Different methods of presenting risk information and their influence on medication compliance intentions: results of three studies

Abstract

Background: Pharmaceutical noncompliance is an increasingly important problem in the United States, leading to hundreds of thousands of deaths and billions of wasted dollars each year. Patients' fear of adverse events (AEs) is one possible reason for lack of compliance.

Objectives: The aims of the 3 studies described in this article were to investigate whether commonly used methods of conveying AE risk might influence subjects' perceptions of their risk of experiencing drug-related AEs and whether disclosing this information by other means might subsequently influence their intentions to comply with prescribed medication regimens.

Methods: In study 1, randomly selected participants were surveyed to estimate their percentage risk for medication AEs. In study 2, randomly selected participants were presented with a fictitious medical scenario, informed of their AE risk either in terms of specific percentages or in general semantic terms (eg, "some people may experience"), and then asked to rate their fear of AEs and likelihood of compliance. Study 3 was a randomized, controlled experiment in which we duplicated the methods of study 2, with the addition of real-life stimuli (pharmaceutical advertisements).

Results: In study 1, 40 subjects were surveyed. Participants overestimated their risk of AEs when information was disclosed semantically. In study 2, people were more fearful of experiencing AEs and less likely to intend to comply with prescribed medication regimens (both, P < 0.01) when presented with AE risk information in the form of semantic risk frames rather than actual risk percentages. In study 3, 120 subjects participated. Again, participants expressed stronger intent to comply with medication regimens when they received AE risk information as percentages rather than in semantic terms (P < 0.04). In addition, intended likelihood to comply was negatively correlated with fear of experiencing AEs (P < 0.01).

Conclusions: In these studies, informing participants of actual percentage risk of AEs was associated with less fear about AEs and greater intent to comply with prescribed regimens. Using verbal descriptors to disclose AE risk information was associated with less intent to comply.