Dartmouth professor Lewis Glinert testified before a Federal Drug Administration panel in Washington, D.C., this month about his research on direct-to-consumer drug advertising.
Glinert, a professor in the Asian and Middle Eastern studies department, examined how the benefits and risks of certain drugs are communicated to consumers through television advertising.
Officials at the FDA wanted to utilize Glinert's extensive background in linguistics to assist them as they explore new methods of regulating drug and medical advertising.
"This is an important issue, and I'm glad that the FDA wanted to hear from so many different constituents regarding DTC advertising," Glinert said. "The experience was synergic and may mark a turning point in health education."
The main conflict facing the FDA is the fair presentation of benefit and risk information. Currently no practical procedure exists for judging a fair balance.
Glinert chose to examine the way risk information may or may not stand out to consumers. He said that the FDA has been using research conducted in the 1980s, now outdated, to justify the way information is currently presented to the public.
His research looked at advertising for high-risk and low-risk drugs and where the warning information is placed. He found that placing the side-effect information at the end of risky medication advertisements improved comprehension, and did not make the medication appear more risky. Perception of low-risk drugs did not change significantly when the warning was placed at the beginning as opposed to the end of the advertisement.
Glinert cited the need to extend his research beyond first-year pharmaceutical students and into a more general population. He believes there is a need to study advertising effects on vulnerable groups including the elderly and those who have difficulty reading.
"The elderly have been shown to have difficulty with rapid or disorganized texts and elaborate inferencing," he said. "Even at the best of times, TV ads, like any spoken message, cannot offer the viewer the same opportunity for scrutiny as printed advertisements."
Glinert worries that risk messages are presented to the consumer in flawed ways that downplay their importance.
"Risk messages frequently competed with up-beat music and visuals. Having to process the warning caption, 'Your results may vary,' together with an image of a beaming woman and a quick-fire string of superlatives, the average viewer may well not consider the possibility that, for many people, the effect may be less than complete cure," Glinert said.
According to Glinert's research, even the intonation and syntax of a sentence used in advertising has a huge impact on the way its message is perceived.
"The associations in a phrase like 'Ask your doctor,'" Glinert said as an example, "'ask' can mean 'inquire' but is there a cunning hint here of its other meaning, 'request?'"
Drug advertisements also switch from the source of authority on the drug to patient testimonials without clear distinctions between the two, and Glinert cited additional problems with claims of absolute verses relative effectiveness of drugs that are never made clear to the consumer.
Glinert hopes that his presentation to the FDA and continued research will help the government agency as they make decisions regarding the future of American drug advertising.
"It can contribute to our general understanding of how TV advertisements convey meaning with respect to drug benefits and risks, with implications for advertisers, regulators and patient education," Glinert said.
