J. Med. Internet Res. - Can online consumers contribute to drug knowledge? A mixed-methods comparison of consumer-generated and professionally controlled psychotropic medication information on the internet.

Tópicos

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Resumo

CKGROUND: Ongoing initiatives to filter online health searches exclude consumer-generated content from search returns, though its inferiority compared with professionally controlled content is not demonstrated. The antidepressant escitalopram and the antipsychotic quetiapine have ranked over the last 5 years as top-selling agents in their respective drug classes. Both drugs have various off-label mental health and non-mental health uses, ranging from the relief of insomnia and migraines to the treatment of severe developmental disorders.OBJECTIVE: Our objective was to describe the most frequently reported effects of escitalopram and quetiapine in online consumer reviews, to compare them with effects described in professionally controlled commercial health websites, and to gauge the usability of online consumer medication reviews.METHODS: A stratified simple random sample of 960 consumer reviews was selected from all 6998 consumer reviews of the two drugs in 2 consumer-generated (www.askapatient.com and www.crazymeds.us) and 2 professionally controlled (www.webmd.com and www.revolutionhealth.com) health websites. Professional medication descriptions included all standard information on the medications from the latter 2 websites. All textual data were inductively coded for medication effects, and intercoder agreement was assessed. Chi-square was used to test for associations between consumer-reported effects and website origination.RESULTS: Consumers taking either escitalopram (n = 480) or quetiapine (n = 480) most frequently reported symptom improvement (30.4% or 146/480, 24.8% or 119/480) or symptom worsening (15.8% or 76/480, 10.2% or 49/480), changes in sleep (36% or 173/480, 60.6% or 291/480) and changes in weight and appetite (22.5% or 108/480, 30.8% or 148/480). More consumers posting reviews on consumer-generated rather than professionally controlled websites reported symptom worsening on quetiapine (17.3% or 38/220 versus 5% or 11/220, P < .001), while more consumers posting on professionally controlled websites reported symptom improvement (32.7% or 72/220 versus 21.4% or 47/220, P = .008). Professional descriptions more frequently listed physical adverse effects and warnings about suicidal ideation while consumer reviews emphasized effects disrupting daily routines and provided richer descriptions of effects in context. The most recent 20 consumer reviews on each drug from each website (n = 80) were comparable to the full sample of reviews in the frequency of commonly reported effects.CONCLUSION: Consumer reviews and professional medication descriptions generally reported similar effects of two psychotropic medications but differed in their descriptions and in frequency of reporting. Professional medication descriptions offer the advantage of a concise yet comprehensive listing of drug effects, while consumer reviews offer greater context and situational examples of how effects may manifest in various combinations and to varying degrees. The dispersion of consumer reviews across websites limits their integration, but a brief browsing strategy on the two target medications nonetheless retrieved representative consumer content. Current strategies for filtering online health searches to return only trusted or approved websites may inappropriately address the challenge to identify quality health sources on the Internet because such strategies unduly limit access to an entire complementary source for health information.

Resumo Limpo

ckground ongo initi filter onlin health search exclud consumergener content search return though inferior compar profession control content demonstr antidepress escitalopram antipsychot quetiapin rank last year topsel agent respect drug class drug various offlabel mental health nonment health use rang relief insomnia migrain treatment sever development disordersobject object describ frequent report effect escitalopram quetiapin onlin consum review compar effect describ profession control commerci health websit gaug usabl onlin consum medic reviewsmethod stratifi simpl random sampl consum review select consum review two drug consumergener wwwaskapatientcom wwwcrazymedsus profession control wwwwebmdcom wwwrevolutionhealthcom health websit profession medic descript includ standard inform medic latter websit textual data induct code medic effect intercod agreement assess chisquar use test associ consumerreport effect websit originationresult consum take either escitalopram n quetiapin n frequent report symptom improv symptom worsen chang sleep chang weight appetit consum post review consumergener rather profession control websit report symptom worsen quetiapin versus p consum post profession control websit report symptom improv versus p profession descript frequent list physic advers effect warn suicid ideat consum review emphas effect disrupt daili routin provid richer descript effect context recent consum review drug websit n compar full sampl review frequenc common report effectsconclus consum review profession medic descript general report similar effect two psychotrop medic differ descript frequenc report profession medic descript offer advantag concis yet comprehens list drug effect consum review offer greater context situat exampl effect may manifest various combin vari degre dispers consum review across websit limit integr brief brows strategi two target medic nonetheless retriev repres consum content current strategi filter onlin health search return trust approv websit may inappropri address challeng identifi qualiti health sourc internet strategi unduli limit access entir complementari sourc health inform

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