There are calls for pharmacists to play a bigger role in supporting self-care. Experts discuss the opportunities.
13 January 2017
As consumer behaviour changes, more people are searching for answers to their medical questions online. But it may take a doctor’s more considered approach to ensure that information helps not hinders.
If you are tempted to search for medical information or advice online, you are not alone. One in 20 of Google’s 1.5 billion searches per day are health-related.
The problem is you might not get the answer you want, or need. A 2015 study by Australian university QUT, in collaboration with the CSIRO and TU Wien (TUW) in Europe, found that only one third of the top ten results for medically-related searches was ‘highly useful’, and only a half ‘somewhat relevant’.
That’s a lot of consumers getting misleading, false or potentially dangerous information, says one of the QUT study’s authors, Dr Guido Zuccon.
“People are more and more familiar with searching for health information on the web. The digitally native do not even question the choice of using search technologies to find answers to their questions and doubts,” Zuccon says.
Google recently launched a ‘Symptom Search’ app in collaboration with Harvard Medical School and the Mayo Clinic. And Chinese search engine Baidu is working on Melody, a medical diagnosis bot that, according to Zuccon, mines data from a raft of professional texts to deliver a user a diagnosis. Yet while search engines are becoming increasingly sophisticated, they are still only as good as the person behind the computer, iPad or mobile, says Zuccon.
“Current search engines are doing a good job in answering clearly formulated medical queries like ‘coeliac disease’,” he says.
“However, when the query is ambiguous or poorly formulated, search engines can fail in providing relevant, correct information that’s easy for the average person to understand.”
Yet research shows that people not only value the health information they find, they trust it, says Zuccon. He cites one study in which 95 per cent of respondents believed the health information they found online to be reliable. And another study that points to the sheer numbers today who often use the internet to search for advice about health: 40 per cent of the populations in India and Russia, for example.
The good, the bad, the ugly
That trust is not always misplaced. ‘Dr Google’, as it is commonly known, is found by many to be particularly useful when it comes to looking for first-hand experiences around topics such as pregnancy or chemotherapy.
“Through the internet, these experiences are communicated by people actually experiencing the conditions or treatments rather than from secondary information reported by health professionals,” Zuccon says.
The Royal Australian College of General Practitioners (RACGP) immediate past president, Dr Frank Jones, also underscores the potential positives, pointing out that online searches can assist by freeing up surgeries from trivial ailments and boosting health literacy. One in every five patients who comes through Dr Jones’s doors has done some do-it-yourself self-diagnosis beforehand, he says, and they’re not always the young and IT savvy.
“All patients can now research a particular symptom or disease so they have a rough idea when they come in and talk to me, which can make life a lot easier,” he says.
“I’m happy for people to do that. But the problem is there’s a vast amount of information online and it’s hard for patients to work out what’s good and what’s bad.”
This barrage of data can make a person unnecessarily anxious about otherwise common symptoms, a condition that’s been labeled ‘cyberchondria’. If you type in ‘ankle swelling’, for instance, the proposed causes can be very confronting. Says Dr Jones: “Internet searches can give you the most sinister, severe illnesses first which might make people panic and want to come in and see us yesterday versus tomorrow.”
Add a complex disease to the mix and it can be even more problematic, especially as internet searches provide none of the individual context and continuity of care you get with a face-to-face consultation.
Discuss don’t dismiss
That’s where good patient communication comes in. When you see such patients, it’s important to explore what drove them to search their condition online in the first place, says Dr Jones.
“That can often defuse the situation. If it’s more complicated, we may go to the site together and I can explain how it is not applicable to them, or whatever the case may be. I always have a conversation with my patients, not just a consultation.”
“Of course, GPs don’t know it all,” he adds. “Some patients are very well informed and I’m always happy to say ‘Thanks, I haven’t seen that information but let’s look at it together now’ or ‘I’ll look this up and we’ll chat again’. It’s all about working as a team to get the best possible outcome for that patient.”
In search of facts
While nothing can replace the ‘face-to-face’, experts recommend steering iPad-happy patients to evidence-based, peer-reviewed websites hosted by government health departments, universities, medical journals and health organisations.
Some sites available online include:
• The Federal Government’s Department of Health website provides information for consumers and health professionals, plus resources, programs and travel health information.
• Better Health is hosted by the Victorian Government, this is one of the more user-friendly sites with easily digestible information on all matters related to health and wellbeing.
• NPS MedicineWise is an independent, not-for-profit and evidence-based website with lots of good patient information sheets around illnesses, medications and therapeutics.
• Health Direct is another government-funded, not-for-profit site that offers general health information and advice services covering a range of conditions, symptoms and life stages.
• The official website for the Australian Natural Therapists Association Limited (ANTA), representing about 10,000 accredited therapists.
• mayoclinic.org This United States non-profit organisation’s website for physicians, scientists and researchers has global trials and research as well as information on diseases, drugs and more.
• Science Daily. For research junkies, this explores the latest scientific breakthroughs and research around topics including health and medicine, mind and brain, and living well.
• Beyond Blue. An independent Australian-based website that provides information, research and support around mental health issues.
 Use of the internet as a resource of health information by patients: A clinic-based study in the Indian population, http://www.bioline.org.br/pdf?jp05046