J. Med. Internet Res. - Changes over time in the utilization of disease-related Internet information in newly diagnosed breast cancer patients 2007 to 2013.


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CKGROUND: As the number of people with Internet access rises, so does the use of the Internet as a potentially valuable source for health information. Insight into patient use of this information and its correlates over time may reveal changes in the digital divide based on patient age and education. Existing research has focused on patient characteristics that predict Internet information use and research on treatment context is rare.OBJECTIVE: This study aims to (1) present data on the proportion of newly diagnosed breast cancer patients treated in German breast centers from 2007 to 2013 who used the Internet for information on their disease, (2) look into correlations between Internet utilization and sociodemographic characteristics and if these change over time, and (3) determine if use of Internet information varies with the hospitals in which the patients were initially treated.METHODS: Data about utilization of the Internet for breast cancer-specific health information was obtained in a postal survey of breast cancer patients that is conducted annually in Germany with a steady response rate of 87% of consenting patients. Data from the survey were combined with data obtained by hospital personnel (eg, cancer stage and type of surgery). Data from 27,491 patients from 7 consecutive annual surveys were analyzed for this paper using multilevel regression modeling to account for clustering of patients in specific hospitals.RESULTS: Breast cancer patients seeking disease-specific information on the Internet increased significantly from 26.96% (853/3164) in 2007 to 37.21% (1485/3991) in 2013. Similar patterns of demographic correlates were found for all 7 cohorts. Older patients (=70 years) and patients with <10 years of formal education were less likely to use the Internet for information on topics related to their disease. Internet use was significantly higher among privately insured patients and patients living with a partner. Higher cancer stage and a foreign native language were associated with decreased use in the overall model. Type of surgery was not found to be associated with Internet use in the multivariable models. Intraclass correlation coefficients were small (0.00-0.03) suggesting only a small contribution of the hospital to the patients' decision to use Internet information. There was no clear indication of a decreased digital divide based on age and education.CONCLUSIONS: Use of the Internet for health information is on the rise among breast cancer patients. The strong age- and education-related differences raise the question of how relevant information can be adequately provided to all patients, especially to those with limited education, older age, and living without a partner.

Resumo Limpo

ckground number peopl internet access rise use internet potenti valuabl sourc health inform insight patient use inform correl time may reveal chang digit divid base patient age educ exist research focus patient characterist predict internet inform use research treatment context rareobject studi aim present data proport newli diagnos breast cancer patient treat german breast center use internet inform diseas look correl internet util sociodemograph characterist chang time determin use internet inform vari hospit patient initi treatedmethod data util internet breast cancerspecif health inform obtain postal survey breast cancer patient conduct annual germani steadi respons rate consent patient data survey combin data obtain hospit personnel eg cancer stage type surgeri data patient consecut annual survey analyz paper use multilevel regress model account cluster patient specif hospitalsresult breast cancer patient seek diseasespecif inform internet increas signific similar pattern demograph correl found cohort older patient year patient year formal educ less like use internet inform topic relat diseas internet use signific higher among privat insur patient patient live partner higher cancer stage foreign nativ languag associ decreas use overal model type surgeri found associ internet use multivari model intraclass correl coeffici small suggest small contribut hospit patient decis use internet inform clear indic decreas digit divid base age educationconclus use internet health inform rise among breast cancer patient strong age educationrel differ rais question relev inform can adequ provid patient especi limit educ older age live without partner

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