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

MULTIVARIATE ANALYSES

The independent effects of the predictor variables were assessed in 4 logistic regression analyses -- 1 for each reaction -- which were coded dichotomously (0 = not at all likely; 1 = somewhat or very likely). Table 2 shows the estimated odds ratios and 95% confidence intervals for the significant predictors in these analyses. Positive evaluations of physician communication abilities were associated with lower ratings for the likelihood of all reactions. A positive attitude toward DTC advertising was a significant multivariate predictor for all reactions except doctor switching. Misplaced faith in the regulation of DTC advertisements was associated with a greater likelihood of using persuasion, prescription shopping, and doctor switching. Finally, individuals who were taking prescription drugs at the time of the survey were more likely to anticipate responding to nonfulfillment with an argument.

TABLE 2
Estimated Odds Ratios for Significant Predictors of 4 Reactions to
Physician Nonfulfillment of an Advertisement-Induced Prescription
Drug Request

Predictor                               Disappointment
Variable                            OR               95% CI

Physician CQ
No relationship                  1.00
Poor                             1.26               .62-2.57
Average                          1.09               .52-2.27
Positive                          .44(*)            .20-.94

Attitude toward DTC advertising
First quartile (most -)          1.00
Second quartile                  1.22               .61-2.43
Third quartile                   1.53               .80-2.93
Fourth quartile (most  )      5.79([dagger])       2.85-11.74

Faith in regulation, misconceptions
None
1-2
3-4

Current prescription drug use
None
Taking more than 1 drug

Predictor                                Persuasion
Variable                            OR               95% CI

Physician CQ
No relationship                    1.00
Poor                                .54             .24-1.20
Average                             .41(*)          .17-.95
Positive                      .141([dagger])        .05-.36

Attitude toward DTC advertising
First quartile (most -)            1.00
Second quartile                    1.40             .60-3.27
Third quartile                      .72             .30-1.72
Fourth quartile (most  )           2.63(*)         1.16-5.94

Faith in regulation, misconceptions
None                               1.00
1-2                                2.12(*)         1.00-4.48
3-4                        3.92([double dagger])   1.60-9.59

Current prescription drug use
None                               1.00
Taking more than 1 drug    2.42([double dagger])   1.34-4.37

Predictor                            Prescription Shopping
Variable                            OR               95% CI

Physician CQ
No relationship                    1.00
Poor                               1.21             .55-2.68
Average                             .59             .25-1.39
Positive                            .25(*)          .10-.67

Attitude toward DTC advertising
First quartile (most -)            1.00
Second quartile                    1.45             .56-3.77
Third quartile                     2.84(*)         1.21-6.68
Fourth quartile (most  )   3.61([double dagger])   1.49-8.76

Faith in regulation, misconceptions
None                               1.00
1-2                                1.34             .64-2.79
3-4                        3.03([double dagger])   1.30-7.05

Current prescription drug use
None
Taking more than 1 drug

Predictor                              Doctor Switching
Variable                            OR               95% CI

Physician CQ
No relationship                    1.00
Poor                               1.34             .54-3.62
Average                             .50             .18-1.43
Positive                            .25(*)          .08-.83

Attitude toward DTC advertising
First quartile (most -)
Second quartile
Third quartile
Fourth quartile (most  )

Faith in regulation, misconceptions
None                               1.00
1-2                                2.20             .83-5.82
3-4                           7.44([dagger])       2.68-20.64

Current prescription drug use
None
Taking more than 1 drug