The Impact of Internet Health Information on Patient Compliance: A Systematic Review and Meta-analysis

Document Type : Systematic Review


1 Kerman University of Medical Sciences

2 District Education, Education Department of Kerman Province, Kerman, Iran.


Background and Objectives: Patient compliance plays an important role in the relationship between the patient and the physicians. The purpose of this systematic review and meta-analysis was to determine the impact of internet health information on patient compliance.

Material and Methods: Comprehensive searches of the databases were used to identify potentially eligible studies. No year range was set in this study. PRISMA guidelines have carried out this systematic view and meta-analysis. The two authors reviewed the studies based on inclusion criteria for systematic review. Statistical analysis was performed using CMA, version 2.0.

Results: The results of this meta-analysis showed that the satisfaction and quality of Internet health information can have a positive effect on patient compliance with treatment.

Conclusions: Internet health information is widely available and interpreted in different ways, so it can positively or negatively affect patients' decision and performance to compliance to treatment. Therefore, physicians need to identify credible and understandable and the quality of health information websites, so that patients have access to quality information.


Availability of data and materials: The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

Conflict of Interest: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Consent for Publication: All authors confirm that the contents of this manuscript can be published.

Ethical consideration:  The authors considered common forms of search biases, such as database bias, citation bias, availability bias, language bias, country bias, and familiarity bias.

Funding: The authors received no financial support for the research, authorship, and/or publication of this article.

Authors' contributions: M.ShB. devised the project, the main conceptual ideas and proof outline. S.ShB.  was in charge of overall direction and planning. M.ShB. and S.ShB. wrote the manuscript with input from all authors.

1. Laugesen J, Hassanein K, Yuan Y. The impact of internet health information on patient compliance: A research model and an empirical study. J Med Internet Res. 2015;17(6):e143.
PMid:26068214 PMCid:PMC4526934
2. Lu X, Zhang R, Wu W, Shang X, Liu M. Relationship between internet health information and patient compliance based on trust: Empirical study. J Med Internet Res. 2018;20(8).
PMid:30120087 PMCid:PMC6119214  
3. Trostle JA. The History and Meaning of Patient Compliance as an Ideology. In: Gochman DS, editor. Handbook of Health Behavior Research II: Provider Determinants [Internet]. Boston, MA: Springer US; 1997. p. 109-24. Available from:  
4. World Health Organization. Adherence to long-term therapies: evidence for action. World Health Organization; 2003. 26 p.  
5. Horwitz RI, Horwitz SM. Adherence to treatment and health outcomes. Arch Intern Med. 1993;153(16):1863-8.  
6. Lu X, Zhang R. Impact of physician-patient communication in online health communities on patient compliance: Cross-sectional questionnaire study. J Med Internet Res. 2019;21(5).
PMid:31094342 PMCid:PMC6535977  
7. Aliakbari R, Vahedian-Shahroodi M, Abusalehi A, Jafari A, Tehrani H. A digital-based education to improve occupational health and ergonomic conditions of dentists: an application of theory of planned behavior. International Journal of Health Promotion and Education. 2020;58(5):268-81.91  
8. Sletvold H, Sagmo LAB, Torheim EA. Impact of pictograms on medication adherence: A systematic literature review. Patient Educ Couns. 2020;103(6):1095-103.
9. Jayanti RK, Whipple TW. Like me… like me not: the role of physician likability on service evaluations. J Mark Theory Pract. 2008;16(1):79-86.  
10. Bichara LM, Aragón MLC de, Brandão GAM, Normando D. Factors influencing orthodontic treatment time for non-surgical Class III malocclusion. J Appl Oral Sci. 2016;24(5):431-6.
PMid:27812612 PMCid:PMC5083019  
11. Brown MT, Bussell J, Dutta S, Davis K, Strong S, Mathew S. Medication adherence: truth and consequences. Am J Med Sci. 2016;351(4):387-99.
12. Meurer WJ, Dome M, Brown D, Delemos D, Oska S, Gorom V, et al. Feasibility of emergency department-initiated, mobile health blood pressure intervention: an exploratory, randomized clinical trial. Acad Emerg Med. 2019;26(5):517-27.
PMid:30659702 PMCid:PMC6945785  
13. Laugesen J, Hassanein K, Yuan Y. The Impact of Internet Health Information on Patient Compliance: A Research Model and an Empirical Study. J Med Internet Res. 2015 Jun;17(6):e143.
PMid:26068214 PMCid:PMC4526934  
14. Shojaei Baghini M, Shojaei Baghini S, Naseri Booriabadi T. Health Literacy of Kerman Province Educational Staff. J Heal Lit. 2020;4(4):64-9.  
15. Im H, Huh J. Does Health Information in Mass Media Help or Hurt Patients? Investigation of Potential Negative Influence of Mass Media Health Information on Patients' Beliefs and Medication Regimen Adherence. J Health Commun. 2017 Mar;22(3):214-22.
16. Li X, Zhang G. Perceived credibility of Chinese social media: toward an integrated approach. Int J public Opin Res. 2018;30(1):79-101.  
17. Erdem SA, Harrison-Walker LJ. The role of the Internet in physician-patient relationships: The issue of trust. Bus Horiz. 2006;49(5):387-93.  
18. Deng Z, Liu S. Understanding consumer health information-seeking behavior from the perspective of the risk perception attitude framework and social support in mobile social media websites. Int J Med Inform. 2017;105:98-109.
19. Tennant B, Stellefson M, Dodd V, Chaney B, Chaney D, Paige S, et al. eHealth literacy and Web 2.0 health information seeking behaviors among baby boomers and older adults. J Med Internet Res. 2015;17(3):e70.
PMid:25783036 PMCid:PMC4381816  
20. Shneyderman Y, Rutten LJF, Arheart KL, Byrne MM, Kornfeld J, Schwartz SJ. Health information seeking and cancer screening adherence rates. J Cancer Educ. 2016;31(1):75-83.
21. Wimble M. Understanding health and health-related behavior of users of internet health information. Telemed e-Health. 2016;22(10):809-15.
22. Liu R, Zhang R, Lu X. An empirical study on the relationship between the satisfaction of internet health information and patient compliance-Based on trust perspective. In: ACM International Conference Proceeding Series. 2018. p. 61-6.  
23. Roy M, Corkum JP, Urbach DR, Novak CB, von Schroeder HP, McCabe SJ, et al. Health Literacy Among Surgical Patients: A Systematic Review and Meta-analysis. World J Surg. 2019 Jan;43(1):96-106.
24. Maloney EK, D'AGOSTINO TA, Heerdt A, Dickler M, Li Y, Ostroff JS, et al. Sources and types of online information that breast cancer patients read and discuss with their doctors. Palliat Support Care. 2015;13(2):107.
PMid:24182945 PMCid:PMC4515565  
25. Zhang H, Zhang R, Lu X, Zhu X. Impact of Personal Trust Tendency on Patient Compliance Based on Internet Health Information Seeking. Telemed e-Health. 2020;26(3):294-303.
26. Noordzij M, Hooft L, Dekker FW, Zoccali C, Jager KJ. Systematic reviews and meta-analyses: when they are useful and when to be careful. Kidney Int [Internet]. 2009 Dec 1 [cited 2021 Mar 16];76(11):1130-6. Available from:
27. Ahn E, Kang H. Introduction to systematic review and meta-analysis. Korean J Anesthesiol [Internet]. 2018/04/02. 2018 Apr;71(2):103-12. Available from:
PMid:29619782 PMCid:PMC5903119  
28. Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015;4(1):1-9.  
29. Ngoh LN. Health literacy: a barrier to pharmacist-patient communication and medication adherence. J Am Pharm Assoc (2003). 2009;49(5):e132-46; quiz e147-9.
30. Rothstein HR, Sutton AJ, Borenstein M. Publication bias in meta-analysis. Publ bias meta-analysis Prev Assess Adjust. 2005;1-7.  
31. Cohen J. A power primer. Psychol Bull. 1992;112(1):155.
32. Cooper H, Hedges LV, Valentine JC. The handbook of research synthesis and meta-analysis 2nd edition. In: The Hand of Res Synthesis and Meta-Analysis, 2nd Ed. Russell Sage Foundation; 2009. p. 1-615.  
33. Ortega DL, Wang HH, Wu L, Olynk NJ. Modeling heterogeneity in consumer preferences for select food safety attributes in China. Food Policy. 2011;36(2):318-24.  
34. Castle SR, McGuire CJ. An analysis of student self-assessment of online, blended, and face-to-face learning environments: Implications for sustainable education delivery. Int Educ Stud. 2010;3(3):36-40.  
35. Chin WW. Modern methods for business research, The partial least squares approach to structural equation modeling (pp. 295-336). New Jersey: Lawrence Erlbaum Associates; 1998.