Perceived risks and benefits of medical remedies and procedures: What do men and women think?

Vieira, Kelmara Mendes; Flores, Silvia Amélia Mendonça; Mendes-Da-Silva, Wesley

doi:10.1590/1678-6971/eRAMG240026.en

Kelmara Mendes Vieira Correspondence concerning this article should be addressed to Kelmara Mendes Vieira, Avenida Roraima, 1000, Prédio 74C, 4212, Camobi, Santa Maria, Rio Grande do Sul, Brazil, ZIP code 97105- 900. Email: kelmara@terra.com.br

Federal University of Santa Maria, Santa Maria, RS, Brazil

Authors’ notes Kelmara Mendes Vieira is now a professor at the Postgraduate Program in Management of Public Organizations of Federal University of Santa Maria; Silvia Amélia Mendonça Flores is now a professor at the Business Department of Federal University of Pampa; Wesley Mendes-Da-Silva is now an associate professor at the Accounting, Finance and Control Department of Getulio Vargas Foundation, School of Business Administration of São Paulo.

https://orcid.org/0000-0002-8847-0941

Silvia Amélia Mendonça Flores

Federal University of Pampa, Bage, RS, Brazil

Authors’ notes Kelmara Mendes Vieira is now a professor at the Postgraduate Program in Management of Public Organizations of Federal University of Santa Maria; Silvia Amélia Mendonça Flores is now a professor at the Business Department of Federal University of Pampa; Wesley Mendes-Da-Silva is now an associate professor at the Accounting, Finance and Control Department of Getulio Vargas Foundation, School of Business Administration of São Paulo.

https://orcid.org/0000-0002-0424-8375

Wesley Mendes-Da-Silva

Getulio Vargas Foundation, School of Business Administration of São Paulo, São Paulo, SP, Brazil

Authors’ notes Kelmara Mendes Vieira is now a professor at the Postgraduate Program in Management of Public Organizations of Federal University of Santa Maria; Silvia Amélia Mendonça Flores is now a professor at the Business Department of Federal University of Pampa; Wesley Mendes-Da-Silva is now an associate professor at the Accounting, Finance and Control Department of Getulio Vargas Foundation, School of Business Administration of São Paulo.

https://orcid.org/0000-0002-5500-4872

Correspondence concerning this article should be addressed to Kelmara Mendes Vieira, Avenida Roraima, 1000, Prédio 74C, 4212, Camobi, Santa Maria, Rio Grande do Sul, Brazil, ZIP code 97105- 900. Email: kelmara@terra.com.br

Authors’ notes

Kelmara Mendes Vieira is now a professor at the Postgraduate Program in Management of Public Organizations of Federal University of Santa Maria; Silvia Amélia Mendonça Flores is now a professor at the Business Department of Federal University of Pampa; Wesley Mendes-Da-Silva is now an associate professor at the Accounting, Finance and Control Department of Getulio Vargas Foundation, School of Business Administration of São Paulo.

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Libro

Block	Variables	Description
Respondents’ profile	From 1 to 14	Multiple-choice questions in which the respondents choose one alternative.
Risks of the prescription of medications	From 15 to 18	Based on what you know about prescription drugs, how often would you say that each of the following situations occurs among patients who have received a prescription? (1 = never; 6 = always) (a) Drugs work as expected; (b) The patient experiences side effects.
		During the past five years, have you experienced any side effects (or unwanted effects) from the prescription of a medicine? (yes; no; don’t know)
		How do you evaluate the severity of this side effect (unwanted effect)? (mild; moderate; severe; not sure)
		When a patient experiences a side effect (unwanted effect) from a prescription drug, how often do you think each of the following is a cause? (1 = never; 6 = always)
Perceived risks and benefits	From 19 to 22	Risk to those exposed To what extent would you say that people (for instance, you or someone you know) exposed to this item are at risk of experiencing personal harm? (1 = they are not at risk; 7 = they are very much at risk)
		Benefits How beneficial do you consider this item to be for society? (1 = not at all beneficial; 7 = very beneficial)
		Knowledge of those exposed To what extent would you say that the risks associated with this item are known precisely to people who are exposed to those risks? (1 = risk level known; 7 = risk level not known)
		Warning sign If you read in the newspaper about an accident or an illness involving this item, in which people were seriously harmed, to what degree would this mishap serve as a warning sign, indicating that the risk of this item might be greater than was thought before the problem occurred? (1 = not a warning sign; 7 = very strong warning sign)

Equation 1

P B_{i} = α_{i} + \sum_{i = 1}^{3} β_{i} R i s k_{i} + \sum_{i = 4}^{12} β_{i} D Y_{i} + β_{i} E n d o g M P_{i} + β_{i} E n d o g N M I_{i} + ε_{i}

Equations 2 and 3

E n d o g M P_{i} (B e n e f M P_{i} = α_{i} + β_{1} P I M P_{i} + β_{2} R K M P_{i} + β_{3} R A M P_{i} + ε_{i})

E n d o g N M I_{i} (B e n e f N M I_{i} = α_{i} + β_{1} P I N M I_{i} + β_{2} R K N M I_{i} + β_{3} R A N M I_{i} + ε_{i})

Variables	Abbreviation or description	Operational definition	References
Perceived benefits of medications	PB	Nothing beneficial – very beneficial (7 points)	Olsen (2001)Olsen, R. A. (2001). Behavioral finance as science: Implications from the research of Paul Slovic. Journal of Psychology and Financial Markets, 2(3), 157–159. https://doi.org/10.1207/S15327760JPFM0203_5 https://doi.org/10.1207/S15327760JPFM020... , Slovic (1987)Slovic, P. (1987). Perception of risk. Science, 236(4799), 280–285. https://doi.org/10.1126/science.3563507 https://doi.org/10.1126/science.3563507... , and Slovic et al. (1989Slovic, P., Kraus, N., Lappe, H., Letzel, H., & Malmfors, T. (1989). Risk perception of prescription drugs: Report on a survey in Sweden. In B. Horisberger, R. Dinkel (Eds.), The perception and management of drug safety risks. Springer., 2004Slovic, P., Finucane, M. L., Peters, E., & MacGregor, D. G. (2004). Risk as analysis and risk as feelings: Some thoughts about affect, reason, risk, and rationality. Risk Analysis, 24(2), 311–322. https://doi.org/10.1111/j.0272-4332.2004.00433.x https://doi.org/10.1111/j.0272-4332.2004... , 2007Slovic, P, Peters, E., Grana, J., Berger, S., & Dieck, G. S. (2007). Risk perception of prescription drugs: Results of a national survey. Drug Information Journal, 41(1), 81–100. https://doi.org/10.1177/009286150704100110 https://doi.org/10.1177/0092861507041001... ).
Risk	Risk alertness (RA), risk awareness (RK), and risk of personal injury (PI).	Little risk – too much risk (7 points)
		Totally unknown risk – totally known risk (7 points)
		Weak risk alert – strong risk alert (7 points)
Dummy variables	DY (0 = no, 1 = yes)	Gender (0 = men, 1 = women)	Brandt and Dickinson, (2013)Brandt, S., & Dickinson, B. (2013). Time and risk preferences and the use of asthma controller medication. Pediatrics, 131(4), e1204–e1210. https://doi.org/10.1542/peds.2011-2982 https://doi.org/10.1542/peds.2011-2982... , Burgess (2015)Burgess, A. (2015). Social construction of risk. In H. Cho, T. Reimer, K. McComas. (Eds.), The Sage handbook of risk communication. Sage., Flynn et al. (1994)Flynn, J., Slovic, P., & Mertz, C. K. (1994). Gender, race, and perception of environmental health risks. Risk Analysis, 14(6), 1101–1108. https://doi.org/10.1111/j.1539-6924.1994.tb00082.x https://doi.org/10.1111/j.1539-6924.1994... , Gardner and Jones (2011)Gardner, G. E., & Jones, M. G. (2011). Science instructors’ perceptions of the risks of biotechnology: Implications for science education. Research in Science Education, 41(5), 711–738. https://doi.org/10.1007/s11165-010-9187-0 https://doi.org/10.1007/s11165-010-9187-... , Green (2006)Green, C. (2006). Gender and use of substance abuse treatment services. Alcohol Research and Health, 29(1), 55–62., Krewski et al. (2006)Krewski, D., Lemyre, L., Turner, M. C., Lee, J. E. C., Dallaire, C., Bouchard, L., Brand, K., Mercier, P. (2006). Public perception of population health risks in Canada: Health hazards and sources of information. Human and Ecological Risk Assessment, 12(4), 626–644. https://doi.org/10.1080/10807030600561832 https://doi.org/10.1080/1080703060056183... , Mahalik et al. (2015)Mahalik, J. R., Lombardi, C. M., Sims, J., Coley, R. L., & Lynch, A. D. (2015). Gender, male-typicality, and social norms predicting adolescent alcohol intoxication and marijuana use. Social Science & Medicine, 143, 71–80. https://doi.org/10.1016/j.socscimed.2015.08.013 https://doi.org/10.1016/j.socscimed.2015... , and Slovic et al. (2007)Slovic, P, Peters, E., Grana, J., Berger, S., & Dieck, G. S. (2007). Risk perception of prescription drugs: Results of a national survey. Drug Information Journal, 41(1), 81–100. https://doi.org/10.1177/009286150704100110 https://doi.org/10.1177/0092861507041001... .
		Works in industry
		Aware of prescription’s problems
		Live with the elderly or sick
		Take care of the elderly or infirm
		Use medication regularly
		Have dysfunctions
		Health insurance
		Side effect

Medications	Percentage
Medications	Men (N = 549)	Women (N = 609)
Vaccines	57.7%	56.8%
Antibiotics	57.4%	59.8%
Prescription drugs	27.0%	29.2%
Medications for allergy	19.1%	29.2%	***
Laxatives	14.4%	21.7%	***
Medication for high blood pressure	13.7%	13.1%
Sleeping pills	12.2%	10.8%
Medications for cholesterol	9.1%	10.3%
None of the above medications	7.7%	5.4%
Medications for anxiety	7.3%	13.0%	***
Medications for depression	6.9%	7.9%
Contraceptive pills	0.0%	38.8%	***
Insulin	3.5%	5.7%
Medication for ulcer	3.3%	3.6%
Hormonal replacement therapy (HRT)	2.7%	6.6%	***
Medications for asthma	2.7%	3.8%
Medication for arthritis	2.4%	4.4%
Medication for erectile dysfunction	2.4%	0.3%	**
Medication for osteoporosis	1.6%	6.4%	***
Chemotherapy	0.9%	1.1%
Medications for Aids^a	0.5%	0.3%
Medication for epilepsy^a	0.0%	1.1%
Medications for Alzheimer’s^a	0.0%	1.0%
Medications from biotechnology^a	1.3%	0.2%

Items	Benefits			Personal injury			Risk awareness			Risk alert
Items	M	W		M	W		M	W		M	W
Panel A: Medications
Vaccines	5.28	5.48	*	2.78	2.88		3.99	3.90		4.56	4.41
Medications for Alzheimer’s	4.95	5.08		3.35	3.39		3.95	3.76	*	4.27	4.23
Medication for asthma	4.80	4.89		2.94	3.28	*	3.69	3.71		4.04	4.19
Antibiotics	4.79	4.81		3.32	3.55	*	4.10	4.06		4.35	4.44
Medications from biotechnology	4.72	4.67		3.08	3.28	*	3.48	3.39		4.13	4.20
Chemotherapy	4.70	4.73		4.83	5.00		4.38	4.56		4.40	4.69	*
Contraceptive pill	4.62	4.89	*	3.42	3.44		4.17	4.14		4.40	4.52
Prescription drugs	4.53	4.61		3.22	3.25		3.90	3.69	*	4.32	4.40
Medication for osteoporosis	4.52	4.75	*	2.99	3.06		3.63	3.49		4.14	4.21
Insulin	4.51	4.70	*	3.45	3.43		3.95	3.89		4.39	4.39
Medication for arthritis	4.48	4.69	*	3.40	3.36		3.62	3.64		4.05	4.25	*
Medications for cholesterol	4.46	4.66	*	3.21	3.33		3.85	3.73		4.23	4.22
Hormonal replacement therapy	4.46	4.43		3.84	4.00		3.94	4.02		4.15	4.37	*
Aspirin	4.46	4.45		2.82	3.01	*	3.64	3.62		4.05	4.11
Medications for allergy	4.37	4.53		3.30	3.45		3.64	3.71		4.11	4.42	*
Phytotherapeutic medications	4.32	4.65	*	2.91	2.86		3.51	3.43		4.09	4.11
Vitamin pills	4.30	4.54	*	2.69	2.76		3.76	3.53	*	4.01	4.11
Laxatives	4.02	3.94		2.92	3.24	*	3.82	3.73		4.09	4.08
Nicotine patches	3.84	4.05	*	2.84	3.07	*	3.52	3.41		3.93	4.09
Medication for erectile dysfunction	3.78	3.77		3.65	3.90	*	3.85	3.68		4.27	4.20
Sleeping pills	3.69	3.75		4.15	4.35	*	3.86	3.88		4.42	4.60
Diet pills	3.57	3.48		3.82	4.28	*	3.59	3.72		4.24	4.50	*
Botox injection	3.01	3.30	*	4.44	4.29		3.67	3.61		4.39	4.56
Panel B: Medical procedures
Prostate exam	5.10	5.32	*	2.93	2.71	*	4.01	3.84		4.34	4.15
CT scan	4.97	5.02		2.94	3.05		3.66	3.76		3.97	4.21	*
Appendix surgery	4.94	4.89		3.49	3.69	*	3.83	3.92		4.20	4.31
Cardiac surgery	4.85	4.92		4.63	4.80		4.52	4.49		4.38	4.68	*
X-ray	4.57	4.41		4.10	4.27		4.06	4.10		4.35	4.56	*
Acupuncture	4.54	4.80	*	2.40	2.40		3.51	3.44		3.91	3.96
Intrauterine device (IUD)	3.92	4.05		3.55	3.40		3.97	3.85		4.24	4.47	*
Panel C: Non-medical risks
Air travel	4.92	4.95		3.16	3.39	*	4.41	4.39		4.07	4.25
Automobiles	4.87	4.91		3.83	4.10	*	4.75	4.63		4.25	4.45
Genetically modified food	3.52	3.45		3.60	3.93	*	3.48	3.52		4.28	4.44
Nuclear power plants	3.23	3.21		5.06	5.32	*	4.36	4.35		4.59	4.80
Alcoholic beverages	3.01	2.75	*	4.67	5.15	*	4.72	4.99	*	4.52	4.80	*
High-fat foods	2.79	2.71		5.13	5.50	*	4.86	4.82		4.57	4.77
Smoking	1.89	1.81		5.92	6.13	*	5.51	5.65		4.82	5.11	*

	Model 1: Endogenous covariates			Model 2: Endogenous covariates and exogenous treatment
				Men		Woman
Variables	Coeff.		Std. error	Coeff.		Coeff.
Dummy gender	0.085	**	0.028	2.545	***	3.287	***
Dummy works in an industry	-0.035		0.047	0.043		-0.111
Dummy aware of prescription problems	0.032		0.029	-0.019		0.065
Dummy live with the elderly or sick	0.012		0.034	-0.033		0.047
Dummy takes care of the elderly or infirm	-0.056		0.038	-0.020		-0.092
Dummy uses medication regularly	0.066	*	0.028	0.078		0.065
Dummy has dysfunctions	-0.014		0.030	0.030		-0.051
Dummy health insurance	0.028		0.037	0.101		-0.034
Dummy side effect	0.010		0.029	-0.020		0.038
Personal injury medication	-0.177	***	0.029	-0.169	***	-0.167	***
Risk awareness medication	0.069	***	0.020	0.095	***	0.039
Risk alertness medication	0.085	***	0.019	0.074	***	0.084	***
Benefits of medical procedures – endogenous	0.241	*	0.115	0.308	***	0.254	*
Benefits non-medical items – endogenous	-0.012		0.099	0.036		0.004
Constant	3.186	***	0.681
Endogenous covariates – benefits medical procedures
Personal injury MP	-0.217	***	0.034	-0.214	***
Risk awareness MP	0.100	***	0.031	0.104	***
Risk alertness MP	0.125	***	0.026	0.126	***
Constant	4.632	***	0.192	4.602	***
Endogenous covariates – benefits non-medical items
Personal injury NMI	-0.264	***	0.031	-0.264
Risk awareness NMI	0.043		0.028	0.046
Risk alertness NMI	0.037		0.022	0.039
Constant	4.432	***	0.161	4.409

P B_{i} = α_{i} + \sum_{i = 1}^{3} β_{i} R i s k_{i} + \sum_{i = 4}^{12} β_{i} D Y_{i} + β_{i} E n d o g M P_{i} + β_{i} E n d o g N M I_{i} + ε_{i}

E n d o g M P_{i} (B e n e f M P_{i} = α_{i} + β_{1} P I M P_{i} + β_{2} R K M P_{i} + β_{3} R A M P_{i} + ε_{i})

E n d o g N M I_{i} (B e n e f N M I_{i} = α_{i} + β_{1} P I N M I_{i} + β_{2} R K N M I_{i} + β_{3} R A N M I_{i} + ε_{i})

[1] Correspondence concerning this article should be addressed to Kelmara Mendes Vieira, Avenida Roraima, 1000, Prédio 74C, 4212, Camobi, Santa Maria, Rio Grande do Sul, Brazil, ZIP code 97105- 900. Email: kelmara@terra.com.br

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Perceived risks and benefits of medical remedies and procedures: What do men and women think?

Abstract

Purpose:

Originality/value:

Design/methodology/approach:

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