Exploring public perspectives of anti-diabetic drugs: a qualitative content analysis of Twitter posts (Preprint)
BACKGROUND Diabetes mellitus is a major global public health issue where self-management is critical to reducing disease burden. Social media has been a powerful tool to understand public perceptions. Public perception of drugs used to treat the disease may be useful for orienting interventions to increase adherence. OBJECTIVE To explore the perceptions of anti-diabetic drugs (ADDs) through the analysis of health-related tweets mentioning such medications. METHODS 4000 tweets from 1st January to 1st October 2019 containing key terms related to ADDs were coded using qualitative content analysis. Tweets were coded for whether they were truly about an ADD, and then whether they were health-related. Health-related tweets were further coded based on who was tweeting, which ADD was being tweeted about, and the content discussed in the tweet. The main outcome of the analysis was the themes identified by analyzing the content of health-related tweets on ADDs. RESULTS 1664 health-related tweets about 33 ADDs were identified. A quarter (415/1664 of tweets were confirmed to have come from people with diabetes, 18% (298/1664) from people posting about someone else, and 3% (45/1664) from healthcare professionals. However, the role of the tweeter was unidentifiable from two-thirds of the tweets. 13 themes were identified, with the health consequences of the cost of ADDs being the most extensively discussed, followed by the efficacy and availability. We also identified issues patients may conceal from healthcare professionals, such as purchasing medications from unofficial sources. CONCLUSIONS This study is the first to use Twitter to explore perceptions exclusively related to ADDs. This analysis gives an insight into the real-life issues individual’s face when taking ADDs, and such findings may be incorporated into health policies to improve compliance and efficacy. This study suggests there is a fear of not having access to ADDs, whether due to cost or physical availability and also highlights the impact of the sacrifices made to access ADDs. Alongside screening for diabetes-related health issues, healthcare professionals should also ask their patients about any non-health concerns with their ADDs. The positive tweets about dietary changes indicate that people with type 2 diabetes may be more open to self-management than healthcare professionals believe.