Elizabeth Chika Tippett

Medical Advice from Lawyers: A Content Analysis of Advertising for Drug Injury Lawsuits

This study examined the medical information contained in a sample of television ads soliciting consumers for lawsuits against drug and medical device manufactures. Almost all such ads involved drugs or devices that have not been recalled and remain on the market. These ads raise important public health questions because they may influence the prospective medical decisions of viewers. The ads contained extensive descriptions of serious adverse events associated with the drugs or devices but almost uniformly failed to disclose information relating to the likelihood of such events. They also failed to effectively advise viewers to consult a doctor. Results also identified a subset of ads that mimicked public service announcements, claiming to be a “medical alert” “consumer alert” or “FDA warning” at the start of the ad. Most such ads did not disclose the attorney source of the advertising until the final few seconds.

Association of Attorney Advertising and FDA Action with Prescription Claims: A Time Series Segmented Regression Analysis

IntroductionAttorneys sponsor television advertisements that include repeated warnings about adverse drug events to solicit consumers for lawsuits against drug manufacturers. The relationship between such advertising, safety actions by the US Food and Drug Administration (FDA), and healthcare use is unknown.ObjectivesTo investigate the relationship between attorney advertising, FDA actions, and prescription drug claims.MethodsThe study examined total users per month and prescription rates for seven drugs with substantial attorney advertising volume and FDA or other safety interventions during 2009. Segmented regression analysis was used to detect pre-intervention trends, post-intervention level changes, and changes in post-intervention trends relative to the pre-intervention trends in the use of these seven drugs, using advertising volume, media hits, and the number of Medicare enrollees as covariates. Data for these variables were obtained from the Center for Medicare and Medicaid Services, Kantar Media, and LexisNexis.ResultsSeveral types of safety actions were associated with reductions in drug users and/or prescription rates, particularly for fentanyl, varenicline, and paroxetine. In most cases, attorney advertising volume rose in conjunction with major safety actions. Attorney advertising volume was positively correlated with prescription rates in five of seven drugs, likely because advertising volume began rising before safety actions, when prescription rates were still increasing. On the other hand, attorney advertising had mixed associations with the number of users per month.ConclusionRegulatory and safety actions likely reduced the number of users and/or prescription rates for some drugs. Attorneys may have strategically chosen to begin advertising adverse drug events prior to major safety actions, but we found little evidence that attorney advertising reduced drug use. Further research is needed to better understand how consumers and physicians respond to attorney advertising.

Does Attorney Advertising Influence Patient Perceptions of Pelvic Mesh

OBJECTIVE To measure the relative influence of attorney advertising on patient perceptions of pelvic mesh compared with a history of surgery and a first urology visit. MATERIALS AND METHODS A 52-item survey was administered to 170 female patients in 2 urology offices between 2014 and 2016. Multiple survey items were combined to form scales for benefit and risk perceptions of pelvic mesh, perceptions of the advertising, attitudes toward pelvic mesh, and knowledge of pelvic mesh and underlying medical conditions. Data were analyzed using hierarchical linear regression models. RESULTS Exposure to attorney advertising was quite high; 88% reported seeing a mesh-related attorney advertisement in the last 6 months. Over half of patients reported seeing attorney advertisements more than once per week. A history of prior mesh implant surgery was the strongest predictor of benefit and risk perceptions of pelvic mesh. Exposure to attorney advertising was associated with higher risk perceptions but did not significantly affect perceptions of benefits. Past urologist visits increased perceptions of benefits but had no effect on risk perceptions. CONCLUSION Attorney advertising appears to have some influence on risk perceptions, but personal experience and discussions with a urogynecologist or urologist also influence patient perceptions. Implications, limitations, and future research are discussed.

Dealing with conflict in a psychiatric setting.

1and they are a daily source of tension in many psychiatric milieus, including inpatient, partial, and residential hospital settings. Patients bicker with one another about making too much noise, talking too much in groups, or acting in some other undesirable manner. Similarly, patients argue with staff about when they can go outside to smoke or whether they can be exempt from a particular group or activity. Conflict among patients and between patients and staff can escalate into a crisis situation, where someone’s physical or psychological safety is in jeopardy. Patients might threaten or actually hurt other patients or themselves. Such situations can heavily burden many parties within the hospital system. The hospital itself faces legal ramifications, safety concerns, and decreased staff and patient satisfaction. Staff often put themselves in emotional and physical danger as they respond to such situations. 2 Patients involved in the crisis face obvious physical and psychological risks, and even those not actually involved can experience the vicarious effects of trauma; many are already struggling to cope with significant personal life disruption. Because conflict escalation can lead to crisis, it is not surprising that hospital staff intervene to help patients quickly and efficiently resolve their conflicts. Staff want to contain conflict, and as a result patients interact with one another in heavily controlled environments, such as in highly structured groups or under the watchful eye of hospital staff. The goal in many hospital settings is crisis containment. If, however, patients and staff have appropriate conflictmanagement skills, interactions are less likely to lead to crisis and more likely to lead to improved relations among patients and staff. A carefully implemented conflict