Evaluations of care by adults following a denial of an advertisement-related prescription drug request: The role of expectations, symptom severity, and physician communication style

• Published in: Social science & medicine (1982) Vol. 62; no. 4; pp. 888 - 899
• Main Authors: Shah, Mansi B., Bentley, John P., McCaffrey, David J.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.02.2006; Elsevier; Pergamon Press Inc
• Series: Social Science & Medicine
• Subjects: Adult; Advertisements; Advertising; Advertising as Topic; Biological and medical sciences; Clinical decision making; Communication; Decision making; Denial; Direct-to-consumer advertising; Doctor-patient relationship; Drug Industry; Drug Prescriptions - statistics & numerical data; Drug Utilization - statistics & numerical data; Drugs; Evaluation; Expectations; Factor Analysis, Statistical; Faculty; Female; Health care; Health care industry; Health Care Surveys; Health participants; Health services; Health Services Research; Humans; Interpersonal communication; Male; Manipulation; Medical personnel; Medical sciences; Medicine; Middle Aged; Miscellaneous; Mississippi; Patient Participation; Patient requests; Patient Satisfaction; Patients; Patients rights; Patient–physician relationship; Pharmaceuticals; Physician communication style; Physician communication style Patient requests Patient-physician relationship Direct-to-consumer advertising Prescription Vignette design; Physician patient relationships; Physician-Patient Relations; Physicians; Prescription; Prescription drugs; Public health. Hygiene; Public health. Hygiene-occupational medicine; Qualitative Research; Refusal to Treat - statistics & numerical data; Research design; Respondents; Severity; Symptoms; Trust; U.S.A; Universities; Variables; Variance analysis; Vignette design; Vignettes; Mississippi; Direct-to-consumer advertising; Prescription; Vignette design; Patient requests; Physician communication style; Patient–physician relationship; Human; Evaluation; Health staff; Decision making; Physician; Patient; Information; Patient-physician relationship; Care; Physician patient relation; Medical prescription; Adult; Critical study; Advertising; Communication
• ISSN: 0277-9536; 1873-5347
• DOI: 10.1016/j.socscimed.2005.06.053

As patients continue to take a more active role in their health care, an understanding of patient requests of health care providers, including what happens when requests are not fulfilled, is becoming more important. Although its merits have been debated, direct-to-consumer advertising of prescription drugs generates patient requests. The objective of this study was to assess the influence of physician communication style, respondents’ expectations of receiving a requested prescription, and perceived symptom severity on respondents’ evaluations of care following a physician denial of a prescription drug request stimulated by direct-to-consumer advertising. A 2×2×2, between-subjects experimental design was used. The respondents were made up of employees of the University of Mississippi. Physician communication style, respondents’ expectations, and respondents’ perceived symptom severity were manipulated using vignettes. Respondents’ post-visit evaluations of care were assessed by measuring trust in the physician, visit-based satisfaction with the physician, and commitment toward the physician. Factorial analysis of variance procedures for a three-way design were used to test the hypotheses and assess the research questions. Manipulation checks suggested that the independent variables were appropriately manipulated. No significant first-order or second-order interactions were noted in any of the analyses. Post-visit evaluations of care were significantly associated with physician communication style (a partnership response led to better evaluations of care). There were no significant effects of either prior expectation of request fulfillment or perceived symptom severity. However, non-significant trends in mean scores suggested a potential role of these variables in the evaluation process following request denial. The manner in which a physician communicates with an individual is an important determinant of the evaluation of care following the denial of a request. The results suggest that health care providers attempting to minimize the effect of request denials on patient evaluations should make an effort to involve the patient in the decision-making process.