Social Media and the Transformation of the Physician-Patient Relationship: Viewpoint

Social Media Use in Dermatology in Turkey: Challenges and Tips for Patient Health

Social media has established its place in our daily lives, especially with the advent of the COVID-19 pandemic. It has become the leading source of information for dermatological literacy on various topics, ranging from skin diseases to everyday skincare and cosmetic purposes in the present digital era. Accumulated evidence indicates that accurate medical content constitutes only a tiny fraction of the exponentially growing dermatological information on digital platforms, highlighting an unmet patient need for access to evidence-based information on social media. However, there have been no recent local publications from Turkey analyzing and assessing the key elements in raising dermatological literacy and awareness in digital communication for patients. To the best of our knowledge, this study is the first collaborative work between health care professionals and a social media specialist in the medical literature. Furthermore, it represents the first author-initiated implementation science attempt focusing on the use of social media in addressing dermatological problems, with the primary end point of increasing health literacy and patient benefits. The multidisciplinary expert panel was formed by 4 dermatologists with academic credentials and significant influence in public health and among patients on digital platforms. A social media specialist, who serves as a guest lecturer on "How social media works" at Istanbul Technical University, Turkey, was invited to the panel as an expert on digital communication. The panel members had a kickoff meeting to establish the context for the discussion points. The context of the advisory board meeting was outlined under 5 headlines. Two weeks later, the panel members presented their social media account statistics, defined the main characteristics of dermatology patients on social media, and discussed their experiences with patients on digital platforms. These discussions were organized under the predefined headlines and in line with the current literature. We aimed to collect expert opinions on identifying the main characteristics of individuals interested in dermatological topics and to provide recommendations to help dermatologists increase evidence-based dermatological content on social media. Additionally, experts discussed paradigms for dermatological outreach and the role of dermatologists in reducing misleading information on digital platforms in Turkey. The main concluding remark of this study is that dermatologists should enhance their social media presence to increase evidence-based knowledge by applying the principles of patient-physician communication on digital platforms while maintaining a professional stance. To achieve this goal, dermatologists should share targeted scientific content after increasing their knowledge about the operational rules of digital channels. This includes correctly identifying the needs of those seeking information on social media and preparing a sustainable social media communication plan. This viewpoint reflects Turkish dermatologists' experiences with individuals searching for dermatological information on local digital platforms; therefore, the applicability of recommendations may be limited and should be carefully considered.

Social media and ADHD: implications for clinical assessment and treatment

The interaction between social media use and mental health is complicated. The mental health information shared on these platforms is frequently of poor quality but has the potential to exert powerful influence on users. Social media trend peaks in some mental disorders have led to increases in illness behaviour through social contagion. There has been a marked upsurge in online interest in attention deficit hyperactivity disorder (ADHD) over the last number of years, which has been particularly noticeable since the onset of the COVID-19 pandemic. The exponential increase in online ADHD interest has the potential to contribute to overloading mental health services with referrals. Mental health professionals and organisations need to consider strategies to ensure that quality health information is disseminated to younger audiences.

Using social media for patient care, research, and professional development: A North American Society of Pediatric Gastroenterology, Hepatology, and Nutrition position paper

The advent of social media has changed numerous aspects of modern life, with users developing and maintaining personal and professional relationships, following and sharing breaking news and importantly, searching for and disseminating health information and medical research. In the present paper, we reviewed available literature to outline the potential uses, pitfalls and impacts of social media for providers, scientists and institutions involved in digestive health in the domains of patient care, research and professional development. We recommend that these groups become more active participants on social media platforms to combat misinformation, advocate for patients, and curate and disseminate valuable research and educational materials. We also recommend that societies such as NASPGHAN assist its members in accessing training on effective social media use and the creation and maintenance of public-facing profiles and that academic institutions incorporate substantive social media contributions into academic promotion processes.

Exploring Predictors of Social Media Use for Health and Wellness during COVID-19 among Adults in the US: A Social Cognitive Theory Application

During COVID-19, SM media was relied upon for health-related information-seeking and activity support. This study uses the social cognitive theory (SCT) and a representative dataset of the population in the US to explore the factors influencing patients' perceptions of SM for health-related activities. As per SCT, consolidated factors comprised personal factors (sociodemographic, health perception, self-efficacy) and environmental factors (social isolation, purpose in life). Multivariate logistic regression analysis was conducted. Among the 6252 respondents, 95.15% rarely use SM to share personal health-related information, and 90.44% rarely use it to share general health-related information. Older individuals and Whites are less likely to consider SM for healthcare decisions. Education levels influence SM's perceived reliability. Those with positive health perceptions find SM more suitable for healthcare discussions. Socially-isolated individuals are less likely to use SM for healthcare. Those with a strong sense of purpose are less inclined to trust it for health decisions and may question its accuracy. SM-based interventions should address sociodemographic differences. Our findings contribute to the literature by SCT relevance validation in identifying the antecedents of SM use in healthcare. Our results also help to understand the challenges to its adoption. This can help enhance SM-based communication strategies and interventions.

Analysis of the Perception and Treatment of Osteoarthritis of the Knee Through Social Media: An Observational Study of the Top 100 Viral TikTok Videos

BACKGROUND

 TikTok is a popular platform that can be used for medical insights. However, spreading inaccurate information about diagnosing or treating medical conditions can undermine the quality of patient care. Our assessment focused on the discourse surrounding knee osteoarthritis on TikTok, with two primary objectives: 1) identifying the creators behind osteoarthritis-related content, and 2) examining whether a connection exists between the reach of video content and the strength of recommendations provided.

METHODS

 The top 100 TikTok videos were chosen based on likes on March 29, 2023. Posts were identified using the hashtag ("#Osteoarthritis"). Videos were classified by the following: number of likes, comments, shares, date of upload, uploader (medical professional, non-medical professional, or business), and video content (medical treatment, home remedy, personal story). Treatments were rated according to the American Academy of Orthopaedic Surgeons (AAOS) Evidence-Based Clinical Practice Guideline for Osteoarthritis using the strength of evidence criteria (1-4 stars). Descriptive and univariate analyses were performed.

RESULTS

 Among the top videos, 67.7% were uploaded by medical professionals. Private companies, despite having the highest average likes (29,681.2) and shares (1,367.5) per video, had a limited average evidence strength of 2.13. Physician-created videos had the second-highest average number of likes (25,440.1) and shares (1,224.5) per video with a strength of evidence of 3.03. Non-medical professional videos had the lowest evidence support (0.89). Medical treatments, the most liked and shared content, had the lowest evidence strength (1). There was no statistically significant correlation between the number of likes (p=0.808), comments (p=0.647), or shares (p=0.439) to the strength of evidence regarding the intervention.

DISCUSSION

 TikTok can be unreliable for knee osteoarthritis treatment information. It is common to find non-physicians sharing medical advice on the platform, with medical treatments demonstrating the weakest level of supporting evidence. Orthopaedic surgeons should advise their patients that TikTok treatment recommendations may not align with established guidelines.

Sociocrinology: Impact of Social Media on Endocrine Health - A Review

Social media (SM) refers to social networking sites (SNSs), which are defined as online services that enable individuals to build a public or semi-public profile and give them the opportunity to create a network of contacts and interact. SM affects all aspects of life and may offer new opportunities to explore new experiences and perspectives of life because of its feasibility. But several times, because of feasibility, misinformation is generated intentionally or unintentionally, which spreads rapidly, and such misinformation can affect all aspects of life. However, health-related misinformation can be life-threatening to individuals. Endocrinology is the branch of medicine that deals with endocrine glands and hormones, which regulates mood, growth, development, metabolism and the way our organ works to maintain internal homeostasis. SM usage and endocrine health impact each other in both positive and negative ways. So, in this review, we will discuss about the effect of SM on Endocrine health.

Mapping the insomnia patient journey in Europe and Canada

Introduction

Insomnia affects daily functioning and overall health, and is thus associated with significant individual, societal, and economic burden. The experience of patients living with insomnia, their perception of the condition, and its impact on their quality of life is not well documented. The objective of this study was to map the patient journey in insomnia and identify unmet needs.

Methods

Participants were individuals with insomnia, and healthcare professionals (HCPs) who treat insomnia, in the United Kingdom, France, Germany, Italy, and Canada. Qualitative interviews (50 patients, 70 HCPs) and a quantitative survey (700 patients, 723 HCPs) were conducted to inform the patient-journey mapping and obtain information on the emotions, perceptions, and experiences of patients and HCPs.

Results

The patient journey comprises seven phases. The first defines the onset of insomnia symptoms. Phase 2 represents self-initiated behavior change to improve sleep (e.g., sleep hygiene, reducing caffeine, exercise). The next phase is characterized by use of over-the-counter (OTC) treatments, which generally fail to provide lasting relief. Phase 4 describes the first HCP consultation (occurring several months to several years after onset) and typically occurs at a crisis point for the patient; patients may be looking for an immediate solution (e.g., medication), which may not align with their HCP's recommendation. The following stage comprises sleep hygiene/behavioral changes (±OTC treatment) under HCP guidance for many patients, although offering prescription treatments without a sleep hygiene stage under supervision is more common in some countries. Phase 6 describes prescription medication initiation, where patients fluctuate between relief/hopefulness and a sense of failure, while HCPs try to balance the need to provide relief for the patient while maintaining best medical practice and minimizing adverse effects. The final phase (living with long-term insomnia) represents an indefinite period during which sleep issues remain unresolved for many patients, with most of them continuing to use prescription treatments for longer than indicated and creating their own variable, self-managed regimens combining multiple modalities.

Conclusion

This patient journey analysis for insomnia revealed seven distinct phases, highlighting different touchpoints where insomnia management could be optimized.

The Role of Social Media and Breast Cancer: How Does It Impact Patients?

Introduction

Patients are increasingly turning to other sources for their health information. Social media has become mainstream, and the easy access to online communities, health professionals, and shared experiences of other patients has made social media a place where many patients turn to.

Methods

In this qualitative report, 2 patients who have had breast cancer describe the reasons why they use social media, what they perceive the advantages and disadvantages are, and what the impact of social media has been through their cancer treatment and beyond.

Results

The reasons why patients turn to social media are varied. These can include information gathering, peer support, shared experiences, and advocacy. There appear to be advantages and disadvantages; however, overall, the impact seems to be a positive one when used judiciously.

Discussion

It is clear that social media has a role to play in healthcare, whether by providing meaningful social connections, delivery of information, or psychological support. Healthcare professionals perhaps should consider the importance of social media in their practice.

Artificial Intelligence-Enabled Analysis of Statin-Related Topics and Sentiments on Social Media

Importance

Despite compelling evidence that statins are safe, are generally well tolerated, and reduce cardiovascular events, statins are underused even in patients with the highest risk. Social media may provide contemporary insights into public perceptions about statins.

Objective

To characterize and classify public perceptions about statins that were gleaned from more than a decade of statin-related discussions on Reddit, a widely used social media platform.

Design, Setting, and Participants

This qualitative study analyzed all statin-related discussions on the social media platform that were dated between January 1, 2009, and July 12, 2022. Statin- and cholesterol-focused communities, were identified to create a list of statin-related discussions. An artificial intelligence (AI) pipeline was developed to cluster these discussions into specific topics and overarching thematic groups. The pipeline consisted of a semisupervised natural language processing model (BERT [Bidirectional Encoder Representations from Transformers]), a dimensionality reduction technique, and a clustering algorithm. The sentiment for each discussion was labeled as positive, neutral, or negative using a pretrained BERT model.

Exposures

Statin-related posts and comments containing the terms statin and cholesterol.

Main Outcomes and Measures

Statin-related topics and thematic groups.

Results

A total of 10 233 unique statin-related discussions (961 posts and 9272 comments) from 5188 unique authors were identified. The number of statin-related discussions increased by a mean (SD) of 32.9% (41.1%) per year. A total of 100 discussion topics were identified and were classified into 6 overarching thematic groups: (1) ketogenic diets, diabetes, supplements, and statins; (2) statin adverse effects; (3) statin hesitancy; (4) clinical trial appraisals; (5) pharmaceutical industry bias and statins; and (6) red yeast rice and statins. The sentiment analysis revealed that most discussions had a neutral (66.6%) or negative (30.8%) sentiment.

Conclusions and Relevance

Results of this study demonstrated the potential of an AI approach to analyze large, contemporary, publicly available social media data and generate insights into public perceptions about statins. This information may help guide strategies for addressing barriers to statin use and adherence.

The Use of Social Media in Delivering Rehabilitation Services by Healthcare Professionals at a Rehabilitation Healthcare City in Riyadh, Saudi Arabia

Background:

The growing popularity of social media has been welcomed by medical professionals. With an increase in the number of healthcare providers addressing healthcare issues by using social media, such as Facebook, Twitter, YouTube, Snapchat, and Instagram, as well as communicating and educating patients on public health, this new technology has a substantial impact on improving the overall public health.

Objective:

The primary purpose of this study was to examine the challenges and benefits of using social media in delivering rehabilitation healthcare services from the perspective of healthcare workers at a private institution in a rehabilitation healthcare city in Riyadh, Saudi Arabia.

Methods:

A cross-sectional study was conducted among rehabilitation department staff working at a selected rehabilitation healthcare city in Riyadh, Saudi Arabia. An online web-based questionnaire was developed based on previous studies. The survey was distributed to the employees of the rehabilitation department via their work email addresses.

Results:

The study population was 108 healthcare providers. Overall, 77.78% of participants had used social media for over five years. Participants reported using social media for numerous purposes. The majority (35.19%) used it for education purposes, 30.56% used it for networking, and others used it for other things, such as communication with patients, online consultations, and job hunting. Furthermore, 49.07% of participants were already using social media to deliver rehabilitation services.

Conclusion:

The study found that most healthcare providers agreed on the benefits of utilizing social media in the healthcare sector. Most of the benefits were expanding the knowledge of both healthcare workers and patients, easier communication with patients, and also a cost-effective means of communication. However, some of the concerns that were raised by healthcare providers were regarding patients’ privacy and confidentiality, the dissemination of false or misleading information, and legal and ethical considerations.

Is TikTok a high-quality source of information on thyroid cancer?

PURPOSE

Increased Internet users tend to use online video platforms as a source of medical information. There are many thyroid cancer-related videos on TikTok, the most popular short-video application in China. However, quality evaluation of these videos remains absent. The aim of this study is to evaluate the quality of thyroid cancer-related videos on TikTok.

METHODS

A search was performed on TikTok with the keyword "thyroid cancer". The top 100 videos in the search results were selected. Characteristics of videos including video length, duration on TikTok, thumbs up, thumbs up/day, comments, comments/day, favorites, favorites/day, reposts, and reposts/day were collected. The Patient Education Materials Assessment Tool (PEMAT), modified DISCERN (mDISCERN), Video Information and Quality Index (VIQI), and Global Quality Score (GQS) were applied to assess the quality of videos.

RESULTS

Among the 100 videos in this study, most were uploaded by surgical physicians (n = 50), and the most common topic was anatomy/basic facts (n = 21). The mean scores of the PEMAT, PEMAT-U, and PEMAT-A were 71.18 ± 16.56, 82.23 ± 15.00, and 44.00 ± 37.57, respectively. Among the five questions of the mDISCERN tool, 71, 90, 82, 9, and 28 videos were evaluated as "yes", respectively. The mean scores of mDISCERN, VIQI, and GQS were 2.80 ± 1.03, 14.87 ± 2.27, and 3.72 ± 1.00, respectively. The characteristics and quality of videos are significantly different based on the uploader and content.

CONCLUSIONS

The quality of thyroid cancer information on TikTok is unsatisfactory. There is a need for high-quality thyroid cancer-related information on short-video platforms for patient education.

What are the ways in which social media is used in the context of complementary and alternative medicine in the health and medical scholarly literature? a scoping review

BACKGROUND

Despite the increased use of social media to share health-related information and the substantial impact that complementary and alternative medicine (CAM) can have on individuals' health and wellbeing, currently, to our knowledge, there is no review that compiles research on how social media is used in the context of CAM. The objective of this study was to summarize what are the ways in which social media is used in the context of CAM.

METHODS

A scoping review was conducted, following Arksey and O'Malley's five-stage methodological framework. MEDLINE, EMBASE, PsycINFO, AMED, and CINAHL databases were systematically searched from inception until October 3, 2020, in addition to the Canadian Agency for Drugs and Technology in Health (CADTH) website. Eligible studies had to have investigated how at least one social media platform is used in the context of a single or multiple types of CAM treatments.

RESULTS

Searches retrieved 1714 items following deduplication, of which 1687 titles and abstracts were eliminated, leaving 94 full-text articles to be considered. Of those, 65 were not eligible, leaving a total of 29 articles eligible for review. Three themes emerged from our analysis: 1) social media is used to share user/practitioner beliefs, attitudes, and experiences about CAM, 2) social media acts as a vehicle for the spread of misinformation about CAM, and 3) there are unique challenges with social media research in the context of CAM.

CONCLUSIONS

In addition to social media being a useful tool to share user/practitioner beliefs, attitudes, and experiences about CAM, it has shown to be accessible, effective, and a viable option in delivering CAM therapies and information. Social media has also been shown to spread a large amount of misleading and false information in the context of CAM. Additionally, this review highlights the challenges with conducting social media research in the context of CAM, particularly in collecting a representative sample.

Challenging norms: Making non-normative choices in childbearing. Results of a meta ethnographic review of the literature

OBJECTIVE

Women have the right to make choices during pregnancy and birth that sit outside clinical guidelines, medical recommendations, or normative expectations. Declining recommended place or mode of birth, routine intervention or screening can be considered 'non-normative' within western cultural and social expectations around pregnancy and childbirth. The aim of this review is to establish what is known about the experiences, views, and perceptions of women who make non-normative choices during pregnancy and childbirth to uncover new understandings, conceptualisations, and theories within existing literature.

METHODS

Using the meta-ethnographic method, and following its seven canonical stages, a systematic search of databases was performed, informed by eMERGe guidelines.

FINDINGS

Thirty-three studies met the inclusion criteria. Reciprocal translation resulted in three third order constructs - 'influences and motivators', 'barriers and conflict and 'knowledge as empowerment'. Refutational translation resulted in one third order construct - 'the middle ground', which informed the line of argument synthesis and theoretical insights.

KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE

The findings of this review suggest that whilst existing literature from a range of high-income countries with similar healthcare systems to the UK have begun to explore non-normative decision-making for discrete episodes of care and choices, knowledge based, theoretical and population gaps exist in relation to understanding the experiences of, and wider social processes involved in, making non-normative choices across the UK maternity care continuum.

Ophthalmology Inquiries on Reddit: What Should Physicians Know?

Purpose

Patients are seeking answers to personal medical questions on social media. Reddit, a popular social media site, has been overlooked as a source of data in the field of ophthalmology. We analyzed posts in the subreddit, r/Ophthalmology, to better understand the most common ophthalmic conditions patients are discussing online and how often those making posts are being advised to seek professional medical care.

Patients and Methods

This cross-sectional study analyzed posts and comments from March 18, 2018 to November 9, 2020. All posts and comments on r/Ophthalmology are public and were accessed using the Python Reddit API Wrapper. This text was analyzed for unique references to common ophthalmic conditions and for mentions and recommendations to different types of medical care.

Results

Nine hundred and nineteen posts were collected from the above timeframe. An auto-moderator makes a comment on every post to discourage patients from asking personal medical questions. Despite this, over two-thirds of posts discussed medical treatment for eye conditions in either a post, comment, or both. Almost half of all posts mention “ophthalmology”, but only 9% go as far as to recommend ophthalmic care. One-third of posts have no reference to medical care. Within posts, flashes and floaters were the most common condition mentioned, making up 15% of unique mentions, followed by glaucoma (7.4%) and retinal detachments (6.7%). Within comments, cataracts were most commonly discussed, making up 12% of unique mentions, followed by glaucoma (8.9%).

Conclusion

These findings show that patients are seeking information about their eye health on the r/Ophthalmology subreddit and that Reddit users are engaging with these types of posts, instead of recommending professional care in most cases. It is important for ophthalmologists to recognize the most common conditions patients are asking about online and learn how they can do a better job of educating their patients in the office.

Who's Posting What? A Qualitative, Cross-Sectional Study Comparing Twitter and Instagram Patterns Between Health Care Professionals and Patients

IMPORTANCE

There is a paucity of evidence-based, physician-authored content available on social media. Data are lacking on physicians use of social media, including intended audience and content.

OBJECTIVE

The aim of this study was to explore the patterns of Twitter and Instagram use for popular urogynecology hashtags between physicians, patients, and allied health professionals (AHPs).

STUDY DESIGN

Twelve hashtags derived from the Urogynecology Tag Ontology project were used as search terms to select Twitter and Instagram posts. Up to 5 top posts per hashtag per author type (physician, patient, or AHP) were included. Posts were analyzed using Dedoose qualitative analytic software by author, hashtag, intended audience, and themes.

RESULTS

On Twitter, 109 posts met inclusion criteria: 41% written by physicians, 40% patients, and 18.3% AHPs. For Instagram, 72 posts were included: 50% written by patients, 39% AHPs, and 11% physicians. Twitter physician posts were mainly intended for health professionals (64%) with only 18% for patients. Patients posted to the general public (57%) and patients (36%). Instagram physician posts were intended for health professionals (49%), whereas 62% of AHPs posted to patients. Most patient posts were directed to other patients (90%). Physicians posted about academic peer discussions, medical education, and advocacy. Patients posted about personal experiences, treatments, or dissatisfaction.

CONCLUSIONS

Physicians are more likely to post on Twitter than Instagram, with content focused primarily on their peer group, and physicians/patients are unlikely to engage with each other. There is an opportunity to improve social media interactions between physicians and the public while increasing high-quality patient education.