Facebook, Twitter, YouTube, and LinkedIn have emerged as important online meeting places for social networking. Studies suggest that patients are increasingly looking to social media to gain information on medical conditions and treatments and to meet and interact with other people with similar health problems for support. “Social media offers patients an opportunity to learn about their illness and get assistance from others with similar experiences,” says Joyce Lee, MD, MPH. Some studies suggest that social networks can improve disease management and health outcomes for patients.
Many disease-specific groups, including diabetes, have arisen on social media sites. “These resources have become important sources of information, support, and engagement for patients,” says Dr. Lee. Despite the emergence of these platforms, questions remain about the extent to which private firms promote their products in this unregulated environment. Furthermore, many physicians and patients are unaware of the extent to which information on social media is clinically accurate and whether patients receive advice to engage in potentially harmful activities.
Exploring Social Media Use
Recent studies have analyzed the content of health-seeking behavior and information sharing on popular social networking websites. “Many patients with diabetes utilize social networks and want to discuss health information online,” Dr. Lee says. Some analyses have shown that patients with diabetes, family members, and their friends use social platforms to share personal clinical information, request disease-specific guidance and feedback, and receive emotional support (Figure 1). Most social media sites that allow for wall posts provide information to patients with diabetes, but others contain advertisements, which are sometimes biased (Figure 2).
The current literature suggests that there is little evidence of dangerous, misleading, or risky self-medication behavior being supported by social media sites for patients with diabetes. However, many sites do not identify the people making posts, putting the trustworthiness of online social networking tools into question. Few sites have editorial monitors or fact-checkers. “When clinicians encounter inquiries from patients with diabetes on what they learn about in social media, it’s important to hear patients out,” adds Dr. Lee.
Users of social media can gain interpersonal and community support from wall posts and discussion threads. They can also access forms of specialized knowledge on diabetes management from peers. “The positive but realistic advice from others can be a help,” says Dr. Lee. “Clinicians should ensure that patients understand the pros and cons of using social media as a support mechanism. I trust my patients because they have great judgment and can often figure out for themselves if the advice online is useful and relevant. At the same time, however, I encourage them to talk with their healthcare providers about the content if they have questions.”
Embrace the Social Media Movement
As social media continues to reach new heights in terms of impact, patients are finding it easier to get information to improve their health, even when they are outside the clinical setting. “Social media can serve as a mechanism of empowerment, which is especially important for people living with diabetes,” Dr. Lee says. “The disease requires intensive, lifelong self-management to prevent long-term morbidity and mortality and to improve quality of life. Clinicians should embrace the fact that many patients are interested in gaining extra support from social media. Social networks have the potential to impact behavior changes, with the added advantage of being able to easily connect to anyone in the world.”
To avoid the potential for patients receiving misinformation, it may behoove clinicians to take time to find social media sites that they trust the most and direct their patients to these sites, says Dr. Lee. “By integrating aspects of social media into the healthcare delivery system, physicians may be able to help patients with diabetes become increasingly involved in their care, leading to more informed and motivated patients,” she adds. “In turn, this could improve health outcomes.”
More research is needed to account for issues of privacy and security and the protection of health information on social media. More data are also needed to determine how best to educate and caution patients about misinformation and unreliable health-based websites. “Social networks have the potential to reach many patients who can benefit from the support of others living with the disease,” Dr. Lee says. “Social media may serve as an important platform for the development of diabetes care interventions and for reaching diverse patient populations.”
Readings & Resources (click to view)
Greene JA, Choudhry NK, Kilabuk E, Shrank WH. Online social networking by patients with diabetes: a qualitative evaluation of communication with Facebook. J Gen Intern Med. 2011;26:287-292. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3043192/.
Cefalu WT. Progress to date for Diabetes Care: going mobile and putting information at your fingertips! Diabetes Care. 2012;35:1397-1398 . Available at: http://care.diabetesjournals.org/content/35/7/1397.long.
Shaw RJ, Johnson CM. Health Information Seeking and Social Media Use on the internet among people with diabetes. Online J Public Health Inform. 2011;3(1).
Chomutare T, Fernandez-Luque L, Arsand E, Hartvigsen G. Features of mobile diabetes applications: review of the literature and analysis of current applications compared against evidence-based guidelines. J Med Internet Res. 2011;13:e65.
Chou WY, Hunt YM, Beckjord EB, Moser RP, Hesse BW. Social media use in the United States: implications for health communication. J Med Internet Res. 2009;11:e48.
Armstrong N, Powell J. Patient perspectives on health advice posted on Internet discussion boards: a qualitative study. Health Expect. 2009;12:313-320.
Thompson LA, Dawson K, Ferdig R, et al. The intersection of online social networking with medical professionalism. J Gen Intern Med. 2008;23:954-957.
Jain SH. Practicing medicine in the age of Facebook. N Engl J Med. 2009;361:649-651.
Farmer AD, Bruckner Holt CE, Cook MJ, Hearing SD. Social networking sites: a novel portal for communication. Postgrad Med J. 2009;85:455-459.
Ravert RD, Hancock MD, Ingersoll GM. Online forum messages posted by adolescents with type 1 diabetes. Diabetes Educ. 2004;30:827-834.