Background/Purpose: Testimonials have been shown to have a strong influence on patient decision-making. Patients are increasingly accessing the Internet as a source of medical information. In this study, we sought to examine whether the presence and order of patients’ testimonials influenced participant’ willingness to take a medication, subjective knowledge, and risk perceptions.

Methods: We administered a survey to senior Mechanical workers (≥ 50 years old; not on medication for osteoporosis or osteopenia) to examine the influence of online medication reviews on participants’ stated willingness to take an osteoporosis medication. We first described osteoporosis and its complications and subsequently asked participants to imagine themselves as a patient with this disease in a clinical encounter during which a physician recommended treatment. Participants’ received information describing outcomes using one of three randomly distributed versions: Icon arrays, icon arrays followed by narrative reviews, or narrative reviews followed by icon arrays. Numeracy was measured using the Rasch-based Numeracy Scale. Participant’ willingness to take a medication, subjective knowledge, perceived benefit, riskiness, and worry related to the medication were measured on 10-point scales before and after reading the description of the medication presented in one of the three versions. We examined whether the presence and order of online testimonials influenced participant’ willingness to take the described medication using a liner regression including age, sex, race, education, previous history of osteoporosis/fracture. Numeracy as a main effect and effect modifier were also included in the model. Similar models were used to examine the influence of online testimonials on participant’ subjective knowledge, perceived benefit, riskiness, and worry.

Results: 499 valid responses were included in the analyses. The mean (SD) age was 59 (7), and the majority were female (61%), white (74%) and college graduate (56%). We found no significant differences in participant’ willingness (p=0.21), subjective knowledge (p=0.43), perceived benefit (p=0.12), riskiness (p=0.51), and worry (p=0.06) across the three groups. Participants with higher numeracy were significantly more willing take the medication (p=0.04). Race was associated with riskiness and worry, with minority subjects having significantly higher scores on both scales. In contrast, participants with personal history of osteoporosis/low bone density were more likely to perceive greater benefit of the medication (p=0.04).

Conclusion: In this study, we found no main effect of the presence or order of online testimonials on participants’ decision-making. Interestingly, willingness and perceptions related to risks and benefits were each associated with different personal characteristics.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-influence-of-testimonials-on-patient-decision-making/