Clinical research study
Social Media Use in Chronic Disease: A Systematic Review and Novel Taxonomy

https://doi.org/10.1016/j.amjmed.2015.06.015Get rights and content

Abstract

Purpose

The purpose of this study is to evaluate clinical outcomes from applications of contemporary social media in chronic disease; to develop a conceptual taxonomy to categorize, summarize, and then analyze the current evidence base; and to suggest a framework for future studies on this topic.

Methods

We performed a systematic review of MEDLINE via PubMed (January 2000 to January 2015) of studies reporting clinical outcomes on leading contemporary social media (ie, Facebook, Twitter, Wikipedia, YouTube) use in 10 chronic diseases. Two reviewers independently performed data extraction and quality assessment; characterization of study outcomes as positive, negative, neutral, or undefined impact; and inductive, thematic analysis to develop our taxonomy.

Results

Of 378 citations identified, 42 studies examining the use of Facebook (n = 16), blogs (n = 13), Twitter (n = 8), wikis (n = 5), and YouTube (n = 4) on outcomes in cancer (n = 14), depression (n = 13), obesity (n = 9), diabetes (n = 4), heart disease (n = 3), stroke (n = 2), and chronic lower respiratory tract infection (n = 1) were included. Studies were classified as support (n = 16), patient education (n = 10), disease modification (n = 6), disease management (n = 5), and diagnosis (n = 5) within our taxonomy. The overall impact of social media on chronic disease was variable, with 48% of studies indicating benefit, 45% neutral or undefined, and 7% suggesting harm. Among studies that showed benefit, 85% used either Facebook or blogs, and 40% were based within the domain of support.

Conclusions

Using social media to provide social, emotional, or experiential support in chronic disease, especially with Facebook and blogs, appears most likely to improve patient care.

Section snippets

Methods

We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations when performing this systematic review.9 Contemporary social media sites were selected based on well-established definitions and global Web traffic rankings.10, 11 We selected chronic diseases listed on the Centers for Disease Control Leading Causes of Death list including heart disease (eg, hypertension, heart failure, coronary artery disease, valvular disease, and cardiac arrhythmias);

Results

Our initial search returned 378 articles, of which 247 were excluded at the title or abstract level. A full-text review was thus performed on 131 articles, of which 42 met inclusion criteria (Figure 1).44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85 Twenty-seven eligible studies reported quantitative outcomes,44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61

Conclusions

This systematic review of the literature is among the first to provide insight into current use and impact of contemporary social media on chronic diseases. Through development of a novel taxonomy, we organize and present our results into the domains of support, education, diagnosis, disease management, and disease modification. This approach allows us to identify opportunities and gaps in the current evidence, while highlighting where use of social media is likely to be most effective. In 42

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    Funding: None.

    Conflict of Interest: None.

    Authorship: All authors had access to the data and a role in writing the manuscript.

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