Online Patient Information on Domiciliary Oxygen Therapy: An Evaluation of Quality, Suitability, Reliability, Readability, and Content

Abstract

Domiciliary oxygen therapy (DOT) is a complex intervention and has significant impact on patients' daily activities, quality of life, and mental well-being. Suitable education is pertinent in improving patients' understanding and use of DOT, because those receiving appropriate education have a better knowledge of their prescription, clearer expectations, and improved adherence to DOT. Do currently available online patient resources on DOT provide high-quality information for patients? We evaluated the first 100 results of three major search engines (Google, Yahoo, and Bing) using the terms home oxygen therapy and information or education. Website content was assessed based on Thoracic Society of Australia and New Zealand and British Thoracic Society domiciliary oxygen guidelines. Validated tools were used to evaluate resource quality (DISCERN instrument), suitability (Suitability Assessment of Materials [SAM]), reliability (Journal of the American Medical Association [JAMA] benchmarks and the Health on the Net [HON] code], and readability (Flesch Reading Ease and Flesch-Kincaid Grade Level). Thirty-six websites met study inclusion criteria. Websites from foundation or advocacy organizations scored the highest in quality and suitability, with a median DISCERN total score of48.0 (interquartile range [IQR], 43.5-60.0), or fair, and a median SAM suitability score of 70%(IQR, 53.0%-71.0%), or superior. Industry or for-profit websites had the best content score of 7.8 (IQR, 5.0-8.6). The HON accreditation seal was present on 14%of the websites, and only five websites met the four JAMA benchmarks. The median readability scores exceeded the recommended reading grades of sixth to eighth level for consumer health-related educational resources. The overall quality, suitability, reliability, and content of online health resources for DOT are of a low to moderate standard, with the reading grade at an unsuitable level for the general population. Health professionals should be aware of the limitations of currently available online DOT patient resources.