The Influence of Direct-to-Consumer Advertising: Who Will Talk to Their Doctor as A Result of Prescription Drug Advertisement?

OBJECTIVES: To identify the types of patients who talk with their physicians as a result of Direct-to-Consumer (DTC) advertising. METHODS: Data were taken from a national survey, Public Health Impact of Direct-to-Consumer Advertising of Prescription Drugs, July 2001- January 2002 , conducted by researchers from Harvard Medical School. Participants (n = 3000) were interviewed by telephone. We constructed a conceptual framework consisting of outcomes (3 types of physician visits), intervention (DTC experience) and five groups of explanatory factors (health beliefs, demographics, health status, socioeconomic status and market factors). Data were analyzed with three multivariate stepwise logistic regressions. The three dependent variables were whether an advertisement for a prescription drug had ever prompted the patient to: 1) visit to discuss prescription drug, 2) visit to discuss new condition, and 3) visit to discuss treatment change. RESULTS: Out of all independent variables, only six variables consistently showed significant effects on the three dependent variables after adjusting for other variables. They were: 1) taking medication on regular basis, 2) having anxiety, 3) having high advertisement attentiveness, 4) viewing media as the most important source prompting one to talk with physician, 5) believing that DTC advertisements increased awareness of new treatment, and 6) believing that DTC advertisements improved discussion with health professionals. The six variables were the strongest predictors for DTC-prompted physician visits.CONCLUSIONS: Our nationally representative study found multiple factors were associated with different types of physician visits prompted by DTC advertisements. This information could be used to target those patients most likely to talk to their physicians as a result of DTC advertisements

CD30 Is Highly Expressed in Chronic Obstructive Pulmonary Disease and Induces the Pulmonary Vascular Remodeling

Chronic obstructive pulmonary disease (COPD) is one of the common and underdiagnosed diseases with the highest morbidity and mortality in the world. The development of COPD can lead to pulmonary vascular remodeling and pulmonary hypertension, further causing the occurrence of pulmonary heart disease. Therefore, attenuation of pulmonary vascular remodeling and pulmonary hypertension caused by COPD can significantly delay cardiovascular complications. In the study, we firstly found that the expression of CD30 and CD30L was increased in COPD. Importantly, the serum CD30L levels were significantly higher in patients with stable COPD relative to those with acute exacerbation of COPD (AECOPD). This suggested that CD30 might be related to the development of COPD. In addition, we found that the expression of CD30 in the COPD rat model was significantly increased compared with control group. And treatment with the anti-CD30 antibody reduced the serum concentration and tissue expression of CD30 in rat. Importantly, anti-CD30 antibody alleviated pulmonary vascular remodeling in COPD model rats. This suggested that CD30 played an important role in the course of COPD. Finally, we found that, in the HPASMC and HPAEC cell lines, CD30 can affect the cell viability and cell migration and inhibited hypoxia-induced cell apoptosis in a concentration-dependent manner. We also found CD30 induced extracellular matrix formation through decreasing the expression of MMP-2, thus promoting the pulmonary vascular remodeling. The study indicated that CD30 and CD30L were involved in pulmonary vascular remodeling and inflammatory response in COPD. Altogether, CD30 might be a marker for the early diagnosis and progression of COPD