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ObjectivesOnline health forums provide rich and untapped real-time data on population health. Through novel data extraction and natural language processing (NLP) techniques, we characterise the evolution of mental and physical health concerns relating to the COVID-19 pandemic among online health forum users. Setting and designWe obtained data from 739,434 posts by 53,134 unique users of three leading online health forums: HealthBoards, Inspire and HealthUnlocked, from the period 1st January 2020 to 31st May 2020. Using NLP, we analysed the content of posts related to COVID-19. Primary outcome measuresO_LIProportion of forum posts containing COVID-19 keywords C_LIO_LIProportion of forum users making their very first post about COVID-19 C_LIO_LINumber of COVID-19 related posts containing content related to physical and mental health comorbidities C_LI ResultsPosts discussing COVID-19 and related comorbid disorders spiked in early- to mid-March around the time of global implementation of lockdowns prompting a large number of users to post on online health forums for the first time. The pandemic and corresponding public response has had a significant impact on posters queries regarding mental health. ConclusionsWe demonstrate it is feasible to characterise the content of online health forum user posts regarding COVID-19 and measure changes over time. Social media data sources such as online health forums can be harnessed to strengthen population-level mental health surveillance. Article SummaryO_ST_ABSStrengths and limitations of this studyC_ST_ABSO_LIAnalysing online health forum data using NLP revealed a substantial rise in activity which correlated with the onset of the COVID-19 pandemic. C_LIO_LIReal-time data sources such as online health forums are essential for monitoring fluctuating population health and tailoring responses to daily pressures. C_LIO_LIIt is not yet possible to establish COVID-19 status or whether concerned posters have pre-existing mental or physical health issues, are recovered, or have become unwell for the first time. C_LIO_LIOnline health forums are help-seeking forums, which introduces self-selection bias. C_LI
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ObjectivesThe recent COVID-19 pandemic has disrupted mental healthcare delivery, with many services shifting from in- person to remote patient contact. We investigated the impact of the pandemic on the use of remote consultation and on the prescribing of psychiatric medications. Design and settingThe Clinical Record Interactive Search tool (CRIS) was used to examine de-identified electronic health records (EHRs) of people receiving mental healthcare from the South London and Maudsley (SLaM) NHS Foundation Trust. Data from the period before and after the onset of the pandemic were analysed using linear regression, and visualised using locally estimated scatterplot smoothing (LOESS). ParticipantsAll patients receiving care from SLaM between 7th January 2019 and 20th September 2020 (around 37,500 patients per week). Outcome measuresO_LIThe number of clinical contacts (in-person, remote or non-attended) with mental healthcare professionals per week C_LIO_LIPrescribing of antipsychotic and mood stabiliser medications per week C_LI ResultsFollowing the onset of the pandemic, the frequency of in-person contacts was significantly reduced compared to that in the previous year ({beta} coefficient: -5829.6 contacts, 95% CI -6919.5 to -4739.6, p<0.001), while the frequency of remote contacts significantly increased ({beta} coefficient: 3338.5 contacts, 95% CI 3074.4 to 3602.7, p<0.001). Rates of remote consultation were lower in older adults than in working age adults, children and adolescents. Despite this change in the type of patient contact, antipsychotic and mood stabiliser prescribing remained at similar levels. ConclusionsThe COVID-19 pandemic has been associated with a marked increase in remote consultation, particularly among younger patients. However, there was no evidence that this has led to changes in psychiatric prescribing. Nevertheless, further work is needed to ensure that older patients are able to access mental healthcare remotely.
