#Incontinence Education on Twitter: Who Is Posting What?

Objectives: Social media is a powerful venue for sharing healthcare information. However, the quality of posts is not regulated resulting in the dissemination of inaccurate information. Few studies have examined the accuracy of social media posts in female urology or urogynecology.

Methods: X (formerly Twitter) is the social media platform most associated with professional use and was therefore selected for this analysis. Tweets with content related to incontinence from 1/1/18 to 9/29/23 were identified using the Top Tweets function and searching for the following keywords: incontinence; urinary, stress, urgency, mixed, coital, insensible, and continuous incontinence; and overactive bladder. The Tweets were then thematically analyzed by two researchers followed by a session of consensus review. Content with an educational theme was further analyzed for sub-themes and accuracy. The identity of users posting educational tweets was also collected and analyzed. Tweets with non-English content, unrelated to humans, with broken links, or with male-only related content were excluded. Statistical analyses were performed using STATA.

Results: 638 tweets met inclusion criteria and there were 586 unique (i.e. not identical or retweeted) tweets. Of the included tweets, 59% (374/638) were considered educational. Other major themes included personal opinion, entertainment, sales, and medical tweets. 90% (337/375) of the educational tweets were considered accurate. Accurate tweets were more likely to be posted by healthcare organizations, journals, physicians, or non-physician healthcare workers compared to inaccurate tweets (83% vs 67%, p< 0.001). Only 18% (68/374) of the educational tweets originated from physicians, and there was no difference in the percentage of accurate vs inaccurate tweets posted by physicians (19% vs 11%, p=0.441). Approximately half of the accurate educational tweets directly referenced research or landmark papers in female urology/urogynecology. There was no difference in the number of duplicate accurate or inaccurate tweets (22% vs 22%, p=1.00). Educational subthemes included diagnosis, risk factors, associated conditions, treatment, and research.

Conclusions: Educational tweets about incontinence are 90% accurate with the most reliable information originating from healthcare-affiliated users. Fewer than 20% of educational posts originated from physicians, highlighting the need for greater physician engagement on social media.