Direct-to-Consumer Advertising Linked to Lower Medication Adherence

Research on direct-to-consumer advertising (DTCA) for pharmaceuticals has focused mostly on whether patients requested and physicians prescribed the featured medications. A study published in Psychiatric Services explores a new angle—whether exposure to DTCA influences adherence to medications already prescribed to people with serious mental disorders. The findings point to the importance of talking to patients about adhering to their medication regimen and encouraging them to discuss any concerns they might have as a result of reading or viewing medication ads directed to consumers.

The study found a significant association between self-reports of DTCA exposure and self-reported medication nonadherence. “Notably, the odds of being nonadherent were nearly five times greater among individuals exposed to DTCA than among those not exposed,” wrote lead author Charee E. Green, L.C.P.C., of the Department of Psychiatry and Behavioral Sciences at Johns Hopkins School of Medicine.

“Our findings highlight the importance of prescriber awareness of the many sources of information, such as listed side effects in DTCA, that affect patient decisions about their care,” according to Green and colleagues.

Participants were drawn from a pool of outpatients aged 18 years or older at a mental health clinic at Johns Hopkins Hospital in Baltimore. Front-desk staff invited patients with scheduled appointments between June 13, 2016, and July 11, 2016, to complete a brief, anonymous survey. The survey was developed by the research team to assess exposure to advertising and patients’ adherence behaviors. Nonadherence was assessed with this question: “Have you ever missed taking a prescription medication for two or more days in one week?”

Of the 630 patients seen in that period, 246 patients (39%) completed the survey. Sixty-one percent of those exposed to DTCA reported nonadherence (72 of 118 patients), compared with 26% of those not exposed (32 of 122 patients). About 48% of the respondents (118) reported exposure to DTCA, and 42% (104) reported nonadherence.

Among those exposed to DCTA and reporting medication nonadherence, 59% reported that they either changed how they took their medications or stopped taking the medication, “specifically as a result of their exposure to side-effect information.” Only 39% of these respondents waited to speak to their physician before making the changes, according to the study.

“This raises concerns about the limitations of the role of physician input in decision-making process about their treatment,” the authors wrote. “A substantial proportion (36%) did not take physician input into account at all.”

For related information, see the Psychiatric News article “AMA Calls for Ban On Advertising Directed at Consumers.”

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