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Randomized Study of Placebo and Framing Information in Direct-to-Consumer Print Advertisements for Prescription Drugs

  • Original Article
  • Published:
Annals of Behavioral Medicine

Abstract

Background

Research suggests that quantitative information in direct-to-consumer (DTC) prescription drug ads may be helpful for consumers.

Purpose

The objective was to examine the effect of adding placebo rates and framing to DTC ads.

Methods

In study 1, 2,000 Internet panel members with chronic pain participated in a randomized controlled experiment of DTC ads varying in placebo rate and framing. In study 2, 596 physicians ranked DTC ads varying in placebo rate and framing by how well they conveyed scientific information and their usefulness for patients.

Results

In study 1, participants who viewed placebo rates were able to recall them and use them to form certain perceptions. A mixed frame led to lower placebo rate recall and perceived efficacy. In study 2, overall, physicians preferred a placebo/single frame ad.

Conclusions

Adding placebo rates to DTC ads may be useful for consumers. The evidence does not support using a mixed frame.

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References

  1. Prescription Drug Advertisements, 21C.F.R. Sect. 202.1 (2012).

    Google Scholar 

  2. Woloshin S, Schwartz L, Tremmel J, Welch HG. Direct to consumer advertisements for prescription drugs: What are Americans being sold? Lancet. 2001; 358: 1141-1146.

    Article  CAS  PubMed  Google Scholar 

  3. Fagerlin A, Ubel PA, Smith DM, Zikmund-Fisher BJ. Making numbers matter: Present and future research in risk communication. Am J Health Behav. 2007; 31: S47-S56.

    Article  PubMed  Google Scholar 

  4. Lipkus I. Numeric, verbal, and visual formats of conveying health risks: Suggested best practices and future recommendations. Med Decis Making. 2007; 27: 697-713.

    Article  Google Scholar 

  5. O'Donoghue AC, Sullivan HW, Aikin KJ, Chowdhury D, Moultrie RR, Rupert DJ. Presenting efficacy information in direct-to-consumer prescription drug advertisements. Patient Educ Couns; in press (available online 25 Dec 2013). doi:10.1016/j.pec.2013.12.010.

  6. Woloshin S, Schwartz LM, Welch HG. Using a drug facts box to communicate drug benefits and harms: Two randomized trials. Ann Intern Med. 2009; 150: 516-527.

    Article  PubMed  Google Scholar 

  7. Applebaum PS, Roth LH, Lidz C. The therapeutic misconception: Informed consent in psychiatric research. Int J Law Psychiatry. 1983; 5: 319-329.

    Article  Google Scholar 

  8. Stead M, Eadie D, Gordon D, Angus K. “Hello, hello—it’s English I speak!”: A qualitative exploration of patients’ understanding of the science of clinical trials. J Med Ethics. 2005; 31: 664-669.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  9. Miller JD. The measurement of civic scientific literacy. Public Underst Sci. 1998; 7: 203-223.

    Article  Google Scholar 

  10. Petty RE. Two routes to persuasion: State of the art. In: d’Ydewalle G, Eelen P, Bertelson P, eds. International Perspectives on Psychological Science, Vol. 2: The State of the Art. Hillsdale, NJ: Lawrence Erlbaum Associates, Inc.; 1994:229–247.

  11. Schwartz LM, Woloshin S, Welch HG. Using a drug facts box to communicate drug benefits and harms: Two randomized trials. Ann Intern Med. 2009; 150: 516-527.

    Article  PubMed  Google Scholar 

  12. Tversky A, Kahneman D. The framing of decisions and the psychology of choice. Science. 1981; 211: 453-8.

    Article  CAS  PubMed  Google Scholar 

  13. Schwartz LM, Woloshin S, Welch HG. Risk communication in clinical practice: Putting cancer in context. J Natl Cancer Inst Monogr. 1999; 25: 124-133.

    Article  PubMed  Google Scholar 

  14. Moxley A, O’Connell D, McGettigan P, Henry D. Describing treatment effects to patients: How they are expressed makes a difference. J Gen Intern Med. 2003; 18: 948-959.

    Article  Google Scholar 

  15. O’Connor AM. Effects of framing and levels of probability on patients’ preferences for cancer chemotherapy. J Clin Epidemiol. 1989; 42: 119-126.

    Article  PubMed  Google Scholar 

  16. Bernstein LM, Chapman GB, Elstein AS. Framing effects in choices between multi-outcome life-expectancy lotteries. Med Decis Making. 1999; 19: 324-338.

    Article  CAS  PubMed  Google Scholar 

  17. Peters E, Hart PS, Fraenkel L. Informing patients: The influence of numeracy, framing, and format of side effect information on risk perceptions. Med Decis Making. 2011; 31: 432-436.

    Article  PubMed  Google Scholar 

  18. McNeil B, Pauker SG, Tversky A. On the framing of medical decisions. In: Bell DC, Raffa H, Tversky A, eds. Decision Making: Descriptive, Normative, and Prescriptive Interactions. Cambridge, UK: Cambridge University Press; 1988: 562-568.

    Chapter  Google Scholar 

  19. Lipkus IM, Samsa G, Rimer BK. General performance on a numeracy scale among highly educated samples. Med Decis Making. 2001; 21: 37-44.

    Article  CAS  PubMed  Google Scholar 

  20. Jeffery RW. Risk behaviors and health: Contrasting individual and population perspectives. Am Psychol. 1989; 44: 1194-1202.

    Article  CAS  PubMed  Google Scholar 

  21. Schwartz LM, Woloshin S, Black WC, Welch HG. The role of numeracy in understanding the benefit of screening mammography. Ann Intern Med. 1997; 127(11): 966-972.

    Article  CAS  PubMed  Google Scholar 

  22. Herr PM, Kardes FR, Kim J. Effects of word-of-mouth and product-attribute information on persuasion: An accessibility–diagnosticity perspective. J Consum Res. 1991; 17: 454-462.

    Article  Google Scholar 

  23. Mizerski RW. An attribution explanation of the disproportionate influence of unfavorable information. J Consum Res. 1982; 9: 301-310.

    Article  Google Scholar 

  24. Finucane ML, Alhakami A, Slovic P, Johnson SM. The affect heuristic in judgments of risks and benefits. J Behav Decis Making. 2000; 13: 1-17.

    Article  Google Scholar 

  25. Slovic P, Peters E. Risk perception and affect. Curr Dir Psychol Sci. 2006; 15: 322-325.

    Article  Google Scholar 

  26. Nelson W, Fagerlin A, Peters E. Clinical implications of numeracy: Theory and practice. Ann Behav Med. 2008; 35: 261-274.

    Article  PubMed Central  PubMed  Google Scholar 

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Acknowledgments

The OMB Control Number for this study is 0910-0692. We would like to thank Adam Rosenblatt, M.A., of Penn Schoen Berland for his assistance with data collection and Kayla Gray of RTI International for her assistance with stimuli development. They both received compensation for their work through contracts with FDA. The study was funded by FDA, the organization at which all authors are employed.

Authors’ Statement of Conflict of Interest and Adherence to Ethical Standards

Authors O’Donoghue, Sullivan, and Aikin declare that they have no conflict of interest. All procedures, including the informed consent process, were conducted in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000.

Author information

Authors and Affiliations

  1. U.S. Food and Drug Administration, Silver Spring, MD, USA

    Amie C. O’Donoghue Ph.D., Helen W. Sullivan Ph.D., M.P.H. & Kathryn J. Aikin Ph.D.

  2. U.S. Food and Drug Administration, 10903 New Hampshire Ave., Bldg 51, Rm. 3236, Silver Spring, MD, 20993-0002, USA

    Amie C. O’Donoghue Ph.D.

Authors
  1. Amie C. O’Donoghue Ph.D.
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  2. Helen W. Sullivan Ph.D., M.P.H.
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  3. Kathryn J. Aikin Ph.D.
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Corresponding author

Correspondence to Amie C. O’Donoghue Ph.D..

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O’Donoghue, A.C., Sullivan, H.W. & Aikin, K.J. Randomized Study of Placebo and Framing Information in Direct-to-Consumer Print Advertisements for Prescription Drugs. ann. behav. med. 48, 311–322 (2014). https://doi.org/10.1007/s12160-014-9603-1

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  • DOI: https://doi.org/10.1007/s12160-014-9603-1

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