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Research Letter
Health Care Reform
January 10, 2011

Perception of Drug Safety and Knowledge Influences Drug Selection

Author Affiliations

Author Affiliations: Department of Epidemiology, Gillings School of Public Health, University of North Carolina, Chapel Hill (Drs Van Dole and West); Center for Drug and Evaluation Research, Food and Drug Administration, Silver Spring, Maryland (Ms Mease); and Pharmaceutical Safety Institute, Newtown, Pennsylvania (Dr Olsen). Dr Van Dole is now with the Worldwide Epidemiology Department at GlaxoSmithKline, Research Triangle Park, North Carolina. Dr West is now with RTI International, Research Triangle Park. Ms Mease and Dr Olsen are now with Quintiles Incorporated, Durham, North Carolina.

Arch Intern Med. 2011;171(1):90-91. doi:10.1001/archinternmed.2010.470

Since 1997, people have faced a constant barrage of direct-to-consumer television and print advertisements for prescription drugs, so it is conceivable that the term drug side effect would be understood by many Americans.1 However, the degree to which the American public understands drug safety is unknown. We investigated the association between the level of self-perceived knowledge about drug safety and the impact of such knowledge on patient input when being prescribed a new prescription medication.

Harris Interactive's HarrisPollOnline (HPOL) was used to conduct a cross-sectional survey of adults in the United States that evaluated individuals' knowledge about drug safety, the importance they accorded drug safety knowledge, and their preference for active participation in prescribing decisions. Respondents provided free-text response to the question “What does the term drug safety mean to you?” Two authors (K.B.V. and S.L.W.) independently determined whether each category addressed a drug side effect or adverse drug events (ADEs), drug effects appropriate for the condition being treated (physiologic effects), both, or neither. To assess the respondent's level of knowledge about drug safety, we used a composite variable derived from 3 questions, each of which had a 5-level Likert response format to rate their knowledge about drug side effects, serious safety events, and drug-drug interaction. We also asked respondents to rank how important knowledge of drug side effects and drug-drug interactions was to them. By weighting respondent's knowledge of drug safety by its importance, we developed a 3-level categorical variable: low, medium, and high level of knowledge and importance (henceforth noted as weighted knowledge). Our primary outcome was whether the respondents preferred to choose the medications to be prescribed (as appropriate for their condition) or to have the physician select their medication. A secondary outcome was what occurred during the last physician-patient interaction when a medication was prescribed. We evaluated the following covariates for both confounding and effect modification: age, sex, race/ethnicity, education, previous ADEs, respondent-defined drug safety, and whether the respondent sought information on drug safety or was interested in participating in a drug safety monitoring program. We used logistic regression to estimate odds ratios for the 2 outcomes of interest.

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