A Drug By Any Other Name...

What's in a name? Drug makers agonize over what to call their products--"Viagra" carries that bit of virility at the front, for instance, while "Lunesta" evokes the moon. The idea is to associate drugs with positive attributes as well as make them memorable. Looks like the companies know what they're doing: in a disturbing study from Canada, scientists find that names can strongly influence decisions patients make about treatment.

To investigate what role a name plays, scientists at McMaster University started out by showing volunteer patients information on the benefits and harms of various treatment options. It's well known that many patients suffer from "health illiteracy" "and inability to understand what their doctor tells them or the meaning of printed information that comes with prescription drugs. The McMaster team therefore set out to see whether the format of the information would make any difference in patients' understanding and decisions.

They compared a graphic presentation called a decision board, a decision booklet plus audiotape, and an interactive computer program, all displaying benefits and risks of three treatments for blood clots on a pie graph or pictogram. The treatment options were labeled "treatment A," "treatment B" and "treatment C." Patients' understanding of whether their condition was one the treatment was good for, and of the risks and benefits, all improved significantly with the board, booklet and computer program, with pie chart or pictogram. Virtually all (96 percent) of the participants said the decision aid helped them choose among the three treatments.

Then the scientists replaced A, B and C with the treatment's true name "warfarin, acetylsalicylic acid (aspirin) and "no treatment." Under these conditions, 36 percent of the patients changed their initial choice, including 46 percent of those who initially chose warfarin and 78 percent who initially chose no treatment, the scientists are reporting this evening in the Canadian Medical Association Journal.

Although they grasped the risks and benefits, that rational decision was trumped by the pull of the name, or the belief that no treatment (which is actually the best option in some cases) must be the worst choice. No wonder drug advertising is so effective.

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