Walden University ScholarWorks Walden Dissertations and Doctoral Studies Walden Dissertations and Doctoral Studies Collection 1-1-2011 Physician decision criteria regarding omega-3 dietary supplements Warren P. Lesser Walden University Follow this and additional works at: https://scholarworks.waldenu.edu/dissertations Part of the Advertising and Promotion Management Commons, Health and Medical Administration Commons, Marketing Commons, and the Public Health Education and Promotion Commons This Dissertation is brought to you for free and open access by the Walden Dissertations and Doctoral Studies Collection at ScholarWorks. It has been accepted for inclusion in Walden Dissertations and Doctoral Studies by an authorized administrator of ScholarWorks. For more information, please contact [email protected]. Walden University College of Management and Technology This is to certify that the doctoral study by Warren Lesser has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Robert A. Miller, Committee Chairperson, Doctor of Business Administration Faculty Dr. Michael Ewald, Committee Member, Doctor of Business Administration Faculty Dr. Judith Blando, University Reviewer, Doctor of Business Administration Faculty Chief Academic Officer Eric Riedel, Ph.D. Walden University 2014 Abstract Physician Decision Criteria Regarding Omega-3 Dietary Supplements by Warren P. Lesser MBA, Centenary College of Louisiana, 1987 BA, Taylor University, 1976 Doctoral Study Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Business Administration Walden University March 2014 Abstract American Heart Association officials and other expert cardiologists recommend omega-3 (n-3) dietary supplementation for the secondary prevention of cardiovascular disease, a prevalent health problem in the United States. Physicians’ lack of understanding of possible n-3 preventive health benefits results in underprescribing n-3 dietary supplements and lower n-3 dietary supplement product sales. N-3 dietary supplement marketers do not understand physician n-3 prescribing decision criteria enough to optimize high-impact communication to physicians to increase n-3 dietary supplement product use. The purpose of this phenomenological research study was to improve n-3 marketers’ understanding of how physicians reach decisions to prescribe or recommend products including n-3 dietary supplements. Argyris’ ladder of inference theory provided the study framework to facilitate understanding physicians’ decision criteria. Rich data collected and analyzed from 20 primary care physician interviews in Kentucky, Indiana, and Tennessee revealed physicians use similar decision criteria for drugs and n-3s. Three essential influencers of physician decisions included clinical evidence, personal experience, and cost. Other influencers were opinions of peers, pharmaceutical representatives, samples, direct-to-consumer advertising, and knowledge of dietary supplements. Study outcomes may inform pharmaceutical marketers regarding presentation of clinical evidence, cost emphasis, and pharmaceutical representative skills and may facilitate competitive advantage for n-3 marketers. The social benefit of this study is improved physician understanding of n-3s may result in more accurate and appropriate prescribing to augment positive health outcomes. Physician Decision Criteria Regarding Omega-3 Dietary Supplements by Warren P. Lesser MBA, Centenary College of Louisiana, 1987 BA, Taylor University, 1976 Doctoral Study Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Business Administration Walden University March 2014 UMI Number: 3611495 All rights reserved INFORMATION TO ALL USERS The quality of this reproduction is dependent upon the quality of the copy submitted. In the unlikely event that the author did not send a complete manuscript and there are missing pages, these will be noted. Also, if material had to be removed, a note will indicate the deletion. UMI 3611495 Published by ProQuest LLC (2014). Copyright in the Dissertation held by the Author. Microform Edition © ProQuest LLC. All rights reserved. This work is protected against unauthorized copying under Title 17, United States Code ProQuest LLC. 789 East Eisenhower Parkway P.O. Box 1346 Ann Arbor, MI 48106 - 1346 Acknowledgments Many thanks to my committee members for their guidance, especially my Chair, Dr. Robert Miller; Second Chair, Dr. Michael Ewald; and methodologists Dr. Gene Fusch and Dr. Doug Campbell, and URR Dr. Judith Blando. Special thanks also go to my classmate and friend, Dr. Gregory Banks. Most importantly, I thank my wife, Mary, for her unwavering and incalculable support. Table of Contents Section1: Foundation of the Study .......................................................................................1 Background ....................................................................................................................2 Problem Statement .........................................................................................................6 Purpose Statement ..........................................................................................................7 Nature of the Study ........................................................................................................8 Research Question .......................................................................................................11 Conceptual Framework ................................................................................................12 Definition of Terms......................................................................................................13 Assumptions, Limitations, and Delimitations ..............................................................17 Assumptions .......................................................................................................... 17 Limitations ............................................................................................................ 17 Delimitations ......................................................................................................... 18 Significance of the Study .............................................................................................19 Reduction of Gaps................................................................................................. 19 Implications for Social Change ............................................................................. 19 Study Prospects for Improving Society ................................................................ 20 A Review of the Professional and Academic Literature ..............................................21 Complementary and Alternative Medicine ........................................................... 22 Omega-3 Cardiovascular Efficacy and Safety ...................................................... 24 Customer Needs and Ladder of Inference ............................................................ 41 Dietary Supplement Physician Education ............................................................. 49 i Factors Affecting Patient Compliance .................................................................. 55 Drug and CAM Marketers’ Methods to Physicians .............................................. 60 Method and Design ............................................................................................... 67 Transition and Summary ..............................................................................................74 Section 2: The Project ........................................................................................................76 Purpose Statement ........................................................................................................76 Role of the Researcher .................................................................................................77 Participants ...................................................................................................................79 Research Method and Design ......................................................................................79 Method .................................................................................................................. 79 Research Design and Method Justification ........................................................... 80 Population and Sampling ...................................................................................... 83 Data Collection ............................................................................................................84 Instruments ............................................................................................................ 84 Data Collection Technique ................................................................................... 88 Data Organization Techniques .............................................................................. 93 Data Analysis Technique .............................................................................................94 Reliability and Validity ................................................................................................97 Reliability .............................................................................................................. 97 Validity ................................................................................................................