Datti Balaji, Carter Mary W
Center on Aging and Department of Community Medicine, West Virginia University School of Medicine, Morgantown, West Virginia 26506-9127, USA.
Drugs Aging. 2006;23(1):71-81. doi: 10.2165/00002512-200623010-00007.
Although older adults are frequent consumers of prescription drugs and increasingly the intended audience of direct-to-consumer advertising (DTCA) marketing efforts, little is known about the effect of DTCA on older adults' prescription drug-seeking behaviour. In response, the objective of this study is to examine factors associated with requesting a prescription drug from a physician following exposure to DTCA among older adults, and whether the drug or other medical treatment was prescribed during the encounter.
A secondary data analysis of the "Public Health Impact of Direct-to-Consumer Advertising of Prescription Drugs", a data set publicly available through the Inter-university Consortium for Political and Social Research (ICPSR 3687), was conducted. For the purposes of this study, only those respondents who indicated that they had been exposed to DTCA (n = 2601) were included in the study sample. Using a two-step weighted logistic regression approach, separate models were estimated to examine first, whether a request for the advertised drug was made following exposure to DTCA and secondly, the outcomes of any patient-physician encounters that occurred following exposure to DTCA.
Descriptive analysis of the outcome variables revealed that, among respondents exposed to DTCA, 31% (n = 801) requested a prescription drug from their physician. Approximately 5% of those who made a request were > or =75 years of age. Among respondents requesting a prescription drug, 69% (n = 556) received a prescription in response to their request, of whom, approximately 5% were > or =75 years of age. Multivariate findings suggest that although adults > or =75 years of age are less likely to request a prescription drug following exposure to DTCA (odds ratio [OR] = 0.58; p = 0.032), when they do approach their physicians, they are more likely to receive recommendations for further treatment, with ORs indicating a 250% (OR = 3.507; p = 0.002) increase in the odds of further referral among adults > or =75 years of age.
Overall, results from the study suggest that DTCA influences the patient-doctor relationship and prescription drug acquisition behaviour of patients; however, the nature of the effect of DTCA on older adults is complex. Because future cohorts of older adults may be more comfortable about requesting prescription drugs and the consumer-driven approach to obtaining medical care, understanding the impact of DTCA on older consumers represents an important area for further inquiry.
尽管老年人是处方药的频繁使用者，且越来越成为直接面向消费者的广告（DTCA）营销活动的目标受众，但关于DTCA对老年人处方药寻求行为的影响却知之甚少。为此，本研究的目的是探讨老年人在接触DTCA后向医生索要处方药的相关因素，以及就诊时该药物或其他医疗治疗是否被开具处方。
对“处方药直接面向消费者广告的公共卫生影响”进行二次数据分析，该数据集可通过大学间政治和社会研究联盟（ICPSR 3687）公开获取。就本研究而言，研究样本仅纳入那些表示接触过DTCA的受访者（n = 2601）。采用两步加权逻辑回归方法，分别建立模型，首先检验接触DTCA后是否会索要广告中的药物，其次检验接触DTCA后发生的任何医患就诊的结果。
对结果变量的描述性分析显示，在接触DTCA的受访者中，31%（n = 801）向医生索要了处方药。索要者中约5%的年龄在75岁及以上。在索要处方药的受访者中，69%（n = 556）的请求得到了处方，其中约5%的年龄在≥75岁。多变量研究结果表明，尽管75岁及以上的成年人在接触DTCA后索要处方药的可能性较小（优势比[OR] = 0.58；p = 0.032），但当他们就医时，更有可能获得进一步治疗的建议，OR值表明75岁及以上成年人进一步转诊的几率增加了250%（OR = 3.507；p = 0.002）。
总体而言，研究结果表明DTCA会影响医患关系和患者的处方药获取行为；然而，DTCA对老年人的影响性质较为复杂。由于未来的老年人群体可能对索要处方药以及以消费者为导向的医疗获取方式更为适应，了解DTCA对老年消费者的影响是一个需要进一步探究的重要领域。
