Bozic Kevin J, Smith Amanda R, Hariri Sanaz, Adeoye Sanjo, Gourville John, Maloney William J, Parsley Brian, Rubash Harry E
Department of Orthopaedic Surgery, University of California San Francisco, CA 94143-0728, USA.
Clin Orthop Relat Res. 2007 May;458:202-19. doi: 10.1097/BLO.0b013e31804fdd02.
Direct-to-consumer advertising (DTCA) has become an influential factor in healthcare delivery in the United States. We evaluated the influence of DTCA on surgeon and patient opinions and behavior in orthopaedics by surveying orthopaedic surgeons who perform hip and knee arthroplasties and patients who were scheduled to have hip or knee arthro-plasty. Respondents were asked for their opinions of and experiences with DTCA, including the influence of DTCA on surgeon and patient decision making. Greater than 98% of surgeon respondents had experience with patients who were exposed to DTCA. The majority of surgeon respondents reported DTCA had an overall negative impact on their practice and their interaction with patients (74%), and their patients often were confused or misinformed about the appropriate treatment for their condition based on an advertisement (77%). Fifty-two percent of patient respondents recalled seeing or hearing advertisements related to hip or knee arthroplasty. These patients were more likely to request a specific type of surgery or brand of implant from their surgeon and to see more than one surgeon before deciding to have surgery. Direct-to-consumer advertising seems to play a substantial role in surgeon and patient decision making in orthopaedics. Future efforts should be aimed at improving the quality and accuracy of information contained in consumer-directed advertisements related to orthopaedic implants and procedures.
直接面向消费者的广告（DTCA）已成为美国医疗保健服务中的一个影响因素。我们通过对进行髋关节和膝关节置换手术的骨科外科医生以及计划进行髋关节或膝关节置换手术的患者进行调查，评估了DTCA对骨科外科医生和患者的意见及行为的影响。受访者被问及他们对DTCA的看法和经历，包括DTCA对外科医生和患者决策的影响。超过98%的外科医生受访者有过接触DTCA的患者的经历。大多数外科医生受访者报告称，DTCA对他们的业务以及他们与患者的互动产生了总体负面影响（74%），并且他们的患者常常基于广告对自身病情的适当治疗感到困惑或得到错误信息（77%）。52%的患者受访者回忆起看过或听过与髋关节或膝关节置换术相关的广告。这些患者更有可能向他们的外科医生要求进行特定类型的手术或使用特定品牌的植入物，并且在决定进行手术之前会咨询不止一位外科医生。直接面向消费者的广告似乎在骨科外科医生和患者的决策中发挥了重要作用。未来的努力应旨在提高与骨科植入物和手术相关的面向消费者的广告中所包含信息的质量和准确性。
