Advertisement-Induced Prescription Drug Requests Patients' Anticipated Reactions to a Physician Who Refuses

Journal of Family Practice, June, 1999 by Robert A. Bell, Michael S. Wilkes, Richard L. Kravitz

Health perceptions and demographic characteristics. Each respondent's subjective evaluation of personal health was assessed with the 5-item general health perception subscale of the 36-Item Short Form Health Survey (alpha = .83).[23] Respondents also reported their current prescription drug use by indicating how many different prescription drugs they were taking at the time of the interview. The interview concluded with a set of standard demographic questions.

STATISTICAL ANALYSES

Our hypotheses were examined using cross-tabulations for the categorical predictor variables and independent sample t tests for the continuous variables.[24] The multivariate relationships of the predictor variables to the dependent measures were examined using 4 logistic regression analyses, I for each of the dependent measures.[25] To increase the statistical power of our comparisons, we collapsed across the categories of several variables as

follows: (a) race was treated as a dichotomous variable (0 = minority; 1 = white), because there were too few cases to make comparisons across the different ethnic groups; (b) age was recoded in 3 groups (18-39, 40-59, and 60 and older); and (c) income was recoded in 3 groups ([is less than] $30,000, $30,000 - $59,999, and [is greater than or equal to] $60,000).

RESULTS

ANTICIPATED REACTIONS TO REQUEST NONFULFILLMENT

Approximately 54% of respondents reported that they would not become disappointed if their request for a prescription was denied; 38% said they would be somewhat likely to become disappointed; and 8% reported a very likely rating. Fewer individuals thought that they would use persuasion in response to request nonfulfillment: 75% indicated that they would be not at all likely to try to change their physician's mind; 21% thought they would be somewhat likely to attempt to do so; and only 4% reported being very likely to attempt influence. Seventy-six percent considered prescription shopping to be an unlikely response; 18% thought it was a somewhat likely response; and 6% believed that they would be very likely to seek a prescription from a different physician. Doctor switching was not a likely outcome of request denial: 85% of respondents said they were not at all likely to seek a new doctor; 12% said that it was somewhat likely that they would do so; and only 3% thought that they would be very likely to switch doctors.

Disappointment, as an internal affective response, is qualitatively different from persuasion, prescription shopping, and doctor switching, all of which entail overt actions. Approximately 47% of respondents indicated that they would be neither disappointed in their physician nor likely to take any action in response to the denial of a prescription drug request. The percentage of respondents who would not be disappointed but would nevertheless take action was only 7%. Slightly more than 16% of respondents anticipated that they would be disappointed but not take action, and the remaining 30% thought that they would be both disappointed and take action.