The Impact of Internet Health Information on Patient Compliance: A Research Model and an Empirical Study

Abstract

BackgroundPatients have been increasingly seeking and using Internet health information to become more active in managing their own health in a partnership with their physicians. This trend has both positive and negative effects on the interactions between patients and their physicians. Therefore, it is important to understand the impact that the increasing use of Internet health information has on the patient-physician relationship and patients’ compliance with their treatment regimens.ObjectiveThis study examines the impact of patients’ use of Internet health information on various elements that characterize the interactions between a patient and her/his physician through a theoretical model based on principal-agent theory and the information asymmetry perspective.MethodsA survey-based study consisting of 225 participants was used to validate a model through various statistical techniques. A full assessment of the measurement model and structural model was completed in addition to relevant post hoc analyses.ResultsThis research revealed that both patient-physician concordance and perceived information asymmetry have significant effects on patient compliance, with patient-physician concordance exhibiting a considerably stronger relationship. Additionally, both physician quality and Internet health information quality have significant effects on patient-physician concordance, with physician quality exhibiting a much stronger relationship. Finally, only physician quality was found to have a significant impact on perceived information asymmetry, whereas Internet health information quality had no impact on perceived information asymmetry.ConclusionsOverall, this study found that physicians can relax regarding their fears concerning patient use of Internet health information because physician quality has the greatest impact on patients and their physician coming to an agreement on their medical situation and recommended treatment regimen as well as patient’s compliance with their physician’s advice when compared to the impact that Internet health information quality has on these same variables. The findings also indicate that agreement between the patient and physician on the medical situation and treatment is much more important to compliance than the perceived information gap between the patient and physician (ie, the physician having a higher level of information in comparison to the patient). In addition, the level of agreement between a patient and their physician regarding the medical situation is more reliant on the perceived quality of their physician than on the perceived quality of Internet health information used. This research found that only the perceived quality of the physician has a significant relationship with the perceived information gap between the patient and their physician and the quality of the Internet health information has no relationship with this perceived information gap.

The Relationship between Internet Health Information and Patient Compliance based on Trust: An Empirical Study (Preprint)

“…The discussion about Internet health information was divided into two areas: quality and source. The Internet health information quality is defined as a second-order construct [1] to describe fitness for use and information reliability [11] and comprises four dimensions: relevance, understandability, adequacy and usefulness [1]. Currently, the significant relationship between Internet health information quality and patients' trust in physicians is not directly supported by evidence.…”

“…1) were covered by the survey instrument that shown in Multimedia Appendix 1. Patient compliance, which was discussed from a different perspective in a previous study by Laugesen et al, was measured using a 5-item scale from the same reference [1]. Cognition-and affect-based trust were proposed by Mcallister [18] and measured by the same author using a 6-item and a 5-item scale, respectively.…”

“…There are two second-order constructs: Internet health information quality and source of Internet health information. Internet health information quality is consist of the first-order factors of relevance, understandability, adequacy and usefulness [1], and source of Internet health information comprised the first-order factors of reliability, authority and accessibility. Internet health information quality was measured using a 16-item scale from Laugesen et al [1].…”

“…Internet health information quality is consist of the first-order factors of relevance, understandability, adequacy and usefulness [1], and source of Internet health information comprised the first-order factors of reliability, authority and accessibility. Internet health information quality was measured using a 16-item scale from Laugesen et al [1]. As a second-order construct, Internet health information quality is consist of four factors, thus, this 16-item scale was also divided into four parts.…”

“…Referring to research methods from previous studies [1,39], structural equation modelling (SEM) was used to analyse relationships between variables and test the hypotheses. In comparison with simple correlation-based models, intermediate variables and complex relationships between variables were included in this research model.…”