The contemporary role and potential of pharmacist contribution for community health using social media

Introduction

Whether you are a professor or a primary school student, from high-income countries (HICs) or low- and middle-income countries (LMICs), a gadget freak, or an amateur, people nowadays are familiar with and – most of them – connected with social media (SM). Nearly half of the global population are active SM users, and the number keeps increasing [1]. Facebook, Instagram, Twitter, YouTube, and WhatsApp are among the top SM platforms that have gained popularity over the past decade. SM has broadly affected our lives, not only in the way we communicate with others but also in the way we live and work. Health care, particularly pharmacy practice, is also not immune from impact of SM.

A number of studies have reported the influence of SM to pharmacy. For example, pharmacists used WhatsApp to communicate with peers about their professional works and share best practice between junior and senior pharmacists [2]. The most popular photo sharing application – Instagram – has been used by pharmacists to share health-related images, including providing patient education and sharing the latest research in pharmacy [3]. Other popular SM platforms such as Facebook have long been used by pharmacists to communicate with patients and to facilitate discussion about medication management [4].

The use of SM by pharmacists, however, has sparked a number of concerns, such as privacy issues [5], confidentiality [6], and unprofessional misconduct by pharmacists during online activities [7]. In addition, pharmacists have been found to use SM primarily for personal [8] or social [9] purposes. For example, only 10% of Twitter accounts owned by pharmacists in the United States were used for tweeting professional issues, with the remaining accounts used for posting comments about social life [10]. Other studies reported that pharmacists were not very enthusiastic to use SM for professional matters [11].

It is without a doubt that SM provides opportunities and challenges for pharmacists to deliver better pharmacy services. The contribution of pharmacists to improve community health through SM seems to be promising. However, the evidence of pharmacist involvement and contributions using SM particularly in LMICs is limited. The growing popularity of SM in LMICs teamed up with technological advancements, e.g., high-speed Internet connection and increased Internet penetration, may have provided a venue for pharmacist online interaction [12]. Nevertheless, not much is known about pharmacists’ activities and their roles in SM in the setting of LMICs. Therefore, this study aimed to identify pharmacist activity in SM and to explore potential role for pharmacist contributions using SM in Indonesia, representing one of the LMICs with the highest number of active SM users [13].

Materials and methods

Results

Overall, 41 pharmacists participated in four FGDs. All participants were Indonesians, and majority of participants were female (Table 1). All respondents were active users in multiple SM platforms, and WhatsApp was the most commonly used SM (Table 2).

Discussion

This study identified pharmacists’ activities in SM and their contributions to the community health using SM. To the best of our knowledge, this is the first study observing pharmacists using SM in Indonesia. There are three key findings explored from this study related to the current use of SM by pharmacists, the opportunities for pharmacist contributions via SM, and the challenges of using SM.

The first key finding shows that SM has been used by pharmacists for supporting pharmacy practice. Apart from the fact that participants in this study mostly used SM for their personal and social life, there are some significant initiatives delivered by pharmacists to support practice using SM. For example, WhatsApp was used to debunk myths, misunderstanding, and misinformation about medications, treatments, and health issues. In the current era, information can be easily accessed by the lay public from the Internet and via SM. However, there is always a risk that such information might be misleading, a hoax, and potentially harmful to public health [19]. Using SM, pharmacists can fill this gap by providing valid and reliable professional information that the public can use as reference. A pharmacist’s role against misleading information is particularly important in the setting of LMICs, including in Indonesia, because of poor health literacy and limited physical access to health care professionals [20]. Such role is actually not new to pharmacists in the conventional practice setting. However, the evidence showed positive feedback toward the efforts of pharmacists and health professionals in addressing false opinion and misinformation in an online environment [21].

The second key finding suggests that the use of SM provides an avenue to pharmacist role expansion and allows wider and larger number of public members to communicate with pharmacists compared with using conventional communication channels, e.g., face-to-face interaction. This study argued that physical interaction between a pharmacist and a patient is irreplaceable and fundamental to pharmacy services. Nevertheless, the use of SM offers alternatives for patients to interact with pharmacists in a professional manner without being limited by the distance and physical space. Several studies highlighted such opportunities, arguing that the contribution of pharmacists cannot be limited within the walls of the pharmacy [22], [23]. This study found that Telegram has been used by pharmacists to access more audience than any other SM applications. This can be considered a potential approach to communication in pharmacy.

The use of SM cannot be separated from the Internet. However, this study argued that pharmacists might contribute more in public health communication using SM than the traditional Internet format. Pharmacists have been using the Internet for professional purposes for years, mainly for accessing reliable information and communicating their business or services via websites and e-mail [24], [25]. By contrast, SM is an emerging platform of networking and communicating. Unlike the Internet in its traditional “passive” format, SM allows “active” interaction between users. In fact, a more intensive communication can be built on an SM platform by changing the privacy settings, which allow other users to become friends, followers, or subscribers. SM, therefore, seems to be a promising vehicle for the lay public to access a broad range of information, including medical and health information from the health care professionals as friends, followers, or subscribers. Many SM influencers and celebrities have used a similar method to advertise their business and products [26]. This can be an insight into alternative modes of interaction with patients and communities.

The third and the final key finding highlights that the use of SM is not without its challenges. Despite positive acceptance from the public and anecdotal evidence of pharmacist contributions in community health, being online in SM leads to a number of issues associated with time management, privacy, fears for inappropriate response, relationship with others, and lack of skills to create a viral message. A number of studies reported similar challenges reflecting pharmacist reluctance to continue to undertake professional activities when using SM [27], [28], [29]. Although SM quickly becomes a mainstream application nowadays, there is perhaps a pharmacist who resists this platform and becomes averse in SM. This might be the case for pharmacists in LMICs. For example, a pharmacist as an individual in Indonesia usually lives in a strong communal culture and bounded by strict relationships, such as respect for the elders and conflict avoidance [30]. This may affect pharmacist-patient relationship in a direct and open conversation such as in SM. Such challenge has not been explored in other publications, reflecting a novel finding generated from this study.

Several limitations need to be noticed from this study. SM in the FGD is mostly referred to social networking and sharing content platform. There are numerous types of SM, and such restriction may not portray the broader horizon of other SM types, such as LinkedIn and Google+, which are commonly used for professional business. Other limitations include the inclusion of some pharmacist SM influencers into the FGD, which may not represent the overall picture and habits of pharmacists in the SM as these persons really devote their time to exist in SM.

Conclusions

SM has become a venue for pharmacists to improve health of the people. Several unique features in SM may facilitate pharmacist contributions; however, whether pharmacists continue to undertake such initiative cannot be guaranteed.