Social Networking Does Not Affect Health Outcomes in Rheumatoid Arthritis

Social networking may positively affect perceptions of peer support, but it does not result in significant changes in health outcomes or self-efficacy among patients with rheumatoid arthritis (RA), according to findings published in Seminars in Arthritis and Rheumatology.

Researchers conducted a randomized controlled trial in the United States and Canada from April 2016 to January 2017 to assess the efficacy of social networking in improving knowledge and health status in patients with RA. The intervention and control groups each contained 105 patients.

Outcomes were measured at baseline, 3 months, and 6 months. The researchers evaluated RA knowledge, self-efficacy in RA disease management, and empowerment. They also analyzed patient satisfaction with social and peer support, patients’ beliefs about locus of control for their personal health, health-related behaviors, mood, and actual health outcomes.

The intervention group gained access to a secret Facebook community where 2 peer leaders living with RA introduced different RA-related discussion topics weekly for 26 weeks. Patients in the intervention group freely communicated with each other. The Facebook website also linked to an educational website providing RA-related information. Six of the 105 patients never logged onto the Facebook site.

The control group had access to the same educational website as the intervention group; however, they did not participate in social networking about RA. The educational website provided various self-guided sources of RA-related information, including a learning center, links to evidence-based RA websites aimed at patient education, news on the latest updates from RA societies and organizations, and information about chronic disease management strategies (ie, goal setting, coping skills, tips for healthy lifestyle and behaviors, and ways to improve communication skills).

Regarding patient engagement, patients in the control group accessed the educational website more than patients in the intervention group (493 times vs 260 times). Patients in the intervention group posted 3493 comments, with 72% of them doing so routinely at least once per month.

At 3 months and 6 months, 87% and 85% of all patients completed the follow-up assessments, respectively. Patient knowledge and self-efficacy improved slightly in both groups after 6 months. While knowledge improved more in the control group (0.4 vs 0.3 points) and self-efficacy improved more in the intervention group (0.7 vs 0.3 points), neither change was statistically significant. No differences in empowerment existed between groups.

Patients in the intervention group reported higher satisfaction with social and peer support and higher internal locus of control scores than the control group. No differences in mood, health behaviors, or health outcomes were observed between groups.

Limitations of the study include privacy issues with online networking, a lack of critical mass on Facebook large enough to impact health outcomes, a lack of generalizability to patient populations outside of educated White women, and the possibility of patients in either group being involved in other open RA groups during the study.

The study authors conclude, “Our virtual community with readily accessible evidence-based information was well-received, but [it did] not support the concept that these networks may enhance changes in health outcomes or self-efficacy in patients with RA.”

Reference

Lopez-Olivo MA, Foreman JT, Leung C, et al. A randomized controlled trial evaluating the effects of social networking on chronic disease management in rheumatoid arthritis. Semin Arthritis Rheum. 2022;56:152072. doi:10.1016/j.semarthrit.2022.152072