Leveraging Health Communication Research to Inform Regulation of Direct-to-Consumer Ads for Prescription Medications: a

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INVITED COMMENTARY

Leveraging Health Communication Research to Inform Regulation of Direct-to-Consumer Ads for Prescription Medications: a Comment on O’Donoghue et al. Lila J. Finney Rutten, Ph.D., M.P.H.

# The Society of Behavioral Medicine 2014

Direct-to-consumer (DTC) advertisement of prescription medications has dramatically increased over the past several decades [1–3]. The shift in market approach from physician-directed promotion to consumer-facing marketing raises important questions about the impact of DTC advertisement on patients, clinicians, and healthcare organizations [1, 3–6]. A growing body of research evaluating consumer and clinician responses to DTC advertising and communication of information about prescription medication has emerged from this controversy [7–12]. In this issue, O’Donoghue and colleagues [13], build upon previous research through an assessment of the impact of including placebo rates in and applying message framing to prevention and treatment claims on patients’ and physicians’ perceptions of the information contained in DTC print advertisement. A unique contribution of the research conducted by O’Donoghue and colleagues is the evaluation of the same set of ads by both patients and clinicians. The inclusion of both patient and clinician audiences more closely captures the complexity of the marketing and decision-making environment within which patients make decisions in collaboration with or under the advice of their healthcare providers, who are also likely to be exposed to said advertising.

L. J. F. Rutten (*) Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA e-mail: [email protected] L. J. F. Rutten Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA

In the first study described by O’Donoghue et al. [13], patients viewed 1 of 14 fictitious DTC prescription medication ads which were varied according to message frame (single-positive or mixed-positive and negative), placebo information (no information, small difference between placebo and medication effect, and big difference between placebo and medication effect), and nature of claim (prevention or treatment). Participants who viewed ads containing no placebo information and those who viewed ads with large differences between the medication and the placebo reported similar perceptions of medication benefit which were uniformly greater than perceptions of benefit reported by those who viewed ads reporting small differences in effect between the placebo and medication. That is, in the absence of placebo information (i.e., current practice in DTC ads), participants were more likely to believe that prescription medications work well. These important findings suggest that the inclusion of placebo rates in DTC ads may encourage more accurate perceptions of the effectiveness of prescription medications. The second study described by O’Donoghue et al. [13] assessed primary care physicians’ perceptions of ficti