title: Social media and palliative medicine: a retrospective 2-year analysis of global Twitter data to evaluate the use of technology to communicate about issues at the end of life.
abstract: BACKGROUND
  Social media describes technological applications which are used to exchange information in a virtual environment. The use of social media is increasing, in professional and social contexts, on a variety of platforms such as Twitter; however, the scope and breadth of its use to discuss end-of-life care has not previously been reported.
  
  
  OBJECTIVE
  To determine the frequency, sentiment and trend of Twitter 'tweets' containing palliative care-related identifiers (hashtags) and/or phrases sent by users over a 2-year period.
  
  
  METHODS
  A 2-year retrospective analysis of Twitter posts (tweets), between the 1 August 2011 to 31 July 2013, using a social media analytics tool: TopsyPro. Thirteen search terms were identified and analysed for tweet volume, frequency, sentiment and acceleration.
  
  
  RESULTS
  A total of 683.5K tweets containing a combination of 13 palliative care terms were analysed. The tweet volume for all terms increased by 62.3% between 2011-2012 (262.5K) and 2012-2013 (421K). The most popular terms include 'end-of-life' (210K), #hpm (114K) and 'palliative care' (93.8K). Sentiment was high with 89% of tweets rated more positive than all other tweets sent on Twitter during this period. The term 'Liverpool Care Pathway' experienced the highest percentage increase in tweets (55% increase) reaching a peak in July 2013.
  
  
  CONCLUSIONS
  A lot of discussion about palliative care is taking place on Twitter, and the majority of this is positive. Social media presents a novel opportunity for engagement and ongoing dialogue with public and professional groups.
authors.affiliation: Marie Curie Palliative Care Institute Liverpool (MCPCIL), University of Liverpool, Liverpool, UK.
authors.forename: Amara Callistus
authors.identifier: http://orcid.org/0000-0003-0014-3741
authors.initials: AC
authors.lastname: Nwosu
authors.affiliation: Lancashire Teaching Hospitals, NHS Foundation Trust, Preston, UK.
authors.forename: Maria
authors.initials: M
authors.lastname: Debattista
authors.affiliation: The Christie NHS Foundation Trust, Clinical Oncology, Manchester, UK.
authors.forename: Claire
authors.initials: C
authors.lastname: Rooney
authors.affiliation: Marie Curie Palliative Care Institute Liverpool (MCPCIL), University of Liverpool, Liverpool, UK.
authors.forename: Stephen
authors.initials: S
authors.lastname: Mason
mesh_terms: D058015:Health Communication; D006801:Humans; D010166:Palliative Care; D012189:Retrospective Studies; D061108:Social Media; D013727:Terminal Care
keywords: Communication; Cultural issues; Education and training; Supportive care; Terminal care