When People with Chronic Conditions Turn to Peers on Social Media to Retrieve and Share Information: A Systematic Review of the Implications for Relationships with Healthcare Professionals (Preprint)

BACKGROUND People living with chronic conditions such as diabetes turn to peers on social media to obtain and share information. Although social media use has grown dramatically within the past decade, little is known about its implications for relationships between people with chronic conditions (PWCC) and healthcare professionals (HCPs). OBJECTIVE To systematically review the content and quality of studies examining what PWCC retrieval and sharing of information on social media imply for their relationships with HCPs. METHODS We conducted a search of studies in MEDLINE (Ovid), Embase (Ovid), PsycInfo (Ovid), CIHNAL (EBSCO). Eligible studies: 1) were primary studies; 2) examined social media use; 3) included adults with any type of diabetes, diabetes-related cardiovascular diseases, obesity, hypertension, or dyslipidemia; and 4) reported on the implications for PWCC-HCP relationships when PWCC access and share information on social media. We used the Mixed Method Appraisal Tool (MMAT) version 2018 to assess the quality of studies, and included studies were narratively synthesized. RESULTS Of 3111 screened studies, 17 were included. Most studies were of low quality. The narrative synthesis identified implications for PWCC-HCP relationships when PWCC access and share information on social media, divided into three main categories with seven subcategories. These categories of implications address 1) how PWCC peer interactions on social media can influence their communication with HCPs, 2) how PWCC discuss advice and medical information from HCPs on social media, and 3) how PWCC discuss their relationships with HCPs on social media. The implications are illustrated collectively in a conceptual model. CONCLUSIONS More evidence is needed to draw conclusions, but the findings illustrated in the conceptual model indicate that PWCC peer interactions on social media are implicated in the ways in which PWCC equip themselves for clinical consultations, evaluate the information and advice provided by HCPs, and manage their relationships with HCPs. Future populations with chronic conditions will be raised in a digital world, and social media will likely remain a strategy for obtaining support and information. However, the generally low quality of studies included in this review points to the relatively immature state of research exploring social media and its implications for PWCC-HCP relationships. More studies and better methods for conducting research on social media are needed to generate robust evidence.