“Pill Pushers and CBD Oil”—A Thematic Analysis of Social Media Interactions About Pain After Traumatic Brachial Plexus Injury

Abstract

Purpose: Brachial plexus injury (BPI) patients use on-line groups for peer support, often seeking information from Facebook groups devoted to BPI. We hypothesized that a qualitative thematic analysis of posts from BPI Facebook groups would demonstrate the areas in which patients were seeking information regarding treatment of BPI and reveal potential sources of misinformation that patients may encounter. Methods: We identified the 2 most popular public Facebook groups for BPI by searching key words “traumatic brachial plexus injury.” We selected posts containing comments regarding BPI from November 1, 2018 through October 31, 2019. We excluded posts regarding brachial plexus birth injury. We used iterative inductive and deductive thematic analysis for the qualitative data to identify recurring topics, knowledge gaps, potential roles of patient educational interventions, and patient interaction dynamics. Two investigators independently coded all posts and resolved discrepancies by discussion. Results: A total of 7,694 posts from 2 leading Facebook support groups were analyzed. Three themes emerged: (1) When discussing pain management, there was recurring anti-opioid sentiment. Posters who currently used opioids or supported those who did discussed perceived effects of the opioid epidemic on their treatment, on their relationships with care providers, and on availability of the medication. (2) Posters advocated for alternatives to traditional approaches to pain management, referring to prescribers as pill pushers and touting cannabinoids as a safer and more effective replacement. (3) There was strong anti-gabapentinoid sentiment owing to reported adverse effects and a perceived lack of efficacy, despite its role as a first-line treatment for neuropathic pain. Conclusions: Examination of posts from Facebook support groups for BPI revealed recurring themes, questions, misinformation, and opinions from posters with regard to treatment of neuropathic pain. These findings can help clinicians who care for BPI patients identify areas to focus on during patient encounters to address neuropathic pain that commonly occurs with BPI. Clinical relevance: Brachial plexus injury surgeons should be aware of information, misinformation, and opinions on social media, because these may influence patientesurgeon interactions.

Social media discourse and internet search queries on cannabis as a medicine: A systematic scoping review

“…In this category, the research focus was on social media topics relating to management and treatment options for a range of health conditions rather than on medicinal cannabis per se (Table 6). There were eleven studies, and the health conditions included inflammatory and irritable bowel disease(59), opioid use disorder (37, 55), pain (38), ophthalmic disease (41), cluster headache and migraine(49), asthma (44), cancer (52, 67), autism disorder (66) and brachial plexus injury (73).…”

“…The manually labelled studies calculated proportions and trends and developed themes (40, 41, 43, 44, 46, 47, 51-53, 57, 58, 61, 62, 79, 83-91). (63-65) reported on Google trends data that delivered an index of Google search trends over time.…”

Consumer-Generated Discourse on Cannabis as a Medicine: Scoping Review of Techniques

“…Themes were identified in 62% (26/42) of the studies. Manual coding of the themes was performed by 69% (18/26) of the studies, either by using pre-existing categories or by observing a sample of the data and generating a codebook [22,23,25,26,28,30,31,37,41,[47][48][49]52,[55][56][57][58]60]. Of the 26 studies, 2 (7%) studies used the services of social media data analytics companies [42,50].…”

“…For conducting user analysis, 57% (24/42) of the studies examined either the subject of the posts, as from individuals or others (ie, from self, retail, media, or professionals), or who the post was about (self, others, or general) [22,23,[25][26][27][28][29]33,37,[41][42][43]45,[47][48][49][50]52,55,57,58,[60][61][62].…”

Team Approach: Management of Brachial Plexus Injuries

“…However, the implications for patients and society are remarkable. Even after surgical reconstruction, patients lose upper-extremity function, have substantial functional limitations 4,5 and bothersome neuropathic pain 6,7 , and are at increased risk for depression, anxiety, and prolonged opioid use 8 . From a societal perspective, the estimated median combined cost of a single BPI case (including both direct [cost of treatment] 9 and indirect [loss of economic productivity] 10 ) is $840,000 USD, providing clear impetus to maximize functional recovery.…”