Social networks do not affect health outcomes in rheumatoid arthritis

Social networks may positively influence perceptions of peer support but do not lead to significant changes in health outcomes or self-efficacy among patients with rheumatoid arthritis (RA), according to findings published in Workshops on arthritis and rheumatology.

Researchers conducted a randomized controlled trial in the United States and Canada from April 2016 to January 2017 to evaluate the efficacy of social networks in improving knowledge and health status in patients with RA. The intervention and control groups contained 105 patients each.

Outcomes were measured at baseline, 3 months and 6 months. Researchers assessed knowledge about RA, self-efficacy in managing RA disease, and empowerment. They also analyzed patients’ satisfaction with social and peer support, patients’ beliefs about locus of control over their personal health, health-related behaviors, mood, and actual health outcomes.

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The intervention group was given access to a secret Facebook community where 2 leaders living with RA presented different RA-related discussion topics each week for 26 weeks. Patients in the intervention group freely communicated with each other. The Facebook website is also linked to an educational website providing information related to RA. Six of the 105 patients had never accessed the Facebook site.

The control group had access to the same educational website as the intervention group; however, they did not participate in RA social networks. The educational website provided a variety of self-directed sources of information related to rheumatoid arthritis, including a learning hub, links to evidence-based rheumatoid arthritis websites aimed at patient education, news about the latest updates from RA societies and organizations, and information on chronic disease management strategies (ie, goal setting, coping skills, tips for healthy lifestyles and behaviors, and ways to improve communication skills).

Regarding patient engagement, patients in the control group accessed the educational website more than patients in the intervention group (493 times vs. 260 times). Patients in the intervention group posted 3,493 comments, with 72% doing so routinely at least once a month.

At 3 months and 6 months, 87% and 85% of all patients, respectively, completed follow-up assessments. Patient knowledge and self-efficacy improved slightly in both groups at 6 months. While knowledge improved more in the control group (0.4 vs. 0.3 points) and self-efficacy improved more in the intervention group (0.7 vs. 0.3 points), neither change was statistically significant. No differences in empowerment existed between groups.

Patients in the intervention group reported higher satisfaction with social and peer support and higher internal locus of control scores compared to the control group. No differences in mood, health behaviors, or health outcomes were observed between groups.

Limitations of the study include online privacy issues, lack of a critical mass on Facebook large enough to affect health outcomes, lack of generalizability to patient populations beyond educated white women, and the possibility that patients from both groups could be included in other open RA groups during the study.

The study authors concluded: “Our virtual community of easily accessible evidence-based information was well received, but [it did] do not support the concept that these networks can improve changes in health outcomes or self-efficacy in patients with RA.


Lopez-Olivo MA, Foreman JT, Leung C, et al. A randomized controlled trial evaluating the effects of social networking on chronic disease management in rheumatoid arthritis. Semin Arthritis Rheum. 2022;56:152072. doi:10.1016/j.semarthrit.2022.152072

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