We Hold the Keys and We Know It

We are all consumers. We read articles about health care in magazines and newspapers. We self-treat our symptoms with over-the-counter products. We experiment with natural herbal remedies and alternative medicines. We read articles and hear friends discuss the prescription medications they are taking.

Over the years, many of us have come to view prescription drugs like any other commodity. And now, many of us are trying to make informed decisions about new drug treatments from information in DTC ads and pamphlets sent from toll-free numbers.

The advent of DTC advertising has added an entirely new dimension to our role in prescription medication decisions. Consumers are now on the cutting edge–we can judge a medication’s merits before we even go to the doctor’s office. Some ads inform us to “watch for it soon”–before the drug is even approved.

Levels of Understanding

Most consumers have no medical background. The first time we experience the health care system, we are very trusting. That continues until the day we make a mistake unknowingly about how to take a prescription drug or suffer an unexpected adverse reaction.

We realize that we are the ones who have to live with the consequences of a prescription drug therapy, and we vow to become better informed. Many of us try to do research or find information about our condition and treatment. We start asking more questions, but without a medical background we can only ask those that we “think” are important. Some of us receive additional guidance in making wise decisions about how to manage our medications from health professionals and written information.

Too often, we cannot understand the information we read in DTC ads about a particular drug as well as the information we receive once the drug has been prescribed. In fact, studies have shown that as many as 97 percent of patient education materials are written at a reading level higher than the average consumer can understand.

The best way to understand the situation is to put yourself in the shoes of a consumer reading an ad for a new prescription drug in a magazine. It catches your attention because you have some of the symptoms described. As you read the ad, you come across words such as “stroke” or “hypertension,” which the ad writers apparently thought were common but which most consumers don’t understand.

Communication Breakdown

You turn the page and see the product labeling information, presented in the form of columns of black and white medical terminology. You have no idea what to make of language such as, “[Drug] should not be given to patients with ischemic heart disease (angina pectoris, history of myocardial infarction, or documented silent ischemia) or to patients who have symptoms or findings consistent with ischemic heart disease, coronary artery vasospasms, including Prinzmetal’s variant angina or other significant underlying cardiovascular disease (see WARNINGS).” Your warning flags go up! You read on… “If, during the cardiovascular evaluation, the patient’s medical history, electrocardiographic, or other investigations reveal findings indicative of, or consistent with, coronary artery vasospasm or myocardial ischemia, [Drug] should not be administered.” Then the ad refers you to the “Professional Information Brochure,” for more information, which you have no idea how to find or even what it is!

As soon as consumers realize they do not understand the information in the DTC ad or collateral material, they start asking questions. A list of adverse effects written in medical terminology makes them uneasy at best; frightened at worst. We turn to friends, family members, and the Internet for advice. We think we are making informed choices, but we really aren’t.

The consequences of our decisions are that we don’t receive the full benefit of the treatment, our quality of life suffers, and our taxes eventually have to cover the $100 billion each year to pay for the additional health care required to treat our mistakes and decreased work productivity.

Joining Forces

If a prescription drug is ever going to have a chance to work, we need information that we can trust and understand. Consumers hold the key to the success of a drug therapy as well as to decreasing the present out-of-control health care costs. Those high costs are a result of patients making unwise decisions with their prescription drug therapies.

Once the doctor hands us a prescription, we as consumers start making critical decisions that will determine whether the medication will ever have the chance to be effective. For example, each time we receive a prescription, we try–as best we can–to weigh the risks against the benefits and decide what we will do: Have the prescription filled? Take the medication as directed? Stop taking it at the first sign of side effects? Have it refilled?

The key is to give consumers information they can understand and trust. Make the consumer your ally. This is a time when consumers know that what is presented in the press as “the truth” frequently isn’t “the whole truth” or is slanted wording. Consumers are predisposed to be suspicious.

When it comes to published materials on medications, consumers want straightforward, practical information about the benefits of the medication and its associated risks, how to take it, how to manage side effects and when to seek medical help, and how to know if the medication is helping them.

That means no more medical terminology written at the Grade 16 level. A good Patient Package Insert that is FDA-approved will contain information that incorporates language consumers can understand and behavior modification techniques that will help improve patient compliance

Bottom Line

DTC programs present a real opportunity to help consumers become more responsible partners in their drug therapy. The most strategic approach a pharmaceutical company can take is to base its DTC advertising and collateral materials more on patient education principles and less on advertising techniques. DTC programs should aim to educate consumers–not just sell them a new product.

The initial DTC messages to consumers can set the stage for all patient compliance programs to follow once the medication has been prescribed. Give consumers a consistent message–one that is reinforced if the physician prescribes the medication in the DTC program. The most effective

DTC program will be one that is integrated with the patient education programs for the specific medication.

Consumers are savvy. We hold more power today than we did yesterday. Consumers will reward health professionals, organizations, and pharmaceutical companies that give them the information we want and need to make wise decisions about their prescription drug therapies. The first step is to make consumers your strongest ally!

Dr. Dorothy L. Smith is a consumer education expert and president of Consumer Health Information Corporation. The full-service company specializes in patient labeling, program development, and strategic planning for DTC campaigns.

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Published in Pharmaceutical Executive, May 1998. Copyrighted material; All rights reserved.