Physician Assistants’ Views of Direct-to-Consumer Advertising Effects during Patient Encounters

Abstract

Purpose: Direct-to-consumer advertising (DTCA) has become an important tool for disseminating drug information that directly impacts the patients and providers in the delivery of health care. Limited research shows that DTCA has both benefits and drawbacks that impact public health. However, there is a paucity of empirical evidence of the effects of DTCA information discussed during an office visit from the perspective of physician assistants. The purpose of the study was to examine physician assistants’ general views of DTCA benefits and drawbacks, as well as the effects DTCA information discussed during patient encounters on physician assistant-patient relationship, physician assistants’ prescriptive authority and time efficiency of the visit. Methods: A cross-sectional design was used to survey physician assistants in a single U.S. Midwestern state. A random sample of 860 of the state’s 4,483 physician assistants was drawn. The final sample consisted of 161 PAs (18.72%). Of these, 149 PAs (93%) had experience with discussing DTCA during an office visit. Pearson’s chi-squared analysis, logistic regression and multinomial logistic regression analyses were used to measure the associations between the variables. Results: Of the 161 physician assistants, most thought that DTCA drove up drug costs (76%), promoted unnecessary fear of side effects (71%), and did not provide a balanced view of risks and benefits of the product (64%). Conversely, most agreed that DTCA alerted patients to new therapies (74%) and did not create a conflict between the physician assistant and supervising physician (71%). Of the 149 physician assistants who experienced discussion about DTCA during a visit, 49% reported that patients did so because they wanted a drug; 62% deemed patients’ requests inappropriate; and 74% viewed DTCA as worsening the time efficiency. Worsened efficiency was associated with the patient wanting a test, bringing a printed advertisement, and the advertisement not being relevant. Worsened physician assistant-patient relationship was associated with challenged authority. Conclusions: The study highlights the need to enhance dialogue between the physician assistant and the supervising physician about patient needs, to provide targeted DTCA educational training opportunities that sharpen communication and interpersonal skills, and to incorporate physician assistants’ perspectives in future guidelines governing DTCA.