title: The Impact of Internet Health Information on Patient Compliance: A Research Model and an Empirical Study.
abstract: BACKGROUND
  Patients have been increasingly seeking and using Internet health information to become more active in managing their own health in a partnership with their physicians. This trend has both positive and negative effects on the interactions between patients and their physicians. Therefore, it is important to understand the impact that the increasing use of Internet health information has on the patient-physician relationship and patients' compliance with their treatment regimens.
  
  
  OBJECTIVE
  This study examines the impact of patients' use of Internet health information on various elements that characterize the interactions between a patient and her/his physician through a theoretical model based on principal-agent theory and the information asymmetry perspective.
  
  
  METHODS
  A survey-based study consisting of 225 participants was used to validate a model through various statistical techniques. A full assessment of the measurement model and structural model was completed in addition to relevant post hoc analyses.
  
  
  RESULTS
  This research revealed that both patient-physician concordance and perceived information asymmetry have significant effects on patient compliance, with patient-physician concordance exhibiting a considerably stronger relationship. Additionally, both physician quality and Internet health information quality have significant effects on patient-physician concordance, with physician quality exhibiting a much stronger relationship. Finally, only physician quality was found to have a significant impact on perceived information asymmetry, whereas Internet health information quality had no impact on perceived information asymmetry.
  
  
  CONCLUSIONS
  Overall, this study found that physicians can relax regarding their fears concerning patient use of Internet health information because physician quality has the greatest impact on patients and their physician coming to an agreement on their medical situation and recommended treatment regimen as well as patient's compliance with their physician's advice when compared to the impact that Internet health information quality has on these same variables. The findings also indicate that agreement between the patient and physician on the medical situation and treatment is much more important to compliance than the perceived information gap between the patient and physician (ie, the physician having a higher level of information in comparison to the patient). In addition, the level of agreement between a patient and their physician regarding the medical situation is more reliant on the perceived quality of their physician than on the perceived quality of Internet health information used. This research found that only the perceived quality of the physician has a significant relationship with the perceived information gap between the patient and their physician and the quality of the Internet health information has no relationship with this perceived information gap.
authors.affiliation: Pilon School of Business, Sheridan College, Mississauga, ON, Canada. john.laugesen@sheridancollege.ca.
authors.forename: John
authors.identifier: http://orcid.org/0000-0002-3042-4205
authors.initials: J
authors.lastname: Laugesen
authors.forename: Khaled
authors.identifier: http://orcid.org/0000-0002-5902-1717
authors.initials: K
authors.lastname: Hassanein
authors.forename: Yufei
authors.identifier: http://orcid.org/0000-0002-8388-8433
authors.initials: Y
authors.lastname: Yuan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002983:Clinical Competence; D054626:Consumer Health Information; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D010349:Patient Compliance; D010465:Perception; D010817:Physician-Patient Relations; D010820:Physicians; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Internet health information; consumer health; information asymmetry; patient compliance; patient-physician concordance; physician quality