Outcomes of the use of targeted online consumer health information in primary care: a participatory systematic mixed-studies review

Tags: Oral
Pluye P1, El Sherif R1, Granikov V1, Tang DL1, Bujold M1, Hong QN1, Galvao C2, Repchinsky CA3, Hutsul J3, Dunikowski L4, Frati F1, Shoet L5, Vineberg L6, Bartlett G1, Grad R1, Shulha M1, Kloda L1, Burnand B7, Desroches S8, Legare F8, Millerand F9, Rihoux B10, Vedel I1
1McGill University, Canada, 2Universidade de São Paulo, Brazil, 3Canadian Pharmacists Association , Canada, 4College of Family Physicians of Canada, Canada, 5Center for Literacy, Canada, 6Patient Representative, Canada, 7Institut Universitaire de Médecine Sociale et Préventive, Switzerland, 8Universite Laval, Canada, 9Universite du Quebec a Montreal, Canada, 10Universite Catholique de Louvain, Belgium

Background: Consumers regularly seek online health information. Systematic reviews in public health and oncology, and on decision aids, suggest the use of targeted information improves knowledge, participation in health care and health. However, little is known about the outcomes associated with information-use in primary care (outside shared decision-making aids). Thus, for primary healthcare patients, what are the outcomes associated with the use of targeted (vs non-targeted) online consumer health information?

Objective: Identify types of patient health outcomes and related conditions (context, information-seeking, use).

Methods:

- Participatory systematic mixed studies review (integrating qualitative and quantitative evidence).

- Eligibility criteria: qualitative, quantitative, or mixed-methods study; English or French; 1990 to 2014; community-based primary health care; online consumer health information-use.

- Information sources: MEDLINE, Embase, PsycINFO, CINAHL, LISA, and grey literature.

- Search strategy built by four specialized librarians.

- Selection (DistillerSR) and critical appraisal (Mixed Methods Appraisal Tool) of included studies by two independent researchers.

- Data extraction and synthesis: Deductive-inductive qualitative thematic data analysis by four researchers, and disambiguation of themes.

Results: Flow diagram (Fig 1): 50 included studies with diverse designs, four concern targeted information (one non-randomized, two quantitative descriptive, and one qualitative). Inter-rater reliability scores (kappa) indicate substantial agreement between researchers for selection (0.62) and appraisal (0.67). The qualitative synthesis suggests key conditions and negative/positive outcomes (e.g. decreased/increased worries).

Conclusions: Results will allow us to explore ‘condition-outcome’ configurations (content and Boolean analysis). Using a mixed-methods research design, this is the first systematic review to explore outcomes of targeted online consumer health information-use in primary care. This will lead to design a tool to help patients for finding and using (e.g. with partners or clinicians) information such as decision aids.