JMIR Publications

ABSTRACT

Background:

Social media has rapidly accelerated information-sharing and has been increasingly adopted by providers and health care systems as a tool to rapidly communicate key information to patients, colleagues, and the public. However, because information on social media is not curated both in terms of expertise or content, there is a recognized risk of misinformation, disinformation, and premature dissemination of unvalidated information that may be scaled widely and rapidly with potential for widespread untoward harmful effects.

Objective:

To determine whether social media has an undue influence on the prescribing behavior of providers, using the COVID-19 pandemic as the setting.

Methods:

In this retrospective study, we gathered utilization of hydroxychloroquine in 48 hospitals in the United States between January and December 2020. We compared the temporal association of the utilization of hydroxychloroquine to X/Twitter mentions and shares, including the “sentiment” favoring or against these therapies.

Results:

X/Twitter mentions of hydroxychloroquine favoring its use peaked at 29,730 and the number of negative sentiments on its use peaked at 127,150, both on May 19, 2020. The baseline median daily utilization of hydroxychloroquine before the first confirmed case of COVID-19, was 559 new prescriptions (IQR 339.3-728.3) per day. As the pandemic progressed, there was an increase in the utilization of hydroxychloroquine to a median of 685.5 (IQR 459.8-897.3). The number of hydroxychloroquine prescriptions showed significant temporal association with the number of negative (P=.039) and neutral (P <.001) X/Twitter mentions

Conclusions:

During the first year of the COVID-19 pandemic, there was a significant association between X/Twitter mentions and the number of prescriptions of hydroxychloroquine. This study showed that X/Twitter can influence the prescribing behavior of providers. Providers need to be vigilant on their potential unconscious exposure to social media as a source of medical knowledge, and health systems and organizations need to be more diligent on identifying expertise, source, and quality of evidence when shared in social media platforms.