Deepening perspectives: How social media is driving our understanding of HCP sentiment

On the 31st of May, news broke that the NHS was launching its “world-first” cancer vaccine matchmaking programme. The scheme uses vaccines tailored to a patient’s tumours in the hope of permanently curing cancer. This news, of course, sounds fantastic - for patients, healthcare professionals (HCPs), and the NHS. Across industries, many hailed the news as a “landmark moment” for cancer treatment.

A snap analysis of over 100 posts on social media from 90 HCPs relating to cancer vaccinations found on the surface the same sense of optimism. But there appeared to be a catch. Posts following the news, at first glance, were overwhelmingly positive in sentiment. One Manchester-based immunologist labelled the vaccines a “complete game-changer”, citing its trial successes against certain forms of lymphoma.

It might then be concluded that HCPs were straightforwardly optimistic in response to the programme's introduction, echoing wider sentiment towards the news. But an analysis of each individual social media post allows us to assess any and all underlying attitudes, particularly those that might go against the grain of overarching excitement. This is indeed what was found.

Below the surface, it was discovered that one in 10 posts analysed expressed concern with an issue particularly pertinent, given the nature of the treatment - anti-vaccine sentiment and vaccine hesitancy. Some HCPs were especially concerned that these feelings could be detrimental to the success of the programme. One, after praising the development, said that she “really hoped” vaccine hesitancy would “not dissuade people from taking [it] up”.

Using social media as a tool of analysis permits an unmasking of attitudes otherwise hidden within celebration of the approval. It should not detract from the celebration, but instead remind us of the real-life - and real-time - concerns of HCPs on the front line of delivery. Warnings should be heeded by policymakers to ensure that the NHS’ cancer vaccination programmes can work as efficiently as they should.

Why social media analysis holds value

It should be acknowledged that understanding the perspectives of HCPs is notoriously difficult. Rarely is it possible to fully assess either a widespread attitude or a more nuanced opinion. Often we are left with mere ‘crumbs’ of insight, almost always when the attitudes of HCPs begin to break tangibly into the public sphere. Strike action is perhaps the most prominent example. One might be able to conclude from BMA balloting that a significant proportion of junior doctors feel aggrieved at a particular issue - perhaps inadequate pay or unmanageable working hours.

Surveys of HCPs can provide a less ambiguous source. Though sparing and often subject-specific, they can prove valuable as demonstrations of perspective. For example, the BMA’s March survey of GP registrars found that three-quarters said they were experiencing burnout or stress. The value of these illustrations in shaping policy should not be understated.

These methods are not, however, where the story has to end. Nor does an exploration of HCPs’ perspectives need to be limited to an assessment of wellbeing or experience in health service. In the same way that the perspectives, criticisms, future predictions and past reflections can prove valuable to the ways in which health systems work, the same can be said in relation to the pharmaceutical industry, which permeates through the work of these systems across the globe.

But this does require a different approach. It is far less common to find HCPs collectively sharing their thoughts on pharmaceutical news and developments, especially with any semblance of collective voice. That is not to say that they do not exist, but identifying, analysing, and understanding these is more difficult.

Social media has, however, become a tool from which this analysis can take place. Edging towards five billion users globally, including several million HCPs, social media has ushered in a new era for health. As the presence of HCPs online has increased, so has the value of listening to their conversations.

Analysing these is different to the means of assessing perspectives mentioned earlier, for several reasons. First, social media posts are unprompted, where balloting and industry polling are not. Second, social media posts are independently-authored, whereas surveys and balloting tend to be anonymous and aimed at providing a holistic and collective view. It is the individualism of social media posts, combined with the volume of posts that HCPs produce, that allow us to bring together and explore the detail and diversity of attitudes among a range of HCPs, uncovering the nuanced attitudes - and underlying sentiment - of those on the frontlines.

Uncovering perspective: Treatment

Beyond offering a first-hand insight into HCPs’ views on the delivery of newly launched pharmaceutical breakthroughs, as offered in assessment of responses to the launch of the NHS’ cancer vaccination programme, social media activity also enables an immediate appraisal of HCPs’ attitudes towards the treatments themselves - their benefits, implications and, often, limitations.

One particularly interesting example of this came following the FDA approval in February of Tagrisso (osimertinib) in combination with chemotherapy, for patients with a certain form of lung cancer, and later its showcasing at ASCO 2024.

Listening to these conversations in both periods, particular praise for the progression-free survival benefits of the combination was heard. HCPs in February suggested the treatment would offer a “great option for selected patients”. Others, in June, labelled its progress as “practice changing”, “mind-blowing”, and a “game changer” for patients. In fact, the presentation of trial data at ASCO2024 received a standing ovation from attendees.

There is little doubt that HCPs consider osimertinib a promising option for patients. But, underneath the surface positivity, an analysis of HCP social media posts again reveals that some apprehension lingers. In February, for example, in response to the approval one HCP argued that, through recommending osimertinib in combination with chemotherapy as opposed to sequentially, the FDA were permitting an option that “could worsen outcomes for people”. Others expressed hesitancy based on a lack of mature overall survival data, while another conceded that “sometimes the FDA approves treatments that I’m not ready to start in all patients.”

Reflective of these conversations’ ability to be strong indicators of future issues, and a tool for predicting concerns and difficulties further down the line, ‘below the surface’ findings in June closely represent those of four months earlier. Once again, a lack of maturity in overall survival data prompted hesitation for some HCPs, with one posting that he had “strong concerns”. For others, questions arose regarding toxicity and length of therapy, as well as unease about the unusually high disparity in progression-free survival between placebo and osimertinib itself. As in February, permeating throughout was a hesitation that the treatment may not be entirely ready for widespread use.

Through analysis of HCP social media conversations, both the health and pharmaceutical sectors can identify - and remedy - the concerns of those on the frontlines of delivery as they arise. Conversation related to delivery and treatment are just two among an indefinite web of analytical opportunities.

Ignoring the nuances and detail of these conversations risks overlooking essential feedback that can inform the better delivery, acceptance, and success of new treatments aiming to tackle the biggest health obstacles of our time.