By Dr Laoibhse Kenny*
The rapid development of the internet means that both a wealth of health information and a minefield of misinformation are now available.No longer are doctors seen as the sole custodians of medical information.
A 2009 survey from the Pew Internet and American Life Study estimated that 61% of American adults search the internet for health information, with many looking for user-generated content written by patients with similar medical conditions.
Like a lot of the information on the net, not all medical content is credible. Steps have been made in health website monitoring in recent times with the development of organisations that oversee and assess content of health websites such as Health on the Net (HON) Foundation.**
A 2007 study highlighted that using health information from the internet for decision making purposes without expert advise could potentially have a negative impact on a patient's health.
Results from a study in 2005 found that over half of the health professionals questioned agreed that there was a 'risk' of self treatment, and 60% of them believed that searching for health information online encourages patients to challenge the physicians authority.
The Irish Medicines Board (IMB) has frequently highlighted the dangers of purchasing medicines online.
The Irish Survey of Lifestyle, Attitudes and Nutrition (SLAN) showed that respondents aged 18-34 were more likely to use the internet as a source of information on health than those over 55.
Results from the 2003 Eurobarometer survey reported that 23.4% of Irish adults had used the internet as a source on health information. The study also found that use of the internet decreased with age and increased with more years of education.
A 2006 survey into the habits of internet users in Ireland over a three month period interestingly highlighted that more people look online for health information than looking for a job or looking at online newspapers.
I carried out a study to determine the level of access to the internet by the patients in our practice, to determine the types of health information sought by them, to assess how they search for this information and to determine how patients choose to validate their newly acquired medical knowledge.
The study also sought to determine the perceptions of GPs within the practice of their patients' use of the internet.
Of the patients who responded to the survey, 92% had internet access. Of these, 79% reported that they had accessed health information on the internet.
The majority of GP's surveyed felt that around 50% of patients accessed health information online.
The most common searches by patients were on specific diseases or conditions (129 patients), exercise and nutrition (87 patients) and medications (54 patients).
The GPs also identified specific disease or condition as the most common search. 76.5% of patients reported searching for health information via entering key words in a search engine with only 0.5% of patients going specifically to a validated health website.
All of the GP's surveyed felt that patients searched only through search engines - 50.5% of patients reported that they understood the information, which correlated with the GPs' views.
Seventy one per cent of patients 'mostly or sometimes trusted this information. The GP's however, thought that 100% of patients trusted the information obtained.
Also, 38% of patients reported validating websites by discussing it with the GP, while 30% validated websites via discussion with family and friends.
GPs rated themselves higher, saying 75% of patients would validate their findings with them - 32% of patients reported never discussing the information obtained from the net with their health provider. This was not reflected among the GPs surveyed.
Of the patients surveyed only 10% reported that their GP had suggested internet sources, with most of the GPs surveyed reporting always suggesting internet sources.
Finally, GPs were asked if they ever knew of patients using the internet for health reasons in an unsafe way - only one of the eight GPs in the practice GP answered no.
Comments from GPs included 'heard of patient ordering abortion pill online', 'patients buy benzodiazepines (tranquilisers) and weight loss medication online', 'patients often use symptom-checker'."
What we learn from this study is that the internet era is here and whether we like it or not our patients will search the internet for health information.
What we also learn is that patients' search techniques are suboptimal and they may trust the wrong information. It also appears that doctors are not helping people to navigate the internet safely.
How has this study changed our practice? As a practice we have now updated our website and can now confidently direct patients to safe internet sites through it.
We also recognise that the majority of our patients will look to the internet when it comes to health and I personally have embraced this and used this to empower patients and educate them in the management of their illnesses.
*Dr Laoibhse Kenny is a GP in Cork.
This is an abridged version of an article in Forum, the journal of the Irish College of General Practitioenrs, published by MedMedia.
** Irishhealth.com subscribes to the principles of the Health on the Net Foundation.
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