Twitter Analysis of Healthcare Providers' Antidepressant Discussions

The eligibility criteria used to assess the tweets included: 1. Containing at least one of the keywords that refers to an antidepressant(s) or the term ‘antidepressant’; 2. Written in English; 3. Posted between a 10-day period between 14th June 2022 and 23rd June 2022; 4. Containing original text; 5. Posted by a user who self-identified as a healthcare provider. Several preliminary searches determined a 10-day span would be feasible considering the scale of data and the capability of manual analysis. Posts on Twitter are generally categorised into tweets (including those that quoted another tweet), retweets and replies. For this study, only tweets and replies were included, since retweets are identical reposts and thus were considered duplicate content.
The inclusion/exclusion criteria were applied within Microsoft Excel, by authors manually reviewing the textual data. Microsoft Excel allowed screening and excluding data easily according to our criteria 1–4. For criterion 5, user profiles (names and bios) associated with the identified tweets were assessed for eligibility, whereby tweets posted by healthcare providers were eligible and categorised by their roles byYD. The definition of “healthcare providers” (Table 1) was adapted from the version defined by Lee et al. which was previously used to conduct a Twitter analysis of healthcare providers.⁴² (link) It was expanded in this study to”relevant healthcare professionals, providers and students”, who were considered people or organisations which the general public may expect to be more knowledgeable about healthcare, such as physicians (including psychiatrists), nurses, pharmacists, psychologists, researchers, medical students, and organisations in medical fields and other allied professionals (e.g, therapists, dietitians). Where there was ambiguity over someone's eligibility due to dubious expression over their role, a second researcher (NW) was consulted. If it was not certain that they were a healthcare provider, i.e., they did not use definitive terminology such as ‘pharmacist’ or ‘medic’, they were not included in the analysis. The content of the tweet text had not been considered in this stage to avoid bias.Table 1

Descriptions and Examples of Categories of Healthcare Providers Identified: This table explained the classification of healthcare providers in this study and listed some examples of their presentations. Identifying information was adapted.

Table 1

Category	Description	Example Bio (partially adapted)
Physicians	Physicians, psychiatrists, doctors from various clinical subjects, dentists, ophthalmologists	“MD […] #physiatrist […]”, “Maternal-Fetal Medicine Physician”, “MBBS (GMC, […])”, “Doctor | Special interest in Long Covid […]”, “Clinician-scientist […]”
Nurses	Nurses, nurse practitioners, registered nurses, retired nurses	“Mom, nurse, wife, daughter, and sister. […]”, “STICU Nurse. […]”, “28. Labor & delivery RN. […]”
Pharmacists	Pharmacists, mental health pharmacists, clinical pharmacists from various clinical subjects	“PharmD/writer w/30y exp.Infect Diseases. […]”, “Retail Pharmacist”, “Mental Health Clinical Pharmacist Practitioner […]”
Psychologists	Psychologists, clinical psychologists	“Dual national,CPsychol, accidental academic. […]”, “A retired developmental psychologist […]”
Medical Students	Medical students, MD and PharmD candidates, students of biomedical areas	“PGY-1 in rural/full-spectrum family med […]”, “[…] | Med student | […]”, “Internal medicine residency applicant”
Organisations	Hospitals, clinics, healthcare businesses, academic groups, journals, medical information providers, charities	“Real vitamins for physical and mental health. […]”, “Original research in physiology with an emphasis on adaptive and integrative mechanisms | An @APSPhysiology journal”, “ACTIV-6 is a research study testing repurposed medications to understand if they can help people with mild-to-moderate COVID-19 feel better faster.”
Researchers	Individual researchers specified in biomedicine, mental health, public health areas	“COVID scientist; Associate Professor of Psychiatry @[…]”, “Training psychiatrist/research fellow @[…]”, “Researcher in Pharmacognosy, Pharmacology & Pharmacy. […]”
Others Allied Professionals	Therapists, dieticians, nutritionists, midwives, social workers, hygienists, health care educators, unspecified professionals	“Social worker in […]”, “[…] Mental Health Therapist […]”, “Health Care Provider, […]”, “NHS midwife, […]”, “Registered Dietitan, Cannabis practitioner, […]”