Amie C. O'DOnoghue

Purpose: Exhibit hall booths at medical conferences are a key avenue for promoting prescription drugs to health care providers (HCPs). Because HCPs spend considerable time interacting with industry representatives at conferences, we explored how representatives’ credentials might influence HCP perceptions and prescribing intentions of promoted drugs. We also examined how disclosures of clinical trial data limitations about these drugs during conference interactions might influence HCP perceptions and intentions. Methods: We conducted a 2 × 2 factorial experimental study with HCPs (n = 430) during or immediately after their attendance at 1 of 12 US medical conferences. Participants viewed video stimuli depicting an exhibit hall interaction between an industry representative and an HCP discussing a fictitious drug for preventing nausea and vomiting. Participants were randomly assigned to 1 of 4 experimental conditions that varied (1) the representative’s educational credentials (MBA vs MD) and (2) a disclosure noting clinical trial data limitations (present vs absent). Participants then completed an online questionnaire with questions about the fictitious drug, such as perceived efficacy and perceived risk. Results: Industry representative credentials had no influence on HCP perceptions and intentions to prescribe the drug, though representatives with medical degrees were rated as having slightly more medical knowledge. Conversely, the disclosure significantly reduced drug efficacy perceptions and led to less positive drug attitudes, although it did not influence prescribing intentions. Conclusions: The findings suggest that HCP perceptions and intentions are not swayed by the industry representative credentials but that data limitation disclosures can temper HCP perceptions of drugs promoted at medical conferences.

Prescribing approved products for unapproved uses (off-label use) is not uncommon among physicians in certain medical specialties. Available evidence about an off-label use – both supportive and unsupportive – can influence prescribers’ decisions about a drug’s appropriateness for a particular case. The objectives of this study were: (1) to examine physician perceptions about off-label uses generally, including their awareness of unsupportive data; and (2) to explore the influence of disclosure information about unsupportive data on off-label prescribing decisions. Semi-structured interviews were conducted between December 2019 and January 2020 with oncologists (n = 35) and primary care physicians (n = 35). Interviews explored general prescribing practices, understanding of and information sources for learning about off-label use of prescription drugs, awareness of unsupportive data related to off-label uses, and preferences and reactions to disclosure statements about the existence of unsupportive data related to an off-label use. Most participants reported prescribing drugs for off-label uses (with half reporting regular off-label prescribing). However, among those who prescribe off-label, approximately two-thirds had never seen unsupportive data about off-label uses. Physicians preferred a disclosure statement that provided a summary of the unsupportive data about the off-label use; this statement also led most physicians to say they were unlikely or less likely to prescribe the drug for that use. This study suggests that physicians’ decision-making about prescribing for off-label uses of approved drugs may be influenced by awareness of unsupportive data. Our interviews also suggest that providing more information about unsupportive study findings may result in a reduction in reported prescribing likelihood.

This study experimentally tested the effects of animation versus rotoscoping versus live action in direct-to-consumer television advertising on outcomes, including risk and benefit perceptions and attitudes toward the drug. The authors used an online panel to recruit participants with chronic dry eye (n = 504) and psoriasis (n = 490). The study found no effects of animation or rotoscoping on perceptions of drug risk or benefit, comprehension, or behavioral intentions. Animated advertisements, however, resulted in more negative attitudes than live-action or rotoscoped advertisements. Future research should explore whether animated advertisements are recalled better over time or have any lagged effects on perceptions.

Direct-to-consumer prescription-drug television advertisements often contain superimposed text (supers) to convey information about the advertised product. This randomized experiment examined three size levels of supers and two levels of background contrast in direct-to-consumer advertisements. Participants (N = 1,272) watched different versions of a television advertisement for a fictitious asthma drug on either a flat-screen television or a tablet computer. Larger supers were more noticeable and memorable than smaller supers. High-contrast supers were less noticeable. Tablet users had more favorable views of the advertisement. Results have implications for the communication of important medical information in direct-to-consumer advertisements.

To determine how individual difference (age, cognition, and hearing) and risk presentation (audio frequency, speed, and organization) variables affect viewing of direct-to-consumer (DTC) prescription drug television ads, participants (N = 1,075) from four age groups across the adult lifespan took an in-person hearing examination, watched a DTC television ad, and responded to survey questions. Results showed that increased age was related to reduced cognition and hearing ability, as well as lower ad comprehension and risk recall. Greater speed and more complex organization of the ad’s risk information lowered risk recall and claim recognition. Audio frequency had no effect. Cognitive abilities mediated the relationship between age and risk recall. Our findings suggest that older adults are likely to have more difficulty recalling and understanding the risks presented in DTC television ads. Risk information can be presented in ways that facilitate or inhibit recall and recognition among individuals across the lifespan.

This study examined the use of an actor to communicate prescription drug risks on pharmaceutical websites. Participants viewed risk information for a fictitious drug in one of several static visual formats or as a paragraph plus an animated actor; and with or without a signal directing them to the risk information text. The signal had little effect on outcomes. Format did not affect risk processing, but participants in the actor condition thought the website placed less emphasis on benefits. Actors communicating risk information on a pharmaceutical website do not appear to improve consumers’ understanding of prescription drug information.

In 2 studies, we investigated how laypersons perceive the Food and Drug Administration (FDA) approval process, FDA authority, and the presentation of composite scores in direct-to-consumer (DTC) prescription drug print ads. The 1st study consisted of 4 focus groups (N = 38) in 2 cities. Using a semi-structured guide, a moderator led participants through the viewing of 3 existing DTC print ads that differed in the presence or absence of composite score information, and participants discussed their views of the ads and their understanding of composite scores. The 2nd study surveyed a nationally representative sample of 1,629 individuals from the general population who saw a fictitious DTC print ad and answered closed-ended questions about the same topics. Results showed that knowledge of FDA approval and authority was mixed, with several misconceptions apparent. Many consumers were not familiar with the use of composite scores in a medical context or in advertising and, in the 1st study, expressed distrust of the product and the ad after learning about how composite scores are used. In the 2nd study, receiving composite score information changed the perceived clarity of the ad but not the perceived risk or benefits. Implications for the presentation of complex medical information are discussed.