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CONTEXT Direct-to-consumer (DTC) advertising of prescription drugs in the United States is both ubiquitous and controversial. Critics charge that it leads to overprescribing, while proponents counter that it helps avert underuse of effective treatments, especially for conditions that are poorly recognized or stigmatized. OBJECTIVE To ascertain the effects(More)
BACKGROUND Patients communicate their desires and expectations largely by making requests. However, the antecedents and consequences of request fulfillment have received limited attention. OBJECTIVE To describe patient and physician characteristics associated with request fulfillment and to understand the consequences of request fulfillment and(More)
Prenatal environmental exposures are among the risk factors being explored for associations with autism. We applied a new procedure combining multiple scan cluster detection tests to identify geographically defined areas of increased autism incidence. This procedure can serve as a first hypothesis-generating step aimed at localized environmental exposures,(More)
BACKGROUND Patient trust is a key component of the patient-physician relationship. A previous qualitative study has suggested that a low level of trust is associated with unfulfilled requests. OBJECTIVE Our aim was to test the hypothesis that patients with a low level of trust will be more likely to report that requested or needed services were not(More)
OBJECTIVES We estimated the prevalence and longitudinal correlates of use of complementary and alternative medicine (CAM) at midlife among participants of the Study of Women's Health Across the Nation (SWAN). METHODS Multiple logistic regression was used to evaluate the relationship between baseline survey-reported symptoms and use of herbal, spiritual,(More)
BACKGROUND Requests can influence the conduct and content of the medical visit. However, little is known about the nature, frequency, and impact of such requests. We performed this study to ascertain the prevalence, antecedents, and consequences of patients' requests for clinical services in ambulatory practice. METHODS This observational study combined(More)
BACKGROUND The objective of this study was to understand the attitudes and preferences of risk-eligible women regarding use of tamoxifen for breast cancer risk reduction. METHODS A cross-sectional, mixed-methods interview study was conducted at a university medical center and at community sites. Participants were women who had an estimated 5-year breast(More)
OBJECTIVE To profile patients likely to have unmet expectations for care, examine the effects of such expectations, and investigate how physicians' responses to patients' requests affect the development of unfulfilled expectations. DESIGN Patient and physician questionnaires were administered before and after outpatient visits. A follow-up telephone(More)