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Aikin KJ, Sullivan HW, Caporaso A, Hoverman V, Yan T, Williams D, Crafts J. Attention to risk information in direct-to-consumer prescription drug print ads: An eye-tracking study. Pharmacoepidemiol Drug Saf 2023; 32:312-320. [PMID: 35864719 DOI: 10.1002/pds.5511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 06/22/2022] [Accepted: 07/16/2022] [Indexed: 11/11/2022]
Abstract
PURPOSE FDA regulations state print ads for prescription drugs must provide a true statement of information "in brief summary" describing "side effects, contraindications and effectiveness." To fulfill these requirements, these ads typically display risk information both as important safety information (ISI) on the "main" ad page with the product claims and on a separate "brief summary" page. The ISI can be lengthy and may repeat brief summary content. METHODS The authors tested two versions of the ISI (short versus long) and the presence or absence of a brief summary in direct-to-consumer prescription drug print ads for two medical conditions: overactive bladder (N = 181) and rheumatoid arthritis (N = 179). Attention was measured with eye-tracking and self-report methods. Risk retention and perceptions were self-reported. RESULTS Participants spent more time viewing ads with a long ISI or a brief summary and in some instances, recalled more risks. The combination of a long ISI and a brief summary did not increase or decrease attention to or retention of risk information. CONCLUSION A long ISI and a brief summary may perform similar functions.
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Affiliation(s)
- Kathryn J Aikin
- US Food and Drug Administration, Office of Prescription Drug Promotion, Silver Spring, Maryland, USA
| | - Helen W Sullivan
- US Food and Drug Administration, Office of Prescription Drug Promotion, Silver Spring, Maryland, USA
| | | | | | - Ting Yan
- Westat, Rockville, Maryland, USA
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Lee YS, Kim SY, Lee H, Chae Y, Lee MS. ACURATE: A guide for reporting sham controls in trials using acupuncture. J Evid Based Med 2023; 16:82-90. [PMID: 36959765 DOI: 10.1111/jebm.12524] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 03/06/2023] [Indexed: 03/25/2023]
Abstract
OBJECTIVE To promote better reporting quality regarding sham acupuncture in clinical trials for a precise appraisal of the adequacy of the sham acupuncture procedure. METHODS A three-stage online Delphi survey was conducted to a group of experts. Items with higher than 80% consensus from the initial checklist were selected as the final candidates. Further discussion among the working group was convened to preclude potential redundancy among the items. RESULTS A total of 23 experts out of 35 (66%) responded to the Delphi process. The final checklist consists of 23 items in six categories: type of sham acupuncture, details of sham acupuncture manipulation, location of sham acupuncture, treatment regimen, practitioner, and protocol and settings. CONCLUSION This paper presents the Acupuncture Controls gUideline for Reporting humAn Trials and Experiments (ACURATE) checklist, an extension of The Consolidated Standards for Reporting of Trials (CONSORT) and to be used along with STandards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) when sham acupuncture needles are used in the study. This checklist focuses on a clear depiction of sham needling procedures to enhance replicability and enable a precise appraisal. We encourage researchers to use ACURATE in trials and reviews involving sham acupuncture to assist reporting sham acupuncture procedures and the related components.
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Affiliation(s)
- Ye-Seul Lee
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
| | - Song-Yi Kim
- Department of Anatomy and Acupoint, College of Korean Medicine, Gachon University, Seongnam, Republic of Korea
| | - Hyangsook Lee
- Department of Science in Korean Medicine, College of Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Younbyoung Chae
- Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Myeong Soo Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
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Giombi K, Thompson J, Wines C, Haughney R, Sullivan HW, Betts KR. A scoping review of empirical research on prescription drug promotion. Res Social Adm Pharm 2023; 19:859-872. [PMID: 36931982 DOI: 10.1016/j.sapharm.2023.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/21/2023] [Accepted: 02/22/2023] [Indexed: 03/04/2023]
Abstract
BACKGROUND Pharmaceutical spending on prescription drug promotion is considerable, and exposure to advertising can influence demand and behavior. The U.S. Food and Drug Administration (FDA) provides industry guidance to help ensure that communications to consumers and health care providers about prescription drug promotion are truthful, balanced, and accurately communicated. As empirical research has accelerated on this topic in the past decade, an understanding of the current landscape of the science will help inform future research. OBJECTIVES Using systematic methods, this rigorous scoping review of the literature over the past decade (2012-2021) (1) examined the extent to which prescription drug promotion has been empirically investigated with consumers, patients, and health care providers; (2) examined the extent to which content and features of prescription drug promotion have been empirically investigated; and (3) identified themes across the literature to better understand the current landscape of prescription drug promotion. METHODS Databases searched include PubMed, Web of Science, CINAHL, APA PsycInfo, Business Source Corporate, Communication Source, Cochrane Library, and ClinicalTrials.gov for original research published in English from January 1, 2012, through November 10, 2021, using terms related to direct-to-consumer advertising, prescription drugs, and outcomes of interest (e.g., attitudes, perceptions, intentions, behaviors). RESULTS Of 804 screened references, 151 studies addressed the first research question, and 40 studies addressed the second. The most common theme across the body of evidence focused on testing of features and content in prescription drug promotional materials (84), followed by studies examining attitudes, perceptions, and behaviors toward prescription drug promotion more generally (43). Some (27) studies focused on targeted populations, such as patients, the elderly, non-English speaking people or individuals of a non-white race/ethnicity. Twenty-four studies assessed influence of exposure to prescription drug promotion on actual clinical outcomes, while 11 studies examined emerging technologies around prescription drug promotion. Seven studies evaluated the extent to which prescription drug promotion complied with existing guidelines and requirements. CONCLUSIONS Findings from this scoping review suggest there has been an increase in the number of empirical studies conducted on prescription drug promotion over the past decade. Potential areas that warrant further study include examination of emerging technologies, an expanded focus on targeted populations, and construct measurement.
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Affiliation(s)
| | | | - Candi Wines
- RTI International, Research Triangle Park, NC, USA
| | | | - Helen W Sullivan
- U.S. Food and Drug Administration, Office of Prescription Drug Promotion, Silver Spring, MD, USA
| | - Kevin R Betts
- U.S. Food and Drug Administration, Office of Prescription Drug Promotion, Silver Spring, MD, USA
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Lee YS, Kim SY, Kim M, Kim M, Won J, Lee H, Lee MS, Chae Y. Reporting quality of sham needles used as controls in acupuncture trials: a methodological evaluation. Chin Med 2022; 17:64. [PMID: 35637519 PMCID: PMC9153153 DOI: 10.1186/s13020-022-00608-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 04/10/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE The description of controls is important in acupuncture clinical trials to interpret its effectiveness without fallacy. This paper aims to evaluate the reporting quality of acupuncture studies on the characteristics of sham needles. STUDY DESIGN AND SETTING Using a checklist developed from previously published reporting guidelines, the distribution of reported items and changes of reporting rates over time were investigated. Two-way ANOVA and linear regression were conducted. RESULTS Original articles of RCTs of any design involving sham needles as controls were eligible for assessment. 117 trials from three 2-year time periods between 2009 and 2018 were included. Seven items out of 25 were reported in more than 50% of the studies. While significant differences of reporting scores among categories were observed, there were no significant differences among time periods; no significant improvement was observed over time. CONCLUSIONS Low reporting qualities of sham needles used in acupuncture studies may influence how researchers understand the effectiveness of acupuncture. This study evaluated previous publications from 2009 to 2018 and found that reporting qualities on sham needles did not improve over time. Further studies are required to validate the items used in this study to endorse better reporting of controls in acupuncture trials.
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Affiliation(s)
- Ye-Seul Lee
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
| | - Song-Yi Kim
- Department of Anatomy and Acupoint, College of Korean Medicine, Gachon University, Seongnam, Republic of Korea
| | - Mariah Kim
- Department of Internal Medicine, Korean Medicine Hospital of Pusan National University, Yangsan, South Korea
| | - Minseo Kim
- Department of Anatomy and Acupoint, College of Korean Medicine, Gachon University, Seongnam, Republic of Korea
| | - Jiyoon Won
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Hyangsook Lee
- Department of Science in Korean Medicine, College of Korean Medicine, Graduate School, Kyung Hee University, Seoul, South Korea
| | - Myeong Soo Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Younbyoung Chae
- Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, 1 Hoegi-dong, Dongdaemun-gu, Seoul, Republic of Korea.
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Khokhar B, Weathers S, Mattingly TJ. Direct‐to‐consumer advertising (
DTCA
) and the advancement of the quadruple aim: a narrative review. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2022. [DOI: 10.1002/jac5.1599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Bilal Khokhar
- Takeda Pharmaceutical Company Cambridge Massachusetts
- General Dynamics Information Technology Silver Spring Maryland
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McConachie SM, Volgyi D, Moore H, Giuliano CA. Evaluation of adverse drug reaction formatting in drug information databases. J Med Libr Assoc 2021; 108:598-604. [PMID: 33013217 PMCID: PMC7524619 DOI: 10.5195/jmla.2020.983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective: The research evaluated the differences in formatting of adverse drug reaction (ADR) information in drug monographs in commonly used drug information (DI) databases. Methods: A cross-sectional analysis of formatting of ADR information for twenty commonly prescribed oral medications in seven commonly used DI databases was performed. Databases were assessed for presentation of ADR information, including presence of placebo comparisons, severity of ADR, onset of ADR, formatting of ADRs in percentile (quantitative) format or qualitative format, whether references were used to cite information, whether ADRs are grouped by organ system, and word count of the ADR section. Data were collected by two study investigators and discrepancies were resolved via consensus. Chi-square analyses and one-way analysis of variance (ANOVA) were used to evaluate for mean group differences in categorical and continuous data, respectively. Results: The seven DI databases varied significantly on each analyzed ADR variable, including variables known to impact interpretation such as placebo comparisons and qualitative versus quantitative formatting. Placebo comparisons were most common among monographs in Micromedex In-Depth Answers (70%) but were absent among monographs in Epocrates, Lexicomp, and Micromedex. Quantitative information was commonly used in most databases but was absent in Epocrates. Average word counts were higher in Clinical Pharmacology and Micromedex In-Depth answers compared to other databases. Conclusion: Substantial variation in ADR formatting exists between the most common DI databases. These differences may translate into alternative interpretations of medical information and, thus, impact clinical judgment. Further studies are needed to assess whether these differences impact clinical practice.
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Affiliation(s)
- Sean M McConachie
- , Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, and, Beaumont Hospital, Dearborn, MI
| | - Derek Volgyi
- , Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI
| | - Hannah Moore
- , Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI
| | - Christopher A Giuliano
- , Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, and, Ascension St. John Hospital, Dearborn, MI
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Lee C, McLean MJ, Huang CJ, Nguyen Zarndt A, Aikin KJ, Rausch P, Cohen BR, Delahanty J, Sholly DM, Slavit WI, Carlton ED. The FDA's Diverse and Dynamic Activities in the Social and Behavioral Sciences: Advancing and Supporting Health Equity. J Prim Care Community Health 2021; 12:21501327211004735. [PMID: 33764795 PMCID: PMC8772347 DOI: 10.1177/21501327211004735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 03/03/2021] [Accepted: 03/04/2021] [Indexed: 11/26/2022] Open
Abstract
The U.S. encompasses a heterogenous mix of people and health disparities exist for various subpopulations, such as minorities, women, people with limited English proficiency, those with low socioeconomic status, and other underserved groups. Differences in health outcomes arise in part due to inequalities and injustices rooted in biological, social, and structural factors. Because the origins of health disparities are multifactorial, the approaches to reduce, or even eliminate them, must be multifactorial as well. The social and behavioral sciences are well poised to address the myriad and complex factors that affect health outcomes, including those at the individual level (eg, individuals' behaviors, attitudes, and beliefs), the neighborhood level (eg, housing), the community level (eg, cultural values and norms), and the policy level (eg, public policies that influence healthcare funding and access to healthcare resources and educational materials). In addition, the social and behavioral sciences (1) help equip government agencies with the perspectives and tools needed to promote health equity and (2) contribute to rigorous, evidence-based solutions for public health issues, such as disparities found in childhood vaccination rates, childhood obesity, tobacco use, and access to health information technology. The FDA, in particular, actively conducts social and behavioral sciences research to guide the Agency's efforts to advance and support health equity.
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Affiliation(s)
- Christine Lee
- U.S. Food and Drug Administration, Silver Spring, MD, USA
| | | | | | | | | | - Paula Rausch
- U.S. Food and Drug Administration, Silver Spring, MD, USA
| | | | | | | | | | - Ewa D. Carlton
- U.S. Food and Drug Administration, Silver Spring, MD, USA
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McConachie SM, Giuliano CA, Mohammad I, Kale-Pradhan PB. Adverse drug reactions in drug information databases: does presentation affect interpretation? J Med Libr Assoc 2020; 108:76-83. [PMID: 31897054 PMCID: PMC6919994 DOI: 10.5195/jmla.2020.748] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 08/01/2019] [Indexed: 01/09/2023] Open
Abstract
Objective Formatting of adverse drug reaction (ADR) information differs among drug information (DI) resources and may impact clinical decision-making. The objective of this study was to determine whether ADR formatting impacts adverse event interpretation by pharmacy practitioners and students. Methods Participants were randomized to receive ADR information in a comparative quantitative (CQUANT), noncomparative quantitative (NQUANT), or noncomparative qualitative (NQUAL) format to interpret 3 clinical vignettes. Vignettes involved patients presenting with adverse events that varied in the extent to which they were associated with a medication. The primary outcome was interpretation of the likelihood of medication-induced adverse events on a 10-point Likert scale. Lower scoring on likelihood (i.e., ADR deemed unlikely) reflected more appropriate interpretation. Linear regression was performed to analyze the effects of ADR information format on the primary outcome. Results A total of 108 participants completed the study (39 students and 69 pharmacists). Overall, the CQUANT group had the lowest average likelihood compared to NQUAL (4.0 versus 5.4; p<0.01) and NQUANT (4.0 versus 4.9; p=0.016) groups. There was no difference between NQUAL and NQUANT groups (5.4 versus 4.9; p=0.14). In the final model, at least 2 years of postgraduate training (-1.1; 95% CI: -1.8 to -0.3; p<0.01) and CQUANT formatting (-1.3; 95% CI: -0.9 to -1.7; p<0.01) were associated with reduced likelihood. Conclusions Formatting impacts pharmacists' and pharmacy students' interpretation of ADR information. CQUANT formatting and at least two years of postgraduate training improved interpretation of adverse events.
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Affiliation(s)
- Sean M McConachie
- Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, and, Beaumont Hospital, Dearborn, MI,
| | - Christopher A Giuliano
- Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, and and, Ascension St. John Hospital, Dearborn, MI,
| | - Insaf Mohammad
- Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, and and, Beaumont Hospital, Dearborn, MI,
| | - Pramodini B Kale-Pradhan
- Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, and and, Ascension St. John Hospital, Dearborn, MI,
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Aikin KJ, Southwell BG, Paquin RS, Rupert DJ, O'Donoghue AC, Betts KR, Lee PK. Correction of misleading information in prescription drug television advertising: The roles of advertisement similarity and time delay. Res Social Adm Pharm 2017; 13:378-388. [DOI: 10.1016/j.sapharm.2016.04.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 04/12/2016] [Accepted: 04/13/2016] [Indexed: 11/28/2022]
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Williams PA, O'Donoghue AC, Sullivan HW, Willoughby JF, Squire C, Parvanta S, Betts KR. Communicating efficacy information based on composite scores in direct-to-consumer prescription drug advertising. PATIENT EDUCATION AND COUNSELING 2016; 99:583-590. [PMID: 26589655 PMCID: PMC8827128 DOI: 10.1016/j.pec.2015.10.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 09/02/2015] [Accepted: 10/28/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Drug efficacy can be measured by composite scores, which consist of two or more symptoms or other clinical components of a disease. We evaluated how individuals interpret composite scores in direct-to-consumer (DTC) prescription drug advertising. METHODS We conducted an experimental study of seasonal allergy sufferers (n=1967) who viewed a fictitious print DTC ad that varied by the type of information featured (general indication, list of symptoms, or definition of composite scores) and the presence or absence of an educational intervention about composite scores. We measured composite score recognition and comprehension, and perceived drug efficacy and risk. RESULTS Ads that featured either (1) the composite score definition alone or (2) the list of symptoms or general indication information along with the educational intervention improved composite score comprehension. Ads that included the composite score definition or the educational intervention led to lower confidence in the drug's benefits. The composite score definition improved composite score recognition and lowered drug risk perceptions. CONCLUSION Adding composite score information to DTC print ads may improve individuals' comprehension of composite scores and affect their perceptions of the drug. PRACTICE IMPLICATIONS Providing composite score information may lead to more informed patient-provider prescription drug decisions.
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Affiliation(s)
| | - Amie C O'Donoghue
- Office of Prescription Drug Promotion, Center for Drug Evaluation and Research, Food and Drug Administration (FDA), Silver Spring, MD, USA
| | - Helen W Sullivan
- Office of Prescription Drug Promotion, Center for Drug Evaluation and Research, Food and Drug Administration (FDA), Silver Spring, MD, USA
| | - Jessica Fitts Willoughby
- RTI International, Research Triangle Park, NC, USA; Edward R. Murrow College of Communication, Washington State University, Pullman, WA, USA.
| | | | | | - Kevin R Betts
- Office of Prescription Drug Promotion, Center for Drug Evaluation and Research, Food and Drug Administration (FDA), Silver Spring, MD, USA
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Mühlbauer V, Mühlhauser I. Understanding adverse drug reactions in package leaflets - an exploratory survey among health care professionals. BMC Health Serv Res 2015; 15:505. [PMID: 26554666 PMCID: PMC4641349 DOI: 10.1186/s12913-015-1160-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 10/30/2015] [Indexed: 01/22/2023] Open
Abstract
Background Current German or UK package leaflets do not contain an explicit notice that the listing of side effects does not imply that they are caused by the drug. Causal interpretations by patients and lay people are frequently observed. The authors examined whether health professionals understand that there is not necessarily a causal relation between drug intake and the frequency of side effects and whether adding placebo comparison improves understanding. Methods Exploratory survey consisting of eight assessments, each containing 2–6 survey items, and focus groups with one survey sample using questionnaires on adverse reactions in standard package leaflets and modified package leaflets supplemented with placebo comparison. Participants were convenience samples of 379 health professionals including 153 physicians (80 gynaecologists, 124 diabetes experts - physicians, nurses, and others, 39 medical students in their last year at university, 49 first year health science and education students with completed vocational training and professional experience in various health care professions and 87 pharmacists/pharmacy students). They were asked to rate how often the different adverse reactions listed were caused by drug intake. All surveys were carried out within university seminars and postgraduate lectures from April 2014 to June 2015 in Germany. Response rate was 86 % or higher. Results Without placebo comparison, the majority of participants responded that the drug causes adverse reactions with the frequency given in the package leaflet or even more often (95 % of health science students, 100 % of medical students, 60 to 80 % of physicians and 66 % of pharmacists/pharmacy students). Simply adding placebo comparison in a table did not prevent misunderstanding. Analysis of focus groups with health science students supported the lack of understanding. Conclusions In the present surveys, health professionals had major difficulties understanding frequency information on side effects in package leaflets. The great majority erroneously implied a causal relation between drug intake and the frequency of side effects, even though most side effects listed are symptoms commonly experienced in daily life. Electronic supplementary material The online version of this article (doi:10.1186/s12913-015-1160-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Viktoria Mühlbauer
- University of Hamburg, MIN Faculty, Health Sciences and Education, Martin-Luther-King Platz 6, D-20146, Hamburg, Germany.
| | - Ingrid Mühlhauser
- University of Hamburg, MIN Faculty, Health Sciences and Education, Martin-Luther-King Platz 6, D-20146, Hamburg, Germany.
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