MRCGP Exam Update - Patient information on the web

Current situation

- The internet is a common and increasingly used resource for medical and health information.

- Typing the word 'health' into a well-known search engine throws up over 3.9 million relevant websites.

- Surveys have shown that between 40 and 54 per cent of patients access medical information via the internet and that this information affects their choice of treatment and their concerns.

What is the evidence?

- The quality of websites varies tremendously.

- One study found that providing references to scientific publications or prescribing information was significantly associated with high content quality (Br J Clin Pharmacol 2004; 57: 80).

- It has been proposed that public health practitioners and health professionals should be involved in the design, dissemination and evaluation of web-based health and medical information (Health Promot Int 2003;18: 381).

- A study has shown that accessing information and/or support online can have a profound effect on men's experiences of prostate cancer and its treatment (Qual Health Res 2005; 15: 325).

Online research can provide a method of taking some control over their disease and limiting the inhibitions that can be experienced in face-to-face encounters.

- People with cancer have been shown to use the internet for a wide range of information and support needs at many different stages of their illness (BMJ 2002; 324: 577-81). Breast cancer is the most common search topic.

- According to a survey, patients are most interested in using the internet to communicate directly with their healthcare providers (Ann Rheum Dis 2006; 65: 121).

- One US study found that internet-based continuing medical education is at least as effective as conventional interactive workshops (JAMA 2005; 294: 1043).

The study demonstrated that patient care can be enhanced by doctors participating in web-based workshops.

Implication for practice

- Knowledge gained from the internet is often used by patients to challenge their doctor during subsequent consultations, which then affects the doctor-patient relationship.

- The problems that GPs experience with the internet include the uneven quality of medical information that is available, difficulties in finding, understanding and using the information, and the potential for harm and risks of over-consumption.

USEFUL WEBSITES

www.hon.ch - Health On the Net Foundation.

www.bmj.com - British Medical Journal.

- Dr Louise Newson is a GP in the West Midlands and author of 'Hot Topics for MRCGP and General Practice', Pas Test 2004

KEY POINTS

- Medical information is very commonly searched for on the internet.

- Patients who download information are often very challenging to doctors.

- Information is often inaccurate.

- The internet is useful for patient education.

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