Impact of Digital Media on the Patient Journey and Patient-Physician Relationship Among Dermatologists and Adult Patients With Skin Diseases: Qualitative Interview Study

Assessing the Public's Preferences and Outcomes in Using Online Resources and Digital Health Tools to Manage Skin Conditions: A Cross-Sectional Study

Background Individuals often seek advice from professionals and others to make decisions that best suit their needs in various situations. With the rapid growth of technology and the variety of available platforms, the general public faces the dilemma of choosing from numerous, diverse options. This study aims to explore the public's online advice-seeking behaviors, along with the reliability and trustworthiness of the information they use to manage their skin conditions. Methods A sample of 853 participants, aged 15 and above, from Saudi Arabia, completed a 20-question close-ended questionnaire, along with one optional open-ended question, assessing their use of online and digital resources for skin-related concerns. Results Statistical analysis revealed that the primary reason for seeking online solutions was convenience (170 participants, or 53.6%), followed by curiosity or self-education (133 participants, or 42%). A significant portion of respondents (164 participants, or 53%) found online information reliable, while 41 (12.9%) did not. Regarding skin condition improvement, 217 participants (68.4%) reported noticing a positive change, while four (1.3%) observed a decline. Conclusion This study highlights the importance of online resources and digital health tools for obtaining health-related information. A clear, positive correlation was found between the use of such resources and improvement in skin conditions.

Patients' preferences on atopic dermatitis skincare and social media use: a qualitative study

BACKGROUND

Atopic dermatitis (AD) is a chronic inflammatory disease with a complex pathophysiology, necessitating strict therapeutic management. Over-the-counter products play a crucial role in AD treatment. The emergence of social media (SM) as a vast information source for skincare and healthy lifestyle has transformed its role from mere entertainment. This study aimed to explore the attitudes of AD patients towards SM as an information source for their AD products, understand their purchase behavior, and identify unmet needs.

METHODS

Qualitative semi-structured interviews were conducted with AD patients recruited from a university hospital in Southern Germany and social media networks. The interviews took place between November 2022 and January 2023. The recorded interviews were transcribed verbatim and analyzed using Mayring's qualitative content analysis.

RESULTS

A total of ten patients (3 men, 7 women) aged 23-42 years were interviewed. Participants reported new perspectives in four categories: opportunities and advantages of SM as information source for AD products, risks and disadvantages, important aspects for patients' choice of AD products, and extent and purpose of SM use in selecting AD skincare.

CONCLUSIONS

Patients exhibit diverse patterns of SM use when selecting daily products and critically evaluate the online content, demonstrating a greater trust in healthcare professionals or familial connections. Electronic word-of-mouth, disease severity and prior product experiences emerge as prevalent factors influencing patients' product selection. Furthermore, female patients express interest in complementary and alternative therapies as part of an integrative therapeutical approach. Understanding patients' needs and preferences regarding AD skincare can inform physicians in recommending more personalized therapies. Additionally, educational interventions on SM, addressing patients' questions and concerns with evidence-based information, hold the potential for beneficial outcomes.

Interventions to Reduce Skin-related Self-stigma: A Systematic Review

Self-stigma beliefs are common among people with visible chronic skin diseases and can negatively affect their quality of life and psychosocial wellbeing. Hence, evidence-based interventions are urgently needed. The objective for this systematic review was to summarize research on available interventions and evaluate their benefits and limitations. Following PRISMA guidelines, we conducted an electronic database search of four databases (EMBASE, PsycINFO, PubMed, Web of Science). Studies were eligible if they (a) investigated interventions to reduce self-stigma in adults with chronic skin disease, (b) were original empirical articles, and (c) were written in English or German. Two independent reviewers conducted the abstract and full text screening as well as data extraction. The quality of the included studies was evaluated using the Critical Appraisal Skills Programme checklists. The initial search yielded 5811 abstracts; of which, 23 records were eligible. Studies addressed a broad range of skin conditions, and interventions ranged from social skills training, counselling and self-help to psychosocial and behavioural interventions. Overall, interventions had mostly positive effects on self-stigma and related constructs. However, the study quality was heterogeneous, and further efforts to develop, thoroughly evaluate and implement interventions tackling self-stigma in multiple skin conditions and languages are warranted.

Digital Media Usage Behavior and Its Impact on the Physician-Patient Relationship: Cross-Sectional Study Among Individuals Affected by Psoriasis in Germany

BACKGROUND

Psoriasis is a chronic skin disorder with a high burden of disease. People affected with psoriasis increasingly use the internet for health-related reasons, especially those with younger age, higher education, and higher disease severity. Despite advantages such as enhancing the individuals' knowledge with the use of digital media for health-related issues, disadvantages were also present such as quality control, and variability in the individuals' health information literacy. While patients with psoriasis within medical settings generally trust physicians over digital media, they commonly withhold their web-based research findings from health care providers.

OBJECTIVE

The study aims to (1) identify further factors associated with regular psoriasis-related internet use, (2) rank specific digital media platforms used, and (3) examine digital media within the physician-patient relationship among individuals with and without dermatological treatment.

METHODS

A cross-sectional, questionnaire-based study was conducted among individuals with self-reported psoriasis in Germany between September 2021 and February 2022. Participants were recruited via digital media platforms and in person at a University Hospital Department of Dermatology in southern Germany. The questionnaire asked about demographic and medical information, individual psoriasis-related digital media use, and the impact of digital media on the physician-patient relationship. Data were analyzed descriptively, and logistic regression models were performed to assess the factors associated with regular psoriasis-related internet use.

RESULTS

Among 321 individuals with a median age of 53 (IQR 41-61) years (nonnormally distributed; females: 195/321), female sex, shorter disease duration, moderate mental burden of disease, and good self-assessed psoriasis-related knowledge were associated with regular psoriasis-related internet use. Of the 188 participants with a mean age of 51.2 (SD 13.9) years (normally distributed) who used digital media 106 (56.4%) usually searched for information on psoriasis-based websites and 98 (52.1%) on search engines, primarily for obtaining information about the disease and therapy options, while social media were less frequently used (49/188, 26.1%). Nearly two-thirds of internet users (125/188) claimed that their physicians did not recommend digital media platforms. About 44% (82/188) of the individuals reported to seek for additional information due to the insufficient information provided by their physician.

CONCLUSIONS

This study revealed the importance of digital media in the context of psoriasis, especially among women, individuals with shorter disease duration, and moderate mental disease severity. The lack of physicians' digital media recommendations despite their patients' desire to receive such and being more involved in health-related decisions seems to be a shortcoming within the physician-patient relationships. Physicians should guide their patients on digital media by recommending platforms with evidence-based information, thereby potentially creating an adequate framework for shared decision-making. Future research should focus on strategies to prevent the spread of false information on digital media and address the needs of patients and physicians to enhance health-related digital media offerings.

Physician Perspectives on Internet-Informed Patients: Systematic Review

BACKGROUND

The internet has become a prevalent source of health information for patients. However, its accuracy and relevance are often questionable. While patients seek physicians' expertise in interpreting internet health information, physicians' perspectives on patients' information-seeking behavior are less explored.

OBJECTIVE

This review aims to understand physicians' perceptions of patients' internet health information-seeking behavior as well as their communication strategies and the challenges and needs they face with internet-informed patients.

METHODS

An initial search in PubMed, Scopus, CINAHL, Communication and Mass Media Complete, and PsycINFO was conducted to collect studies published from January 1990 to August 1, 2022. A subsequent search on December 24, 2023, targeted recent studies published after the initial search cutoff date. Two reviewers independently performed title, abstract, and full-text screening, adhering to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement guidelines. Thematic analysis was then used to identify key themes and systematically categorize evidence from both qualitative and quantitative studies under these themes.

RESULTS

A total of 22 qualifying articles were identified after the search and screening process. Physicians were found to hold diverse views on patients' internet searches, which can be viewed as a continuous spectrum of opinions ranging from positive to negative. While some physicians leaned distinctly toward either positive or negative perspectives, a significant number expressed more balanced views. These physicians recognized both the benefits, such as increased patient health knowledge and informed decision-making, and the potential harms, including misinformation and the triggering of negative emotions, such as patient anxiety or confusion, associated with patients' internet health information seeking. Two communicative strategies were identified: the participative and defensive approaches. While the former seeks to guide internet-informed patients to use internet information with physicians' expertise, the latter aims to discourage patients from using the internet to seek health information. Physicians' perceptions were linked to their strategies: those holding positive views tended to adopt a participative approach, while those with negative views favored a defensive strategy. Some physicians claimed to shift between the 2 approaches depending on their interaction with a certain patient. We also identified several challenges and needs of physicians in dealing with internet-informed patients, including the time pressure to address internet-informed patient demands, a lack of structured training, and being uninformed about trustworthy internet sites that can be recommended to internet-informed patients.

CONCLUSIONS

This review highlights the diverse perceptions that physicians hold toward internet-informed patients, as well as the interplay between their perceptions, communication strategies, and their interactions with individual patients. Incorporating elements into the medical teaching curriculum that introduce physicians to reliable internet health resources for patient guidance, coupled with providing updates on technological advancements, could be instrumental in equipping physicians to more effectively manage internet-informed patients.

TRIAL REGISTRATION

PROSPERO CRD42022356317; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=356317.

Patient Journey und krankheitsbezogene Nutzung digitaler Medien: Eine Querschnittsstudie unter Dermatologie-Patienten in Deutschland: Patient journey and disease-related digital media usage: A cross-sectional study among dermatology patients across Germany

Hintergrund und Ziele

Ziel dieser Studie war es, die Auswirkungen der Nutzung gesundheitsbezogener digitaler Medien auf die Arzt‐Patienten‐Beziehung und die Patient Journey (Weg des Patienten durch alle Phasen seiner Erkrankung) zu untersuchen, um positive Veränderungen in der dermatologischen Praxis zu bewirken.

Patienten und Methodik

Von Juni bis November 2022 füllten Personen mit Hautkrankheiten in Deutschland einen Fragebogen zur Bewertung der gesundheitsbezogenen Nutzung digitaler Medien, der E‐Health‐Kompetenz, des Einflusses der Nutzung digitaler Medien auf die Arzt‐Patienten‐Beziehung und die Patient Journey sowie soziodemografischer und gesundheitlicher Merkmale aus. Die Daten wurden deskriptiv und mittels linearer Regressionen analysiert.

Ergebnisse

Insgesamt wurden 919 Teilnehmer analysiert (medianes Alter: 47,00, Interquartilsbereich [28,00; 61,00] Jahre, weiblich: 53,6%, Nutzer digitaler Medien im Kontext der Erkrankung: 56,8%). Google und Online‐Enzyklopädien wurden am häufigsten vor und nach der dermatologischen Konsultation genutzt. Online‐Selbsthilfegruppen wurden von 76,3% der nicht behandelten Teilnehmer in Anspruch genommen. Die Nutzung digitaler Medien hatte keinen Einfluss auf die Arzt‐Patienten‐Beziehung und wirkte sich positiv auf die Patient Journey aus. Positive Auswirkungen wurden mit höherer E‐Health‐Kompetenz, Zufriedenheit mit der Qualität digitaler Medien, Bedeutung digitaler Medien, ländlichem Wohnsitz, höherem Bildungsniveau und Vertrauen in Dermatologen in Verbindung gebracht.

Schlussfolgerungen

Die dermatologische Versorgung in Arztpraxen kann vom Potenzial digitaler Gesundheitsmedien profitieren. Eine evidenzbasierte digitale Gesundheitsplattform ist erforderlich, um die E‐Health‐Kompetenz der Betroffenen zu erhöhen und ihre Zufriedenheit mit der Qualität digitaler Medien zu verbessern.

Patient journey and disease-related digital media usage: A cross-sectional study among dermatology patients across Germany

BACKGROUND AND OBJECTIVES

This study aimed to fill the gap of evidence-based data by examining the impact of health-related digital media use's impact on the patient-physician relationship and patient journey, with the goal of driving positive changes in office-based dermatological practice.

PATIENTS AND METHODS

German individuals with skin conditions completed a questionnaire assessing health-related digital media use, eHealth literacy, impact of digital media use on the patient-physician relationship and patient journey, and sociodemographic and health characteristics from June to November 2022, followed by descriptive analysis and linear regressions.

RESULTS

Overall, 919 participants were analyzed (median age: 47.00, interquartile range [28.00; 61.00] years, female: 53.6%, health-related digital media users: 56.8%). Google and online encyclopedias were commonly used before and after dermatological consultations. Online self-help groups were used by 75% of non-treated participants. Digital media use had no impact on the patient-physician relationship and a positive impact on the patient journey. Positive impacts were associated with higher eHealth literacy, satisfaction with digital media quality, importance of digital media, rural residence, high education, and trust in dermatologists.

CONCLUSIONS

The potential of health-related digital media in office-based dermatological care necessitates the drive of an evidence-based digital health platform to improve eHealth literacy and satisfaction with the quality of digital media among affected individuals.