On social media, patients with RA generally positive about DMARDs
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A review of social media posts by patients with rheumatoid arthritis revealed generally positive opinions about DMARDs, particularly regarding efficacy, according to findings published in the Annals of the Rheumatic Diseases.
“Studies have shown that in order to improve adherence with DMARDs, clinicians should focus less on provision of medical information and be more aware of patients’ beliefs,” Chanakya Sharma, MBBS, FRACP, of Fiona Stanley Hospital, in Murdoch, Australia, and colleagues wrote. “Understanding patient beliefs, however, is difficult and often relies on qualitative studies which are excellent at providing an in-depth thematic analysis of a specific issue, but are traditionally conducted on a small scale.”
“Social media is widely used by patients to discuss medical issues; in 2012, 26% of internet users were using social media for health issues, making it a rich source of information about patient beliefs,” they added. “A common technique for analyzing social media content is Sentiment Analysis (SA), which involves analyzing the sentiment expressed in textual content. Such analysis has already been shown to have utility in industries such as entertainment and stock market.”
To examine social media discussions on DMARDs, and to better understand the collective sentiment regarding these drugs among patients with RA, Sharma and colleagues used the web analytics firm Treato, which can identify, collect and analyze publicly available content from more than 10,000 sources. According to the researchers, the platform analyzed more than 3 billion posts, dated July 2017 through October 2018, from these sources, which included Facebook, Twitter, discussion forums and blogs. The researchers used strict filters to ensure that their scope was limited to user-generated content.
In all, the researchers included 54,742 posts about DMARDs in their study. These included 28,261 posts on biological/targeted synthetic DMARDs, and 26,841 on conventional synthetic DMARDs, with some overlap. Overall sentiment was expressed as a ratio of positive to negative posts for each DMARD, with a ratio of 1 or greater indicating a positive assessment. Investigators collected and analyzed sentiment data regarding efficacy and side effects through algorithms for all DMARDs except hydroxychloroquine and abatacept. They manually extracted data for these two drugs, a process the researchers repeated for all other DMARDs.
According to the researchers, patients had an overall positive sentiment regarding both biological/targeted synthetic and conventional synthetic DMARDs. However, the ratio of positive to negative posts was higher for the biological/targeted synthetic drugs, at 1.21, than for conventional synthetic DMARDs, which had a ratio of 1.048. The most common reason for positive sentiment was efficacy, while a lack of efficacy was the most common reason for a negative sentiment. These were each followed by the presence or absence of side effects.
“This study is the first to conduct a SA of all available social media posts generated by RA patients for 13 DMARDs,” Sharma and colleagues wrote. “Our study has been able to capture unprompted sentiment as directly expressed by the patient. The sentiment was positive for all the b/tsDMARDs with efficacy being the primary driver of this, followed by lack of side effects. Methotrexate and sulfasalazine had an overall negative sentiment, and descriptions of side effects were particularly common for methotrexate.”
“As big data analytic technology becomes more advanced, there is potential for this methodology to rapidly capture broad-spectrum patient sentiment toward medications,” they added. “This may act as a valuable addition to existing qualitative methods, which allow for a more nuanced assessment than is currently possible with SA. This complementary approach will generate novel insights and improve various aspects of patient–physician interaction, from shared decision-making regarding DMARD selection, to patient adherence.”
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