INTERNET AND SOCIAL MEDIA IMPACTS ON TURKISH HEALTH
CARE PROFESSIONALS’ REACHING HEALTH AND DRUG SIDE
EFFECT RELATED INFORMATION
Yelda Arıkan*, Taylan Benker*
* Boehringer Ingelheim Turkey, Clinical Quality and Drug Safety Department
Background
Objective
Methods
The goal of the study is to create a clear picture of how Turkish Physicians use
internet professionally; and to provide an insight to Health Authorities, Healthcare
Communities, and Pharmaceutical Companies. This study was conducted to
estimate internet and social media use in Turkish Health Care Professionals’ for
professional purpose. This research has aimed to determine
Internet usage frequency
General information sources and the role of internet for medical and professional purpose
Key internet sites which are used for medical and professional purpose
Physicians internet based social media usage habits regarding the search for drug safety issues
Health-related activities stand to benefit enormously from the Internet.
The Internet is beginning to influence the health sector by improving
access to health information.1 Social media, internet and its relevance
to health care have received significant recent attention.However,
the influence of internet and social media on
Turkish Health Care Professionals is not documented.
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Statistics
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This study was conducted by GfK Turkey and it is based on a 15-minute,
quantitative-administered CATI questionnaire.
The physicians were selected randomly for each specialty and region.
Data were collected for between 7th April and 10th May 2011.
During the field execution of this study, data have been collected in
accordance with the ESOMAR rules and regulations and GAB procedures.
Our study included 604 Physicians. (Table 1. -Table.3 and Fig: 1)
T-Test is used for means, and colon test is used for statistical analysis.
P value is <0.05
Demographics
Target Groups
Sample size (n)
Cardiologist
77
Internist
98
GP/ FP
88
Urologist
48
Neurologist
56
Pneumologist
46
Endocrinologist
42
Orthopedist
90
Gynecologist
59
TOTAL
The fieldwork has been conducted in 6 regions of Turkey. The number of interviewees
per city&region is as follows:
Male;
78%
Region
Mean of ...
Total
(n=604)
Age
43
Experience
in specialty
Female;
22%
13
Internist
(n=98)
45
15
Specialist
(n=98)
43
13
FP
(n=98)
41
13
Table. 2. Average age and their experience in their respective specialty
604
Figure. 1. Gender distribution
Table. 1. Distribution of physicians according to specialty
Sample size (n)
Title of physicians
Sample size (n)
Mediterranean
89
Prof.
22
Eastern Anatolia
55
Associate prof.
20
Aegean
107
Assistant prof.
11
Central Anatolia
140
Specialist/GP FP
550
Blacksea
63
Asistant
1
Marmara
150
TOTAL
604
TOTAL
604
Table. 3. Distribution of physicians according to region and title
Results
n=56
n=46
n=42
n=90
n=59
Yes 95,0
97,4
91,8
98,9
97,9
91,1
97,8
95,2
95,6
89,8
No
2,6
8,2
1,1
2,1
8,9
2,2
4,8
4,4
10,2
5,0
Table.4. Percentage of internet use by specialties
Physicians stated that they spend approximately 47% of their time on internet for scientific purposes followed by e-mail
communication (24%), social networking (10%). To get info on side effects/ contraindications of drugs is the purpose
of 12% of professional internet use. There is no significant difference in specialities (Fig.2.) and regions (data not shown).
12
4
4
10
%
12
4
4
13
24
24
47
44
9
4
4
9
11
3
5
10
22
20
12
7
4
10
28
24
15
4
4
10
9
23
5
13
2
7
11
18
14
3
3
9
24
27
31
63
53
50
11
4
4
11
39
46
48
40
36
Other
Shopping
Game / Entertainment
Social Networking
(facebook, twitter, blogs vb.)
Communication (E-mail)
Scientific purposes / related to my job
Total
(n=574)
Cardiologist
(n=75)
Internist
(n=90)
GP/ FP
(n=87)
Urologist
(n= 47)
Neurologist
(n=51)
Pneumologist Endocrinologist
(n=45)
(n=40)
Orthopedist
(n=86)
Physicians are highly engaged with social media. The ratio of internet
users following social networking sites is 46.9%, and Facebook tops
the list. Some of Turkish Physicians are likely to share Medical
information on social network. Twentytwo percent of the social
network followers provide medical advice to someone through
social network such as information about the disease/indication area
suggestion of a medication and side effects of a drug (Table.5).
The information sources Turkish Physicians utilize vary.
The information source that contributes the most to the
physicians’ daily practice is “scientific meetings”
and “medical publications/articles”.
Medical content sites from internet
is the 3rd rank in the information sources
for Drug Efficacy and Side Effect but it is not clear
if they use medically confirmed or official
internet sites. Furthermore, Medical Representatives of
Pharmaceutical Companies are still seen as an important
information source. However, the least contributory
information source is “websites of pharmaceutical
companies” (Fig.3).
Gynecologist
(n=53)
%
Total
Base
I suggested a name of drug/give
information about a drug
n=59
20,3
I give information about the
side effect of a drug
13,6
I give information about a
disease
45,8
Suggested a physician’s name
11,9
I gave information about
treatment alternatives
and related specialties
5,1
Other
13%
10%
11%
6%
5%
6%
1%
0%
Fig.3. Percentage of contribution of information sources for drug efficacy/side effect
Fig.2. The purpose of internet use in different specialties. P<0.05 between specialties)
Social Media Use in Turkish Physicians
15%
Websites of the drug companies
n=48
Opinion Leaders
n=88
My colleagues
n=98
16%
Inf. Source
Medical Representatives
Base n=604 n=77
Urologist Neurologist Pneumo. Endoc. Orthopedist Gynecologist
20%
22%
Medical Publications
Total Cardiologist Internist GP/FP
25%
The Medical Content Sites on the
Internet
%
Information Sources for
Drug Efficacy/Side Effect
25%
Scientific Meetings
Internet usage is very common in Turkish Physicians. Approximately 95% of physicians are active internet-users, and
majority of physicians use internet everyday (Table.4).
30%
Other
Internet Usage
Info about the safety profiles of drugs
Although internet is well acquianted by physicians in terms
of information source,majority of physicians do not use any
internet site to gain information about the safety profiles
of drugs (p <0.05). Websites found from Google (26%)
and PubMed (10%) (p <0.05 and p <0.05 respectively)
are the main internet sites searched for safety information
of drugs (Fig.4.). However, the internet sites which the
physicians use may not be official and medically confirmed
or licenced. Therefore, it is not certain that the websites
found from Google and drug information websites are
reliable sources and contains updated information.
32,2
Table.5. Medical Advice given via Social Networking Environment
Professional Internet Usage
Fig.4. Percentage of internet use for drug safety
Actions taken when there is Side effect / Adverse effect &
Adverse Event Report Awareness
When there is a side effect in their patients, 26% of physicians prefer to switch current treatment and do not inform anyone.
On the other hand,15% of them notify the sales represantative of the product in question. Totally 27.5% of physicians notify
pharmaceutical companies or/and Ministry of Health Pharmacovigilance (Fig.5.).
Turkish Physicians have embraced internet in their
everyday professional lives. The most common
reason for using the internet is “to scan articles/
literatures” (56.3 %), followed by “to learn
developments regarding my speciality”(54.2 %) and
“to get information about clinical studies” (44.4 %).
Endocrinologists and cardiologists are most interested
in using the internet for gaining information on clinical
studies (p < 0.05). GP /FPs use the internet to gain info
on updates from MoH, to get info on side effects of
drugs and their efficacy. (p < 0.05) (Table.6).
%78
Does not know
TUFAM online
%22
Knows
TUFAM online
n=574
Total
71,1
Internist n=87
GP/FP Urologist Neuro. Pneumo.
Endoc. Orthoped. Gyneco.
Table.6. The distribution of the reasons of professional internet use.
Fig.5. Percentage of actions taken when there is a side effect.
Fig.6. Internet Adverse Effect Notification System
of T.C. Ministry of Health Turkey Pharmacovigilance
Center is not known by 78% of 604 physicians.
Conclusion / Discussion
Our study demonstrates that the adverse event reporting and knowledge of reporting methods among Turkish physicians are reportedly low. This study may explicate the reasons why adverse event reporitng numbers in Turkey are lower than expected
for such populations. Listed and non-serious adverse events are not likely to be reported neither to Pharmaceutical Companies nor to the Ministry of Health. Awareness programs on drug safety and notification system of T.C. Ministry of Health Turkey
Pharmacovigilance Center are needed. Adequete Pharmacovigilance Trainings can be organized and included in Physicians Society Meetings.
Medical information sources on internet may not be always reliable. The internet sites which the physicians apply may not be medically confirmed or official. Although the official web-pages of Pharmaceutical Companies are not considered as an
initial information source for the physicians, these internet sites include updated and reliable information.
Our study demonstrated that physicians are likely to share medical information over internet which can also be accessed by non-healthcare providers. As patients frequently refer to internet for medical advice2, a controlled environment may provide increased
patient safety and better patient - physicians’ interactions. Online Physician Communities may have positive impact on patients, but the access of patients should be limited to maintain the physician- patient interaction balance. Tapping into Online
Physician-Patient Communities could boost efforts aroud innovation, product development and patient services for Pharmaceutical and Medical Technology Companies. 3
References:
1. National Research Council. Networking Health: Prescriptions for the Internet. Washington DC: National Academy Press; 2000
2. T.Benker and Y.Arıkan. Use of Internet and Social Media for Health Care and Drug Side Effect information Among Turkish Patients. Poster Presentation 11th ISOP. Istanbul, 2011
3. Doctors, Patients & Social Media, Quantia MD, September 2011