Department of Marketing, School of Business Administration, Southwestern University of Finance and Economics, Chengdu, China.
Department of Marketing, Business School, University of Edinburgh, Edinburgh, United Kingdom.
J Med Internet Res. 2024 Nov 19;26:e56166. doi: 10.2196/56166.
Lack of adherence to prescribed medication is common among patients with depression in China, posing serious challenges to the health care system. Online health communities have been found to be effective in enhancing patient compliance. However, empirical evidence supporting this effect in the context of depression treatment is absent, and the influence of online health community content on patients' attitudes toward medication adherence is also underexplored.
This study aims to explore whether online depression communities (ODCs) can help ameliorate the problem of poor medication taking among patients with depression. Drawing on the stimulus-organism-response and feelings-as-information theories, we established a research model to examine the influence of useful institution-generated content (IGC) and positive user-generated content (UGC) on attitudes toward medication adherence when combined with the mediating role of perceived social support, perceived value of antidepressants, and the moderating role of hopelessness.
A cross-sectional questionnaire survey method was used in this research. Participants were recruited from various Chinese ODCs, generating data for a main study and 2 robustness checks. Hierarchical multiple regression analyses and bootstrapping analyses were adopted as the primary methods to test the hypotheses.
We received 1515 valid responses in total, contributing to 5 different datasets: model IGC (n=353, 23.3%), model UGC (n=358, 23.63%), model IGC+UGC (n=270, 17.82%), model IGC-B (n=266, 17.56%), and model UGC-B (n=268, 17.69%). Models IGC and UGC were used for the main study. Model IGC+UGC was used for robustness check A. Models IGC-B and UGC-B were used for robustness check B. Useful IGC and positive UGC were proven to have positive impact on the attitudes of patients with depression toward medication adherence through the mediations of perceived social support and perceived value of antidepressants. The findings corroborated the role of hopelessness in weakening or even negating the positive effects of ODC content on the attitudes of patients with depression toward medication adherence.
This study provides the first empirical evidence demonstrating the relationship between ODC content and attitudes toward medication adherence, through which we offer a novel solution to the problem of poor medication adherence among patients with depression in China. Our findings also provide suggestions about how to optimize this new approach-health care practitioners should generate online content that precisely matches the informational needs of patients with depression, and ODC service providers should endeavor to regulate the community atmosphere. Nonetheless, we warn that ODC interventions cannot be used as the only approach to addressing the problem of poor medication taking among patients with severe depressive symptoms.
在中国，抑郁症患者普遍存在不遵医嘱服药的情况，这对医疗保健系统构成了严重挑战。已发现在线健康社区有助于提高患者的遵医嘱程度。然而，在抑郁症治疗方面，尚缺乏支持这种效果的实证证据，并且在线健康社区内容对患者对药物治疗的态度的影响也没有得到充分探索。
本研究旨在探讨在线抑郁症社区（ODC）是否有助于改善抑郁症患者服药依从性差的问题。借鉴刺激-机体-反应和感受即信息理论，我们建立了一个研究模型，以检验有用的机构生成内容（IGC）和积极的用户生成内容（UGC）对药物治疗态度的影响，同时结合感知社会支持、抗抑郁药感知价值的中介作用以及绝望感的调节作用。
本研究采用横断面问卷调查法。参与者来自中国不同的 ODC，为主要研究和 2 个稳健性检验生成数据。采用分层多元回归分析和自举分析作为主要方法来检验假设。
我们总共收到了 1515 份有效回复，共分为 5 个不同数据集：模型 IGC（n=353，23.3%）、模型 UGC（n=358，23.63%）、模型 IGC+UGC（n=270，17.82%）、模型 IGC-B（n=266，17.56%）和模型 UGC-B（n=268，17.69%）。模型 IGC 和 UGC 用于主要研究。模型 IGC+UGC 用于稳健性检验 A。模型 IGC-B 和 UGC-B 用于稳健性检验 B。通过感知社会支持和抗抑郁药感知价值的中介作用，证明有用的 IGC 和积极的 UGC 对抑郁症患者对药物治疗的态度有积极影响。研究结果证实了绝望感在削弱甚至否定 ODC 内容对抑郁症患者对药物治疗态度的积极影响方面的作用。
本研究首次提供了关于 ODC 内容与对药物治疗的态度之间关系的实证证据，为解决中国抑郁症患者服药依从性差的问题提供了新的解决方案。我们的研究结果还为如何优化这种新方法提供了建议——医疗保健从业者应生成与抑郁症患者信息需求精确匹配的在线内容，而 ODC 服务提供商应努力规范社区氛围。然而，我们警告说，ODC 干预措施不能作为解决严重抑郁症状患者服药依从性差问题的唯一方法。
