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. .. .. . .. . . Statistics .. 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