E-Patients: Online Health Seeking Behaviour of Cancer Patients in South Western Nigeria

Background: Cancer has been reported to be one of the top three diseases that patients research on the Internet. This is because the Internet is an evolving hub of cancer information and social support for patients. With the increasing connectivity and over 92,000,000 Internet enabled devices in Nigeria, it is expected that mobile health will proliferate and this will change the way cancer patients gather health information and resources, propagating a new age of e-patients. An e-patient is a health consumer who uses the Internet as a health resource. With over 100,000 new cancer cases diagnosed yearly in Nigeria, low doctor to patient ratio, constrained consultation time and limited access to specialist care, the need to promote patients to become e-patients could efficiently empower them to become better-educated healthcare consumers. However, there is a paucity of data on how Nigerian cancer patients use the Internet. Aim: To measure the utilization rate and patient attitudes toward the Internet. Methods: This descriptive cross-sectional study was carried out among 281 cancer patients across the department of radiotherapy in three teaching hospitals in south-western Nigeria in March 2018, using a self-administered questionnaire. The analysis was done with SPSS version 20, and the level of significance was set at < 0.05. Results: The mean age for the 281 participants was 50.8±14.2 years; with the majority between 41 and 60 years (46.6%); and females (78.3%). About 67.6% owned a smartphone ( Table 1 ); and 32% possessed a personal laptop/desktop computer, or lived in households with people with smartphones (66.9%). Majority of the respondents had consistent access to the Internet (59.1%) ( Table 2 ). They also had an e-mail and social media account (52%) in order of decreasing frequency: Facebook, 52.7%; WhatsApp, 18.1%; and Instagram, 17.1% ( Fig. 1 ). At least 43.1% had searched for cancer information online with the purpose of understanding the disease better (41.6%) ( Fig. 2 ). About 45.2% of the respondents also indicated that they would be comfortable having an online medical consultation with their oncologist; however, they had not used any health/cancer app before (71.2%). Patients aged 41-60 years, married, with tertiary level of education, and monthly incomes ≤ N50,000 (∼$140) were more likely to search for cancer information online ( P < 0.05). About 56.9% of the respondents did not use the Internet for cancer information because they preferred getting information directly from doctors (43.2%), lacked the knowledge of Internet use (33.6%), and lacked access to Internet-enabled devices (20.8%). Conclusion: With more cancer patients being connected to the Internet and an increasing trend to be e-patients, there is a need to leverage technology to provide patient education, consultation, navigation and social support services.[Table: see text] [Table: see text][Figure: see text][Figure: see text]