The purpose of this project was to develop an informative article on enhanced external counterpulsation (ECCP) therapy. It focuses on providing primary care providers with knowledge about EECP and its potential benefits for their patients.

EECP is a noninvasive outpatient treatment for coronary artery disease that has been successful for some patients whose angina pectoris has not responded to medical and/or surgical therapy (Cohn, Hui, & Lawson, 2000). Patients undergo EECP treatment 1 hour per day for a total of 35 treatments (Cohn et al., 1995). Each treatment involves external cuffs applied to the patient’s calves, thighs, and buttocks (Burger, Guo, Hui, Lawson, & Soroff, 1997). Sequential inflation during diastole using EKG timing results in more effective coronary artery perfusion (Burger, Guo et al., 1997).

Research data suggest that EECP may provide adjunctive therapy for patients suffering from stable angina (Crawford, Feldman, Schneider, & Soran, 1999). Primary care providers, including nurse practitioners, play an important role in coordinating patient care and must know how to screen and refer patients appropriately (Cram & framework for this project. (Ettinger, 1998).

EECP has demonstrated usefulness in improving exercise tolerance, treating angina, and decreasing cardiac radionuclide perfusion defects (Cohn, Hui, & Lawson, 2000). Dorothea E. Orem’s (2001) Self-care Deficit Theory of Nursing provided the conceptual framework for this project.

Hormone replacement therapy (HRT) is used by perimenopausal women to manage the symptoms associated with menopause and for potential long-term health benefits. These potential benefits include protection against osteoporosis, heart disease, colon cancer, and possibly Alzheimer’s disease (Shaywitz et al., 1999). The decision to start therapy must take into consideration the potential risks of breast and endometrial cancer, and thromboembolic disorders (Cutson & Meuleman, 2000).

The purpose of this project is to provide information to perimenopausal and postmenopausal women related to hormone replacement therapy. This information will be made available via internet and world wide web at www.velocity.net/~rrmartin. The web page was evaluated using the Model for Evaluating Printed Educational Materials by
Bernier and Yasko (1991). The content is based on a review of the literature and is presented at the eighth grade level using the McLaughlin Smog Formula (McLaughlin, 1969). The topics covered include health risks, benefits, and alternative therapies. The theoretical framework for this project is the Neuman Systems Model by Betty Neuman (1995). Based on this theory, the nurse practitioner analyzes how sociocultural, developmental, and psychological variables influence a patient’s health practices (Reed, 1993).

Since the U.S. Food and Drug Administration (FDA) relaxed its restrictions on broadcast TV advertising of pharmaceutical products in 1997, direct-to-consumer (DTC) advertising has boomed. DTC drug ads can encourage dialogue between patients and their health care providers (Morgan and Levy, 1998), which can strengthen the patient-provider bond if the patient gains a sense of participation in his health care (Woodward, 1996). However, these ads can also strain this relationship when the provider does not prescribe the requested drug (Gelles, 1997). With DTC drug ads having such an impact on the patient-provider relationship, it is important to understand the patient attitudes and behaviors that are a result of DTC drug ads. Nurse practitioners are in a position to educate patients who may have misconceptions resulting from DTC ads.

The purpose of this research is to survey health care consumers in order to determine their experiences with DTC drug advertisements, any actions they may have taken as a result of these ads, their attitudes and beliefs regarding DTC drug advertising, and the influence of DTC drug ads on the patient’s perception of the patient-provider relationship. Patients in a rural primary care facility in western New York state completed a self-administered questionnaire. The survey collected demographic information and investigated the respondents’ attitudes and behaviors associated with DTC advertisements. A total of 188 questionnaires were returned. Due to attrition, 137 questionnaires were included in the final analysis. Of the sample population (A=137), 90.51% had been exposed to DTC drug ads. Television was cited most frequently (97.58%) as the source of DTC drug ads. Only 5% of subjects indicated they would not talk with their health care provider about an ad because of trust issues.

In summary, exposure to DTC drug ads is high, with television and magazines being the leading sources of these ads. While the study results show no adverse effects on the patient-provider relationship, the continued rise and evolution of DTC advertising may have an effect on the patient-provider relationship. This provides nurse practitioners with an opportunity to educate patients about prescription drugs. Suggestions are offered for future research of DTC drug advertising.