JMIR Publications

ABSTRACT

Background:

Lack of adherence to prescribed medication is rampant among depressed patients in China, posing serious challenges to the healthcare system. Online health communities (OHCs) have been found to be effective in enhancing patient compliance. However, empirical evidence supporting this effect in the context of depression treatment was absent, and the influence of OHC content on patients' attitudes toward medication adherence was also underexplored.

Objective:

This study aimed to explore whether online depression communities (ODCs) can help ameliorate the poor medication-taking problem among depressed patients. Drawing on S-O-R theory and feelings-as-information theory, we established a research model to examine the influence of useful institution-generated content (IGC) and positive user-generated content (UGC) on attitudes toward medication adherence, when combined with the mediating role of perceived social support, perceived value of antidepressants, and the moderating role of hopelessness.

Methods:

An anonymous questionnaire survey was conducted with participants recruited from various Chinese ODCs, generating data for a main study and a robustness check. Hierarchical multiple regression analyses and bootstrapping analyses were adopted as the primary methods to test the hypotheses.

Results:

We received 642 valid responses in total. The collected data was split into 3 sets: namely Model IGC (N=237), Model UGC (N=232), and Model Both (N=173). Model IGC and Model UGC were used for the main study, while Model Both was used for the robustness check. Useful IGC and positive UGC were proved to have positive impact on depressed patients' attitudes toward medication adherence, through the mediations of perceived social support and perceived value of antidepressants. Hopelessness was corroborated to weaken or even negate the positive effects of ODC content on depressed patients’ attitudes toward medication adherence.

Conclusions:

This study provides the first empirical evidence demonstrating the relationship between ODC content and attitudes toward medication adherence, through which we offer a novel solution to the poor medication adherence problem among depressed patients in China. Our findings also provide suggestions about how to optimize this new approach: healthcare practitioners should generate online content that precisely matches depressed patients' informational needs and ODC service providers should endeavor to regulate the community atmosphere. Nonetheless, we warn that ODC intervention cannot be used as the only approach to addressing the poor medication-taking problem among patients with grievous depressive symptoms.