Background/Purpose: Methotrexate (MTX) is one of the most commonly prescribed disease modifying antirheumatic drugs for rheumatoid arthritis. While data suggests subcutaneously administered methotrexate is more efficacious, there are many potential patient barriers to its use. Video assisted teaching has been shown to be an effective supplementary method for subcutaneous MTX education. This review evaluates the quality of video resources available for patients on YouTube for learning to self-administer subcutaneous MTX.
Methods:
Using the search term “Methotrexate injection” on YouTube, 2 independent clinical reviewers in 2 different geographic locations analyzed the first 3 pages of search results (60 videos). Discrepancies were evaluated and resolved by a 3rd independent reviewer. Source and search rank of videos, audience views video duration and time since video was uploaded to YouTube were recorded. Videos were classified as useful, misleading or a personal patient view. Videos were rated for reliability using the DISCERN reliability tool (0-5, 5 being the most reliable), comprehensiveness (0-4; 1 point each as follows: needle preparation, MTX withdrawal, injection demonstration, needle disposal) & global quality scale (GQS; 1=poor video quality, 5= excellent video quality). Reasons for misleading videos were documented, and personal patient view videos were recorded as being either positive or negative towards MTX injection.
Results:
A total of 51 English videos overlapped between the two geographic locations; 10 videos were classified as useful (19.6%), 14 as misleading (27.5%) & 27 as personal patient view (52.9%). Total views of videos were 161,028: 19.2% useful videos, 72.8% personal patient view videos, & 8.0% misleading videos. Mean GQS was 4.2 (± 1.0) for useful videos, 1.6 (± 1.1) for misleading videos & 2.0 (± 0.9) for personal patient videos (p <0.0001). Mean reliability was 3.3 (± 0.6) for useful videos, 0.9 (± 1.2) for misleading videos, & 1.0 (± 0.7) for personal patient videos (p <0.0001). Comprehensiveness was 2.2 (± 1.9) for useful videos, 0.1 (± 0.3) for misleading videos, & 1.5 (± 1.5) for personal patient view videos (p = 0.0027). Of the personal patient view videos, 77.8% were positive, & 22.2% were negative. No significant correlation was found between the number of video views and quality of the video. The most common reason for a video being misleading was video content being unrelated to MTX injection. Of the 10 videos (19.6%) from university or professional organizations, 80% were useful and 20% misleading, while 72.7% of the 11 medical advertisements/for-profit organizations videos were misleading.
Conclusion: A qualitative review of MTX injection videos posted on YouTube shows a minority of useful videos for MTX injection, with the majority of viewers watching patient created videos. While many of these demonstrate MTX injection positively, this does not necessarily correlate with appropriate and safe technique. While web video may be an additional educational tool available for patients, clinicians need to be familiar with specific resources to help guide and educate their patients to ensure best outcomes.
Disclosure:
R. Rittberg,
None;
T. Dissanayake,
None;
S. J. Katz,
None.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/a-qualitative-analysis-of-methotrexate-injection-videos-on-youtube/