179894 Consumer expectations of success when taking prescription medications while assessing drug risks: A discrete choice experiment

Sunday, October 26, 2008

Jack E. Fincham, PhD , School of Pharmacy, University of Missouri Kansas City, Kansas City, MO
The decision whether to use prescription medications is a complex, multifactor consideration affecting consumers, caregivers, health professionals, and others. Patients assess risks and benefits when choosing to take prescription medications. The expectations for successful outcomes, and acceptance of a degree of risk when consuming medications affects this decision. This study assessed consumers' willingness to use prescription medications when considering various factors. A full factorial discrete choice experiment (DCE) was accomplished with a sample of 500 consumers obtained through a stratified, random digit dialed survey methodology. Three attributes were included in the study design: successful outcomes associated with prescription drugs (4 levels), type of health conditions (2 levels), and perceived risks when taking prescription drugs (2 levels). Thus, there were 16 total levels included in the attribute component of the survey. Additional questions probed the respondents' self assessment of health, and their self assessed level of compliance. Demographic questions including age, gender, income, education, residence type, and metropolitan statistical area (MSA) were also administered. Females accounted for 63 % of the sample, and the average of respondents was 47 years. In the logistic regression model derived from the study, age, education, gender, residence ownership, and MSA status were not significantly related to the choice of willingness to use a prescribed medication. Overall, respondents were not willing to choose to use prescription medications when faced with certain drugs risks and a diminished potential for success for the treatment (p < .001). But, of those expressing willingness to comply with prescribed drugs, a successful outcome (p < .001) and a self stated positive level of compliance (p< .001) were significantly related to the decision to use medications. Levels of self-assessed health status were not significantly related to a decision to comply with medications. In a willingness to use analysis, for participants to choose to use prescription medications, an estimated 30.7% increase in potential success of a therapy was necessary. If the risk of the drugs was not an issue, an estimated 2% increase in potential success was necessary. If an acute drug was being prescribed, an increase of 4% in the possibility for success was necessary to use the prescribed medication. Participants made choices based on trade-offs of drug risk, potential for success of the therapy, and their levels of patient compliance with medications. Further studies examining the decision process of consumers when using prescribed medications should be an ongoing area of research.

Learning Objectives:
At the conclusion of this presentation, the participant (learner) in this session will be able to: 1. Evaluate the trade offs consumers may make when deciding on the potential for successful outcomes when taking prescription medications, 2. Discuss various disease factors impacting the choice or rejection of use of prescription medications, and 3. Recognize discrete choice experiments as a valid tool for assessing consumer decision making.

Keywords: Prescription Drug Use Patterns, Adherence

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the sole author this paper, I performed the data analysis, and structured all aspects of this study.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.