Summary of Hypotheses Tested, Dependent Variables Used to Test Each Hypothesis, Total Number of Respondents Experiencing Each Outcome, and Association with Socioeconomic Status
| Hypothesis*: That DTCA would result in: | DV | N (% of Total Population)† [95% CI] | Significant Associations (see text for details) |
|---|---|---|---|
| Clinical benefits and harms | |||
| More patients attending physicians for preventive health care. | Respondent requested preventive care from a health professional Respondent attended physician or other health professional for a check-up | 203 (6.3%)[5.3–7.5%] 189 (5.9%)[5.0–6.9%) | Low education, Hispanic, chronic disease Low education, Hispanic, chronic disease |
| Increased diagnoses of currently under-diagnosed conditions. | Respondent diagnosed with, or told at risk of, condition mentioned in advertisement during or after consultation | 28 (0.9)[0.6–1.3%] | Being in managed care, no SES association |
| Improved treatments of currently under-treated conditions. | Respondent given medication mentioned in advertisement and doctor said it would benefit patient. | 67 (2.1%)[1.6–2.8%] | Low education, low income, not proactive about health information |
| Worsened treatment | Respondents given medication requested but doctor said it would not benefit patient | 26 (0.8%)[0.5–1.2] | Age 18–24 |
| Psychosocial benefits | |||
| Increased sense of confidence and control by patient during physician visit. | Respondent felt more confident during visit as a result of DTCA | 142 (4.4%)[3.7–5.4%] | No SES association |
| Respondent felt more in control during visit as a result of DTCA | 168 (5.2%)[4.4–6.2%] | Women, not proactive about health information | |
| Effect on doctor-patient relationship | |||
| Enhanced disclosure of health concerns to doctor | Respondent disclosed health concerns to physician as a result of DTCA | 455 (14.2%)[12.8–15.8%] | Low income, nonwhite, chronic disease, proactive about health information |
| Changed global rating of relationship | Respondent’s assessment of effect of discussing information from DTCA on doctor-patient relationship Improved | 51 (1.6%)[1.2–2.2%] | Change in relationship associated with SES. |
| Neutral | 163 (5.1)[4.3–6.0%] | ||
| Worsened | 11 (0.3)[0.1–1.0%] | Worsened relationship associated with the request’s not being filled. | |
| Failure by patient to acknowledge doctor’s expertise or doctor experiencing difficulty with knowledgeable/activated patient | Doctor acted challenged | 30 (0.9%)[0.6–1.4%] | Low education |
| Serious dissatisfaction by patient | Respondent sought 2nd opinion, changed doctor or health plan) | 46 (1.4%)[1.0–2.2%] | Low SES, no relationship with having request filled. |
| Effects on health care system | |||
| Increased costs, without commensurate health gains. | Number of respondents who scheduled visit to physician to discuss ad Number of respondents who made specific requests Number of respondents who received what they asked for | 55 (1.7%)[1.2–2.4%] 161 (5.0%)[4.2–5.9%] 89 (2.8%)[2.2.–3.5] | Low education, being in managed care High SES |
* See previous article15 for full description of hypotheses.
† Outcomes are presented as a percentage of the total population of respondents to allow a comparison of the various effects on a population.
SES, socioeconomic status.