Archive - 2001

Item -  Gluping down the Merlot?  You may want to think twoice.

Item -  Direct-to-consumer marketing is potent medicine.

Item -  Study Shows Internet Searches Affect Health-care Decisions.

Item -  Patients Want to Know Side Effects of Medication.

Item

Gulping Down the Merlot?
You might want to think twice.

Aug., 2001 — Study after study suggests wine drinkers are healthier than beer drinkers, but new research says this may have as much to do with social standing and personality as with beneficial properties of wine.(1, 2)

A new Danish study of almost 700 people shows that wine drinkers are the very same people who tend to be healthier than average. The study also concludes that wine drinkers have higher IQs, are better educated, and have higher socio-economic status than beer drinkers.(1)

On the other hand, a second study, this time from Spain, taking socio-economic factors into account finds no health differences between wine and beer drinkers.(2)

So, if you're resolutely "gulping down the merlot" to improve your health when your taste really runs to a sturdy hefeweissen, you might want to think twice. Wine could be more related to wealth than health.

Wine — for social or health reasons?

The idea that wine promotes health has been around ever since researchers noted the "French paradox" in the early 1990s ... that French people have a much lower risk of heart attack than Americans, despite having similar levels of fat in their diet. The apparent health benefits are thought to stem from antioxidant compounds in the skin of red grapes.

And, too, there is the (1995) Copenhagen City Heart Study which tracked 13,000 people over more than a decade. This was the first of several large-scale studies to link moderate wine-drinking to lower mortality from heart disease, stroke and some forms of cancer.

"It's difficult to say what is a direct physical effect of wine-drinking and what is due to social and psychological differences," reports Erik Mortensen of the Institute of Preventive Medicine in Copenhagen, leader of the Danish study. "We're not saying that wine is not good for your health, but rather, that it's hard to know exactly how beneficial it is."

According to Mortensen, the Copenhagen Study may have been particularly vulnerable to socio-economic skewing. "We were looking at Danes' drinking habits starting in the late 1970s. At that time, wine drinking was just starting to catch on in a traditionally beer-drinking nation, and so was probably limited to the upper classes even more than now".

Epidemiologist Curtis Ellison of Boston University, one of the first investigators of the French Paradox, also expresses concern -- noting that "Many of the studies tried to account for differences in social status, but it is hard to know if they succeeded. We've been tearing out our hair, trying to work out whether the non-alcoholic components of wine offer the health benefits".

Future studies may well prove that wine offers benefits that other alcoholic beverages do not. But in the meantime, says Mortensen, those who are happy drinking beer should probably continue to do so. "Switching to wine isn't going to change one's social status or psychological profile".

References:
1. Mortensen, E. et al. Better psychological functioning and higher social status may largely explain the apparent health benefits of wine. Archives of Internal Medicine, 161, 1844 - 1848, (2001).
2. Guallar-Castillon, P. et al. Consumption of alcoholic beverages and subjective health in Spain. Journal of Epidemiology and Community Health, 55, 648 - 652, (2001).

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Copyright© 2001 by Computer Information Exchange.  All rights reserved.

Item 

Direct-to-consumer marketing is potent medicine
(first in a series of 3 articles)

June, 2001 — Marketing experts say the daily dose of prescription-drug advertising -- for every ailment from overactive bladder to toenail fungus -- works because Americans hate suffering, and because they grow more willing to trust Madison Avenue as they grow less trusting of health care providers and insurers.

Only a few years ago, marketing experts wondered whether they could sell prescription drugs the same way they peddle stain removers or blue-light specials. After all, consumers don't need a doctor's prescription for laundry soap, and advertisers aren't required to list the potential side effects of shopping at Kmart.

No one wonders any more. Sales of the most aggressively advertised prescription drugs are surging. The non-partisan National Institute for Health Care Management Foundation recently reported that the amount Americans spent on prescription medication jumped 40% from 1998 to 2000, reaching $131.9 billion. And according to IMS Health, which provides information to the health-care industry, the pharmaceutical industry spent as much on direct advertising of prescription drugs to consumers in the first half of 2000 as it did in the whole of 1998. ($1.3 billion)

"We're not a society that likes dealing with pain and discomfort,'' says Bonnie Reece, a Michigan State University professor of advertising who studies direct-to-consumer (DTC) marketing. "Sometimes the things that are wrong with us are things that need a lot of work. But Americans often respond with, 'I'd rather take a drug for unhappiness rather than see a therapist for self-examination of lifestyle change.'''

"One way that drug advertising taps into this attitude," she says, "is with visual imagery aimed at people whose health problems restrict their activities. In the world of prescription-drug advertising, people are shown climbing stairs in spite of arthritis and cavorting through fields of flowers regardless of allergies. Middle-aged couples are shown hugging with the romantic fervor of teenagers, allegedly because they've confronted the problem of erectile dysfunction with Viagra."

According to Reece, "The ads almost all focus on pleasant images of people who are happier or better off than they were when 'off' the drugs; and adding the word 'New' -- regardless of the product category -- is always something that gets the consumer's attention.'' She has noticed that print advertisements for prescription medicines usually feature headlines in the form of a question to create a "do-you-know-this?" image -- that we have "news" for you!

Looking at DTC advertisements, Reece finds "they're much more women-focused than male-focused,'' even for gender-neutral products. Not only are women more likely to seek healthcare help than men, Reece notes, but in many families "they still have more of the responsibility or nagging power to get someone to do something'' about a health problem.

When the FDA issued guidelines in 1997 that made it easier to broadcast pitches for prescription drugs, many thought the requirement that commercials proclaim unpleasant potential side effects like vomiting, diarrhea and liver failure would doom DTC advertising on television.

" Surprisingly," says Ed Slaughter, who has directed a 4-year annual survey of consumer reaction to DTC advertising for Prevention magazine, "the better the job the advertising does in presenting balanced risk information, the more effective it is.'' He suggests this is because DTC drug marketing coincides with a patient movement to seize control of health care.

Prevention's survey finds that patients most likely to respond to prescription-drug advertising are those who trust their health care providers least, and 25% of respondents were less trusting of their doctors' advice than a year ago. Slaughter also notes that the fastest-growing age cohort in America is 45- to 64-year-olds. "And that's the time of life when weight, osteoporosis, adult-onset diabetes and arthritis escalate -- as does the amount of money spent out of pocket on health care. The information in prescription-drug commercials is perceived by the public as something that 'gives me back the sense of control.'"

According to Peter Johnsen, who heads DTC research for Market Measures Interactive, a company that provides information to the pharmaceutical industry, "Bringing people in has become the name of the game." As Market Measures Interactive noted in a recent press release: "Proactive consumers can be a pharmaceutical company's strongest ally in the doctor's office.''

"Probably the best news for drug makers is that, while the percentage of those who say they like DTC ads remains fairly steady at about 34 to 38 %, the percentage of those who say they have contacted a doctor for the first time about a disease or condition because of advertising is rising," Johnsen says.

Meanwhile, the American patient has been transformed into a full partner in health care ... or the best sales force the pharmaceutical industry ever had!

Information source:

Cohen, Susan; "Direct-to-consumer marketing is potent tonic for drug sales"; San Jose Mercury News: May 27, ''01;
found at: http://www0.mercurycenter.com/opinion/perspective/docs/drugs27.htm

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Study Shows Internet Searches Affect Health-care Decisions

May, 2001 — The Internet's role in Americans' medical decisions emerges from several surveys taken by the Pew Internet & American Life Project -- released in a report entitled "The online health care revolution: How the Web helps Americans take better care of themselves."

The report finds that 52 million American adults have sought health and medical information on the Web and it calls them "health seekers."

"The emergence of this group ­- the health seekers ­- illustrates perhaps the most profound and dramatic impact the Internet is having on Americans," says Lee Rainie, director of the Pew Internet Project. "In an era when the facetime a patient gets with a doctor during an average appointment has dipped below 15 minutes, many are turning to the Web to get the information they crave so that they can make decisions about how to care for themselves and their loved ones."

According to the report, half the people who have used the Internet to get health and medical information say this information has improved the way they take care of themselves, and many report that online information has directly affected their decisions about how to treat illness and deal with their doctors. A majority of them go online at least once a month to get health information.

These surveys also found that the search strategies of online health seekers are scattershot. Most report that the last time they went hunting online for health information they got the facts they needed. But they relied on Internet searches without the benefit of professional advice and often got information from Web sites they had never heard of before they began the search.

"This should be a wake-up call to medical professionals: Patients are action-oriented when they go online for health information and they will search for it any way they can," says Susannah Fox, Director of Research at the Pew Internet Project and the principal author of this study. "They would probably like help from their doctors in pointing them to the best places for these Internet searches and they really want doctors to answer the questions that emerge during that research about how to treat the sick."

NOTE: These findings come from several surveys. Figures about the size and composition of the "health-seeker" come from surveys conducted almost continuously from March 1 to August 20, '00. In those surveys, 12,751 adults (age 18 and over) were interviewed; 6,413 of them were Internet users. Findings about privacy came from questions asked in a survey in July and August, '00; of 2,109 persons, some 1,101 were Internet users. And finally, a special survey of 521 health seekers was conducted in August, '00, to probe more deeply into their behavior and attitudes, with a special focus on the search they conducted during the last time they went online for health information.

Information source: Pew Internet & American Life Project at: http://pewinternet.org/releases

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Patients Want to Know Side Effects of Medication

April, 2001 — Most patients want their doctor to give them all information regarding possible adverse effects of prescribed medication, according to a report in a recent issue of the "Archives of Internal Medicine."

Dr. Dewey K. Ziegler and colleagues from the University of Kansas Medical Center, Kansas City, evaluated 12-item questionnaires completed by 2500 adults visiting outpatient clinics. The objective of the study was to determine the amount of information patients expect from physicians on the risk for adverse reactions.

The researchers report that 76.2% of respondents wanted to be told of all possible adverse effects of prescribed medication. 13.3% wanted to be told only if an adverse effect occurred 1 in 100,000 times; 10.2% only if such an occurrence was 1 in 100 times; and 0.4% wanted no information at all.

"Percentages were closely similar to those for the same question that restricted opinion to serious adverse effects," the authors explain. They report that 83.1% of patients wanted to know about any serious adverse effects, no matter how rare. And 73.4% believed that physicians were never justified in withholding any information from patients.

According to the report, the wish for maximum information about potential adverse effects was significantly correlated with lower educational level and previous experience with adverse reactions, and in older women.

Dr. Ziegler and colleagues concluded: "Results of our study suggest the possible benefit of a brief dialogue with the patient in which the physician describes the more frequent and serious adverse effects of medication and then mentions (to the patient) that there may well be other rare adverse effects that he or she has not mentioned."


Information source: the Archives of Internal Medicine; 2001;161:706-713.

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Patients With Chronic Disease Get Less Care

March, 2001 — According to a report released early this month, uninsured Americans who have certain chronic diseases are less likely to receive appropriate care for those conditions than individuals who have insurance coverage.

In a joint study, the Lewin Group and Families USA examined data from the 1996 Medical Expenditure Panel Survey and the most recent National Health and Nutritional Examination Survey to evaluate care received by patients with heart disease, hypertension, high cholesterol, arthritis, or chronic back pain.

The study found that across all five conditions, individuals without insurance were more likely to go without needed care. For example, uninsured individuals with hypertension or arthritis were more than twice as likely as their insured counterparts to lack a regular physician, while uninsured people with heart disease were nearly three times more likely.

The uninsured were also more likely to report going without needed care because of cost. More than a quarter of the uninsured with heart disease (26%) reported that they or a family member went without needed care because they could not afford it, compared with 7% of the insured group. Among low-income uninsured people with arthritis, 36.8% said they went without needed care or medications for cost reasons, compared with 16.6% of low-income insured patients.

Families USA Executive Director Ron Pollack said the study should help put to rest the perception that the uninsured get the medical care they need. "The findings in this report should be a clarion call for quick and effective public action to expand health coverage to working Americans who can't afford insurance," he said.

Information source: Reuters Health

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Ad with Reeve walking causes stir

Feb. ’01 - Paralyzed people fooled by a Super Bowl ad showing Christopher Reeve walking have been calling an advocacy group to find out how he was cured, the group's leader said today. 

''Since Sunday, we've received a number of phone calls from persons who are paralyzed or their parents or relatives, saying, 'What research institute did Mr. Reeve go to in order to receive his cure?''' said Thomas Countee Jr., executive director of the National Spinal Cord Injury Association. 

Other advocates and researchers said they found the computerized image thrilling but also worrisome because it could raise false hopes about a quick cure. 

In the ad for Nuveen Investments, the Superman actor, who was paralyzed in a fall from a horse in 1995, appears to be among those gathering in an auditorium of the future to present an award for research that supposedly cured spinal cord injury. 

He gets up from a chair, walks stiffly to the stage and stands with other beneficiaries of the research. 

''When you go out with an advertisement like that you tread a very, very narrow line between trying to be creative ... and being misleading,'' Countee said from association headquarters in Silver Spring, Md. ''I think it could be interpreted as misleading and raising false hopes. But on the other hand, the controversy brings more attention to the issue of spinal cord injury.'' 

Though no date is given for the gathering in the commercial, it is sometime after 2006. An announcer says breakthroughs have been made by then against cancer and AIDS.

''It might be too dramatic,'' said James Peters, executive director of the Eastern Paralyzed Veterans Association. ''The idea that Reeve's bringing home, that there is hope for a cure to spinal paralysis and reason to be enthusiastic, is certainly a welcome attitude.'' 

But a positive date for a cure - and exactly whom it would help - ''are kind of big questions in our minds still,'' he said.

Reeve, 47, has been vowing to walk almost since his accident. He acknowledged Monday that he has been criticized for his unceasing optimism. 

In a statement issued through Nuveen, Reeve insisted that the scene in the commercial is ''something that can actually happen. Most scientists agree that with enough money and talent focused on spinal cord repair, the goal of walking within the foreseeable future is a very real possibility.'' 

Chris Allen of Nuveen said the point of the ad is ''to inspire a dialogue on money, to have a new dialogue and get away from buying bigger boats and bigger cars and think about the impact that money can have on the future.''

Information source: USA TODAY, a division of Gannett Co. Inc.

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FDA Advisers Tied to Industry

January, 2001 - The USA Today conducted a study last September in which they evaluated the ties that exist between the experts (who the FDA consults with regarding questions of safety and effectiveness of pharmaceuticals) and the companies (that produce the very medications they are evaluating).

The Nation's Newspaper found that more than half of the experts commenting on safety and effectiveness have a financial interest in the companies that produce the pharmaceuticals they are evaluating. The financial relationships include stock ownership, consulting fees or research grants.

The FDA has rules against such conflicts-of-interest — but the same have been waived in over 800 cases since 1998.

Information source: USA Today - Sept. 25, 2000.

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