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Patients' Experiences With Prescription Drugs and Drug Advertising

Much of my work focuses on investigating prescription drug users' experiences with prescription drugs and their understandings of pharmaceutical advertising. In this project, I focus on the racial and ethnic differences in users' relationships with drugs. This research resulted in recommendations to physicians to provide culturally competent and holistic care to patients. It also recommends that the drug industry create drug advertisements that are culturally relevant and ethical.

The Problem

How –do racial and ethnic minorities differ from whites in their experiences with prescription drugs and pharmaceutical advertising? We know that Americans are increasingly reliant on prescription drugs over other treatment options. But is this the case for all Americans? Does race matter in explaining whether people are more or less receptive to taking drugs? This project investigates the role race and ethnicity plays in contributing to variations in patients' preferences for prescription drugs and examines how people from different racial and ethnic backgrounds differently respond to drug promotion.

Colorful pills assortment

Research Team

–This project included 6 graduate student Research Assistants and me, the Principal Investigator (PI). As PI, I refined the research problem to be investigated, formulated the research design, strategized all phases of the research process, and supervised RA activities. I communicated the project and the study recommendations to potential stakeholders at 3 conferences and in 3 peer-reviewed publications.

Stand Up Meeting

Approach

We chose to conduct focus groups to investigate the research questions for two principal reasons. First, –this research was exploratory and the team wanted to collect data to help narrow the topic and formulate a more specific research question for a later project. Second, the PI was on a short timeline and wanted to gather data quickly.

 

We decided to conduct race-based focus groups because we wanted to identify differences in discussions around pharmaceuticals across focus groups with different racial demographics. Further, we wanted to ensure that participants felt comfortable speaking up in the group interviews, as research shows that minorities are more comfortable in environments with a shared racial and cultural identity. Twenty-four participants participated in the focus groups, and we decided to structure the focus groups based on minority status and language preference. Two focus groups had non-Hispanic, English-speaking white participants, two were composed of minority English-speakers, and two included minority Spanish-speakers.

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Study Group

Results

–There were three main findings of this research:

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  1. Racial minorities expressed greater skepticism of taking prescription drugs compared to whites. The minority participants believed that most Americans prefer the quick solution (i.e. prescription drugs) over therapies that take more time to see effects, such as lifestyle changes. These participants felt that the American health system and culture rely too much on pharmaceuticals as treatment solutions. The immigrant participants were the most skeptical of taking drugs. The white participants were less skeptical of prescription drugs.

  2. Minorities preferred alternative treatments reflective of their culture. Minorities’ discussions about prescription drugs indicated that their culture influences their health decisions regarding pharmaceuticals. When deciding to take a prescription drug, minorities do not simply weigh the potential risks with the potential payoffs. Instead, they evaluate prescription drugs vis-à-vis other remedies that reflect their cultures, such as holistic therapies and herbal remedies. White participants were less likely to discuss alternatives to prescription drugs. Minority participants felt their personal health approach did not align with that of their primary care physician, who was eager to prescribe.

  3. All participants believed pharmaceuticals should be advertised directly to the public. There were no racial differences in participants' desire for pharmaceutical advertising. While participants were skeptical of the intentions of marketers, they nonetheless believed that it was better for prescription drugs to be marketed to the public than for this information to not be disseminated. They believed physicians are gatekeepers and will not prescribe unnecessary drugs to patients even if patients pressure doctors for a particular diagnosis or drug that they have seen marketed. Minority participants, however, felt advertisements were less relevant to their cultural backgrounds.

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Research Impact

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Three journal articles were published from this study (see the references, below). In addition, 2 policy recommendations follow from the findings:

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  1. Physicians should provide culturally competent and holistic care to patients. Minority patients expressed dissatisfaction with their physicians' lack of openness to alternative therapies, even when these therapies were simple dietary or lifestyle changes. They felt physicians put too much pressure on patients to take pharmaceuticals without first pursuing other avenues. This research recommends that physicians rethink their prescribing practices to consider a treatment regimen that is not narrowly focused on prescription drugs.

  2. Drug advertisements need to be culturally relevant. Minority patients desired drug information from manufacturers. However, they did not feel that advertisements were constructed with their racial and ethnic background in mind. Drug marketers should include more diversity in advertisements and target culturally relevant advertisements to specific racial and ethnic groups.

Publications

 

Harder, B. M., & Adams, C. (2020). Conducting Race-Based Focus Groups on Health Issues: Confronting Challenges in Design, Implementation, and Analysis. SAGE Research Methods Cases: Medicine and Health. SAGE Publications Ltd.

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Adams, C., Harder, B. M., Chatterjee, A., & Hayes Mathias, L. (2019). Healthworlds, cultural health toolkits, and choice: How acculturation affects patients’ views of prescription drugs and prescription drug advertising. Qualitative Health Research, 29(10), 1419-1432.

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Adams, C., Chatterjee, A., Harder, B. M., & Mathias, L. H. (2018). Beyond unequal access: Acculturation, race, and resistance to pharmaceuticalization in the United States. SSM-population health, 4, 350-357.

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