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Woodie M. Zachry III, PhD; James E. Dalen, MD; Terrence R. Jackson, PharmD, MS

Arch Intern Med. 2003;163:1808-1812.

Background  The direct-to-consumer advertising (DTCA) of prescription medications is proliferating in the United States. The relationship between patient exposure to DTCA and the response of clinicians is not well understood.

Methods  A randomized postal survey of Arizona primary care provider physicians (n = 1080) and physician assistants (n = 704) was conducted. A questionnaire was created using a hypothetical patient scenario that varied according to the diagnosis of the patient (ie, hypertension, hypercholesterolemia, seasonal allergies, or obesity) and the type of informational exposure generating the patient's questions (ie, DTCA vs drug references such as Physicians' Desk Reference). Clinicians were randomly assigned 1 of 8 forms of the scenario and were asked standardized questions related to their responses when faced with the patient scenario.

Results  The response rate was 44% (40.5% of physicians and 49.3% of physician assistants). No statistically significant differences were found between the early and late responders or between responders and nonresponders. Relative to clinicians who received the "drug reference book" patient scenario, clinicians who received the DTCA patient scenario were more likely to become annoyed with a patient for asking for more information about medications (P = .003); less likely to answer the patient's questions (P = .03) or provide additional written information (P = .007); more likely to become frustrated (P = .003) and annoyed (P<.001) with the patient for asking to try a specific medication; and less likely to provide samples (P = .001) or a prescription (P<.001) for a specific medication.

Conclusion  Clinicians are amenable to patients asking for drug information and medications, but they are less receptive to questions arising from DTCA.

From the Colleges of Pharmacy (Dr Zachry) and Medicine (Dr Dalen), University of Arizona, Tucson; the College of Pharmacy, University of Illinois at Chicago, Chicago (Dr Jackson). The authors have no relevant financial interest in this article.

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