London (dpa) - Patients who use the internet to reach decisions on treatment rather than listen to the doctor could be putting their health at risk.
That's the conclusion reached by researchers in Britain who believe use of interactive services such as online support groups and chatrooms may leave patients worse off.
Researchers from University College London say using interactive computer tools does help improve the knowledge of people with conditions such as asthma and diabetes and provides positive feelings of social support.
The team, led by Dr Elizabeth Murray from the Department of Primary Care and Population Sciences, reviewed 28 trials involving more than 4,000 participants to measure the effectiveness of Interactive Health Communication Applications (IHCAs).
These applications were defined as a computer-based information sources combined with one or more additional service, such as online support groups, chatroom or tailored advice based on data provided by the user.
The researchers found that the IHCAs had a positive effect on people gaining information and feelings of social support.
But they concluded that the applications had no effect on making patients believe that changing their behaviour for the better was possible or on actually resulting in behaviour change.
They also said that they had a "strikingly negative effect" on health outcomes, leaving some in worse health.
Dr Murray said there were a number of reasons why there was a paradox between actively seeking knowledge and patients' seemingly worse health.
One reason was that when patients learn of small but important statistical effects of their treatment they become less frightened.
This would leave them less motivated to change the way they behave than if a doctor bluntly told a diabetic to control their sugar level or face death, for example.
"But actually, if you become more knowledgeable you realise it's all rather a long way off," Dr Murray said.
"They are less frightened and that reduces their motivation to be really strict in their control."
Dr Murray also said that "knowledge-seekers" might become "so steeped in information" from the internet that they make their own treatment decisions, contradicting advice from doctors.
This might mean that a diabetic who was told by their doctor to lower their blood sugar levels might decide, based on their interpretation of the data, that the short-term trade-off of not complying were worth the long-term risks.
Dr Murray said: "We found that people who use this things (IHCAs) has more sugar in their blood that those who didn't."
Many patients find comfort by discussing their condition with others who have the same illness. But Dr Murray said that some researchers "worry that the friends you make on computer are not the right sort of friends, won't be there for you and may not be good for your social well-being".
The researchers also challenged the assumption that knowledge picked up through interactive sources led to changes in behaviour.
"If knowledge was all that was needed to promote healthy behaviour, smoking would not be as prevalent as it is," they wrote in the journal Cochrane Collaboration.
They also suggested that well-informed patients may not drive down healthcare costs, but could increase them by demanding specific or more costly treatments.
Copyright 2004 dpa Deutsche Presse-Agentur GmbH