Rheumatology International

, Volume 38, Issue 7, pp 1285–1292 | Cite as

English-language videos on YouTube as a source of information on self-administer subcutaneous anti-tumour necrosis factor agent injections

  • Sena ToluEmail author
  • Ozan Volkan Yurdakul
  • Betul Basaran
  • Aylin Rezvani
Patient Opinion


The aim of this study was to evaluate the reliability, content, and quality of videos for patients available on YouTube for learning how to self-administer subcutaneous anti-tumour necrosis factor (TNF) injections. We searched for the terms Humira injection, Enbrel injection, Simponi injection, and Cimzia injection. Videos were categorised as useful information, misleading information, useful patient opinion, and misleading patient opinion by two physicians. Videos were rated for quality on a 5-point global quality scale (GQS; 1 = poor quality, 5 = excellent quality) and reliability and content using the 5-point DISCERN scale (higher scores represent greater reliability and more comprehensive videos). Of the 142 English videos, 24 (16.9%) videos were classified as useful information, 6 (4.2%) as misleading information, 47 (33.1%) as useful patient opinion, and 65 (45.8%) as misleading patient opinion. Useful videos were the most comprehensive and had the highest reliability and quality scores. The useful information and useful patient opinion videos had the highest numbers of views per day (median 8.32, IQR: 3.40–14.28 and 5.46, IQR: 3.06–14.44), as compared with 2.32, IQR: 1.63–6.26 for misleading information videos and 2.15, IQR: 1.17–7.43 for misleading patient opinion videos (p = 0.001). Almost all (91.5%) misleading videos were uploaded by individual users. There are a substantial number of English-language YouTube videos, with high quality, and rich content and reliability that can be sources of information on proper technique of anti-TNF self-injections. Physicians should direct patients to the reliable resources of information and educate them in online resource assessment, thereby improving treatment outcomes.


Anti-TNF agent injection Patient education Internet YouTube 



We thank Yusuf Celik PhD (Department of Biostatistics of Biruni University, Turkey) for the support in biostatistics.

Author contributions

ST: designed study, analysed data, and drafted paper. OVY: analysed data and drafted paper. BB: drafted paper. AR: analysed data and drafted paper.



Compliance with ethical standards

Conflict of interest

The authors declare they have no conflicts of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors. So there is no need for ethical approval.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Physical Medicine and RehabilitationBezmialem Vakıf UniversityFatih, IstanbulTurkey
  2. 2.Department of Anesthesiology and Pain MedicineKonya Training and Research HospitalKonyaTurkey

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