Acute medical exacerbations and use of online health information

Risha Gidwani risha.gidwani@va.gov
Donna Zulman dzulman@stanford.edu

Abstract

Objective: Individuals are increasingly going online to obtain health information from both professionals and peers.   We sought to understand the health characteristics of persons who consume online health information and the specific types of health-related information they seek. We also sought to evaluate the characteristics of persons who engage with the internet for the purposes of consuming versus producing online health information, and specifically, whether healthier versus sicker persons engage with health information technology in these different ways.

Study Design: Data were obtained from the Pew 2012 Health Survey, a telephone survey of 3,014 English- or Spanish-speaking adults living in the United States.  We used multiple logistic regression to examine the association between sociodemographic and health characteristics and the consumption or production of online health information. Sociodemographic variables included age, sex, race and education. Health characteristics included self-reported health status, presence of chronic condition(s), and having an acute medical exacerbation. Acute medical exacerbations were defined as Emergency Department visit, hospitalization, or other serious medical emergency in the last 12 months.

Results: The strongest health-related predictor of consuming online health information was having an acute medical exacerbation (adjusted OR 2.39, p < .0001), followed by having a chronic condition (adjusted OR 1.54, p = .007). Having an acute medical exacerbation was the only predictor of producing online health information (adjusted OR 1.97, p = .003). Approximately 20% of the sample experienced an acute medical exacerbation in the past year.

All respondents, regardless of health status, were most interested in consuming health information regarding diseases or medical problems, rather than information about drugs, health insurance, health care costs, or weight management. Multivariate analyses indicate persons with acute medical exacerbations were more likely to seek health information regarding medical tests, procedures and drugs compared to persons without acute medical exacerbations.

Conclusions: Having an acute medical exacerbation or having a chronic condition were independently associated with consuming online health information, with acute medical exacerbations being the stronger predictor of consumption.

Having an acute medical exacerbation was the only significant predictor of becoming a producer (rather than a consumer) of online health information. Thus, peer-to-peer health-related internet content may be skewed towards persons who are sicker. This over-representation of the experiences of persons with acute medical exacerbations may mean there is not enough peer-generated health information available regarding stable chronic conditions and that available information may not be applicable to persons wishing to prevent an acute medical exacerbation.

Implications for Policy or Practice: Our results suggest that having an acute medical exacerbation presents a “window of opportunity” during which patient engagement with health information technology changes. The desire for health information around the time of a health status change suggests a role for providers to direct patients to high-quality, easy-to-understand online information, especially regarding treatments and procedures. These online resources should augment, but not replace, the distribution of printed patient health information.

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