Liana Fraenkel1,2, Marilyn Stolar3, Sarah Swift1, Richard L Street4,5, Harjinder Chowdhary1, Ellen Peters6. 1. Yale University School of Medicine, New Haven, CT, USA (LF, SS, HC). 2. VA Connecticut Healthcare System, West Haven, CT, USA (LF). 3. Yale Center for Analytical Sciences, Yale University School of Public Health, New Haven, CT, USA (MS). 4. Department of Communication, Texas A&M University, College Station, TX, USA (RLS). 5. Houston Center for Innovations in Quality, Effectiveness, and Safety and Baylor College of Medicine, Houston, TX, USA (RLS). 6. Psychology Department, The Ohio State University, Columbus, OH, USA (EP).
Abstract
BACKGROUND: Order and amount of information influence patients' risk perceptions, but most studies have evaluated patients' reactions to written materials. The objective of this study was to examine the effect of 4 communication strategies, varying in their order and/or amount of information, on judgments related to an audible description of a new medication and among patients who varied in subjective numeracy. METHODS: We created 5 versions of a hypothetical scenario describing a new medication. The versions were composed to elucidate whether order and/or amount of the information describing benefits and adverse events influenced how subjects valued a new medication. After listening to a randomly assigned version, perceived medication value was measured by asking subjects to choose one of the following statements: the risks outweigh the benefits, the risks and benefits are equally balanced, or the benefits outweigh the risks. RESULTS: Of the 432 patients contacted, 389 participated in the study. Listening to a brief description of benefits followed by an extended description of adverse events resulted in a greater likelihood of perceiving that the medication's benefits outweighed the risks compared with 1) presenting the extended adverse events description before the benefits, 2) giving a greater amount of information related to benefits, and 3) sandwiching the adverse events between benefits. These associations were only observed among subjects with average or higher subjective numeracy. CONCLUSION: If confirmed in future studies, our results suggest that, for patients with average or better subjective numeracy, perceived medication value is highest when a brief presentation of benefits is followed by an extended description of adverse events.
RCT Entities:
BACKGROUND: Order and amount of information influence patients' risk perceptions, but most studies have evaluated patients' reactions to written materials. The objective of this study was to examine the effect of 4 communication strategies, varying in their order and/or amount of information, on judgments related to an audible description of a new medication and among patients who varied in subjective numeracy. METHODS: We created 5 versions of a hypothetical scenario describing a new medication. The versions were composed to elucidate whether order and/or amount of the information describing benefits and adverse events influenced how subjects valued a new medication. After listening to a randomly assigned version, perceived medication value was measured by asking subjects to choose one of the following statements: the risks outweigh the benefits, the risks and benefits are equally balanced, or the benefits outweigh the risks. RESULTS: Of the 432 patients contacted, 389 participated in the study. Listening to a brief description of benefits followed by an extended description of adverse events resulted in a greater likelihood of perceiving that the medication's benefits outweighed the risks compared with 1) presenting the extended adverse events description before the benefits, 2) giving a greater amount of information related to benefits, and 3) sandwiching the adverse events between benefits. These associations were only observed among subjects with average or higher subjective numeracy. CONCLUSION: If confirmed in future studies, our results suggest that, for patients with average or better subjective numeracy, perceived medication value is highest when a brief presentation of benefits is followed by an extended description of adverse events.
Authors: Peter A Ubel; Dylan M Smith; Brian J Zikmund-Fisher; Holly A Derry; Jennifer McClure; Azadeh Stark; Cheryl Wiese; Sarah Greene; Aleksandra Jankovic; Angela Fagerlin Journal: Patient Educ Couns Date: 2009-12-09
Authors: Liana Fraenkel; Marilyn Stolar; Jonathan R Bates; Richard L Street; Harjinder Chowdhary; Sarah Swift; Ellen Peters Journal: Med Decis Making Date: 2017-08-30 Impact factor: 2.583
Authors: Charlotte Beaudart; Mickael Hiligsmann; Nannan Li; E Michael Lewiecki; Stuart Silverman Journal: Osteoporos Int Date: 2021-09-24 Impact factor: 4.507