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Drug Safety Updates Often Lacking Online

A year later, a third of Wikipedia pages didn’t reflect safety warnings

Consumers can find lots of information about their medications on the Internet — but it may be lacking important safety updates, according to a study in The New England Journal of Medicine.

Americans rely heavily on search engines such as Google and websites such as Wikipedia for health information, wrote the team of researchers from London and Boston. So the researchers evaluated Google searches and Wikipedia page views for 22 prescription drugs identified in FDA drug-safety communications issued between January 1, 2011, and December 31, 2012. The drugs were indicated for a range of clinical conditions, including hypertension, leukemia, and hepatitis C.

Despite debates over its credibility, the researchers wrote, Wikipedia is reportedly the most frequently consulted online health care resource globally. For each drug in their sample, the researchers checked Wikipedia pages for references to safety warnings.

The 22 drugs they focused on triggered 13 million searches on Google and 5 million Wikipedia page views annually during the two-year study period. FDA safety warnings were associated with an 82% increase, on average, in Google searches for the drugs during the week after the announcement and a 175% increase in views of Wikipedia pages for the drugs on the day of the announcement, compared with baseline trends.

The researchers found that:

  • 41% of Wikipedia pages pertaining to drugs with new safety warnings were updated within 2 weeks after the warning was issued with information provided in the FDA announcements.
  • Wikipedia pages for drugs that were intended for treatment of highly prevalent diseases were more likely to be updated quickly (58% within 2 weeks) than those for drugs designed to treat less-prevalent conditions (20% within 2 weeks).
  • 23% of Wikipedia pages were updated more than 2 weeks after the FDA warning was issued (average, 42 days).
  • 36% of Wikipedia pages remained unchanged more than 1 year later.

The researchers cited the case of brentuximab vedotin (Adcetris, Seattle Genetics), used to treat Hodgkin's lymphoma and systemic anaplastic large-cell lymphoma. The FDA issued a safety communication on January 13, 2012, noting that the drug had been linked to two cases of progressive multifocal leukoencephalopathy. The FDA placed a new boxed warning about this risk on the drug label, a move that was followed by a 50% increase in Google searches for the drug during the ensuing week and a 141% increase in views of the drug's Wikipedia page. However, there was still no mention of the boxed warning on Wikipedia 2 years later.

To improve communication of medication safety information, the authors recommend making it more easily available through the FDA's website. The agency could also do more to integrate social media and to work with other websites to disseminate drug-safety information. In 2008, for instance, the FDA partnered with WebMD to bring public health announcements to all registered users and to quickly integrate this information into WebMD's suite of Web pages.

Source: New England Journal of Medicine; June 26, 2014.

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