted to determine consumer perceptions of the media credibility and informativeness of direct-to-consumer prescription drug advertising (DTC advertising) and to examine how those perceptions are influenced by consumer predispositions and demographic characteristics, especially consumer age. This study specifically surveyed older consumers, who are the most significant market segment for prescription drugs and particularly susceptible and vulnerable to commercial persuasion. Older consumers' perceptions of DTC advertising were found to be neutral but their evaluation of informativeness was found to be more positive. Attitude toward DTC advertising and DTC advertising familiarity predicted perceived credibility across various media and attitude toward DTC advertising was the most prominent predictor of perceived informativeness. Age and usage of different media were also found to predict credibility and informativeness of DTC advertising in certain types of media. This study's findings provide insight into how older consumers evaluate various DTC advertising media as an information source.