title: Exploring Consumer and Patient Knowledge, Behavior, and Attitude Toward Medicinal and Lifestyle Products Purchased From the Internet: A Web-Based Survey.
abstract: BACKGROUND
  In recent years, lifestyle products have emerged to help improve people's physical and mental performance. The Internet plays a major role in the spread of these products. However, the literature has reported issues regarding the authenticity of medicines purchased from the Internet and the impact of counterfeit medicines on public health. Little or no data are available on the authenticity of lifestyle products and actual toxicity associated with their use and misuse.
  
  
  OBJECTIVE
  Our aim was to investigate consumer and patient attitudes toward the purchase of lifestyle products from the Internet, their knowledge of product authenticity and toxicity, and their experiences with counterfeit lifestyle products.
  
  
  METHODS
  A Web-based study was performed between May 2014 and May 2015. Uniform collection of data was performed through an anonymous online questionnaire. Participants were invited worldwide via email, social media, or personal communication to complete the online questionnaire. A total of 320 participants completed the questionnaire.
  
  
  RESULTS
  The results of the questionnaire showed that 208 (65.0%) participants purchased lifestyle products from the Internet mainly due to convenience and reduced cost. More than half (55.6%, 178/320) of participants purchased cosmetic products, whereas only a minority purchased medicinal products. Yet, 62.8% (201/320) of participants were aware of the presence of counterfeit lifestyle products from the Internet, and 11.9% (38/320) experienced counterfeit products. In only 0.9% (3/320) of those cases were counterfeit lifestyle products reported to authorities. Moreover, 7.2% (23/320) of the participants experienced adverse effects due to counterfeit lifestyle products.
  
  
  CONCLUSIONS
  In summary, patients experienced counterfeit lifestyle products that resulted in adverse effects on their health. Although certain adverse effects were reported in this study, counterfeit products were underreported to authorities. Further public awareness campaigns and patient education are needed.
authors.affiliation: Faculty of Science and TechnologyDepartment of Archaeology, Anthropology and Forensic ScienceBournemouth UniversityPooleUnited Kingdom.
authors.forename: Sulaf
authors.identifier: 0000-0002-5142-9179
authors.initials: S
authors.lastname: Assi
authors.affiliation: Faculty of Science and TechnologyDepartment of Archaeology, Anthropology and Forensic ScienceBournemouth UniversityPooleUnited Kingdom.
authors.forename: Jordan
authors.identifier: 0000-0003-1148-8382
authors.initials: J
authors.lastname: Thomas
authors.affiliation: Faculty of ManagementBournemouth UniversityPooleUnited Kingdom.
authors.forename: Mohamed
authors.identifier: 0000-0002-8097-6243
authors.initials: M
authors.lastname: Haffar
authors.affiliation: Faculty of Science and TechnologyDepartment of Archaeology, Anthropology and Forensic ScienceBournemouth UniversityPooleUnited Kingdom.
authors.forename: David
authors.identifier: 0000-0001-5934-2644
authors.initials: D
authors.lastname: Osselton
keywords: Internet; attitude; behaviour authenticity; consumer knowledge; counterfeit; effectiveness; medicinal and lifestyle products; toxicity