Social Intelligence on Cold Sore (Fever Blisters)

Hima K Raman

1
Project objectives and scope

Objective

Social media listening around Cold sore or Fever blisters

• Share of digital voice analysis around Cold sore among teenagers and their mothers
• Mother specific conversation analysis around the disease management and
treatments
• Teenager specific share of voice around disease burdens and treatment options
• Comparative percentage of conversations around treatment options

Scope

• Geography/Countries: US
• Languages: English
• Time Duration for Analysis: 1st Jan 2015 – 31st Dec 2016
• Data Sources:
1. medhelp.org
2. emedicinehealth.com
3. honeycomb.click
4. drugs.com
• Deliverable: One time comprehensive analysis report (MS PowerPoint)
Data considered for the study was extracted and sampled based
on the methodology outlined

1. Determine objectives and 2. Determine keyword universe Extracted data

Data Extraction

scope of the project based on objectives points

Extract relevant data

3. Finalize taxonomy in medical 4. Identify all viable data sources

background and extract data 5,652
• Data is extracted by listed platforms and relevant time period
Contextualization

Total data
• Data is filtered for relevancy filtered

Bucketing of
Data

extracted data points

• Medhelp – 2,847 • Honeycomb – 1066

• Emedicinehealth – 4,049 • Drugs.com – 72
3,577
• Data is sampled based on 95% confidence level and 5% margin of Total data
analyzed
error
Sampling

Analyze sampled data

points

• Medhelp – 339 • Honeycomb – 283

• Emedicinehealth – 1,437 • Drugs.com – 61 683
Agenda

Patients’ Share of Voice

4
A regional segregation of the origin of conversations highlights
Michigan as the city with the most user interest*

Geo locations of Cold Sore patients

The top five states

where cold sore
patients were reported

Michigan
California
New York
Pennsylvania
South Carolina

High volume Medium volume Low data No data

Top Cities for Cold Sore Searches Overview

• Among the identifiable group

Kansas 5
of patients , most
South Carolina 6
conversations were reported
Pennsylvania 9
from the eastern and
New York 9
southern regions of the US
California 10
with maximum search from
Michigan 12
N = 51
Michigan and California

*Demographic data is based on publically

5
available information via user profiles
September and October were the most active months for cold sore on
social media throughout 2015-16

14 Trend of conversation volume during 2015-16 N = 89

12

10
No. of mentions

Mother Teen Male Teen Female

• 81% of the conversations were reported by teens, out of that 54% were females. Only 19%
contributions was from mothers of the teenagers.

• 43% of the total conversations were happening during September and October throughout 2015
and 2016

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Segmentation of patient conversations over social media platforms

Total volume of Platform Breakup N = 89

conversation
3
Drugs.com
2
22%
8
Honeycomb
7

0
Emedicinehealth
0

64
78% Medhelp
3
Mother
s
Teens Moms
Teens

Gender and Age Group of Teens

• In 78% of the total social media conversations were performed by
19 7 10 teens
18 6 9
• Honeycomb is the preferred platform for 59% Mothers to share
65% 17 3 10
thoughts
Age

16 2 4
• Over 85% of teens’ conversations are happening at Medhelp
15 5 1
74% Male • There is a gradual increase in the number of conversations as the
35% 14 0
Female age progresses making senior teenagers talk more over social media
13 0 3
N = 78 N = 60 platforms

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Conversations from the different social media groups about cold sores
65 3 N = 97
60
55
50
No of mentions

45
40
35
30
25
20
15
10 7
5 64 2 0 1 1 3 1
1 8 0
0 0 2 0
0 1 1 1 1

Teens Moms

• Major amount of cold sore conversations from teens are happening in Herpes forum in
medhelp.
• Since it is an unorganized forum most of the Mothers prefer to share their experiences in teens
forum at honeycomb.
• Compared to the topics discussed in Herpes rest of the discussion groups hardly contribute to help
teens cold sore problems

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Agenda

Patient Segmentation
by TOC

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Themes of conversations around oral and genital herpes throughout
patient journey
50 N = 93
45 4
40 5
No of mentions

35
3
30 4
25
20
15
2 5
10
2
1 0
5 1
32 29 7 43 12 8 38 8
0 3 3

Teens Moms

Volume of conversations • Over 46% of patients started thinking about cold sore when they see
between Oral and Genital
blisters on their lips or genital area.

18% • Around 79% of the patients those engaged in social media discussions
are neither diagnosed nor seen a physician
• Over 72% of teens who engaged in conversations are not undergoing
any treatment
82% • Majority of the teens’ social media conversations about cold sore are
Oral
Genital about genital herpes

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Forums are where Cold Sore patients mostly seek peer advice by
sharing experiences anonymously

Seeking advice Throughout patient Sharing

(N=77) journey(N=92) Experiences (N=15)

“My Mother would also get the same outbreaks

“my Mother told me it's just a pimple nothing
on her inner thigh. Is it possible she passed
to worry about….”
the virus to me as an infant?”

“….. I started self-medicating since I did not

“I don't want to tell my Mother and then go
want to tell my Mother because I do not want
to a doctor so someone please help me…”
to disclose my sexual history.”

“i'm just a teenager and I don't know what to “My daughter is just 16 and her light dulled
do…………” yesterday…………….”

“ …..and they came out positive just anyone tell “I explained how I broke up with him because
me what I should do?” he gave me herpes …”

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Agenda

Teens Specific Analysis

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 TEENS

Patients also seek and share advice about cold sore for their loved
ones over different forums
Teens’ social media discussions on different
Teens’ online conversations on Cold Sore
platforms
N = 88 N = 88
1 Seeking 51 12 8 1 1
Son
0
Sharing
Daughter 1
1

Parent's 8
2

Partner's 12 85% 11% 4%

3 <1%

Own condition 51
9

Teens’ volume of conversations between

seeking and sharing • Over 68% of teens conversations about cold sore
on social media are for seeking or sharing their
17% own experiences
• MedHelp is the most preferred platform for teens
• Around 83% of the teen patients were seeking
Sharing peer advice and more info over social media
83%
Seeking platforms

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 TEENS

Change in themes of conversations around cold sore by age

N = 93
35

30

25
No of mentions

20

15

10

0
13 14 15 16 17 18 19
What is it Oral Cold Sore Transmitted from mom
Oral Cold Sore transmission by kissing Genital cold sore transmitted from mom
Genital cold sore transmitted by intercourse Genital cold sore transmitted by oral sex
Could I have cold sore? Seeing a physician
Social stigma Spreading

• Early teenage conversations were mainly towards oral cold sore transmission and physician appointment.
• As the age progresses conversations volume was increasing with a sudden shift of topics from oral herpes
to genital herpes
• Many elder teenagers are always suspecting to have genital cold sore.
• In elder teenagers cold sore is one of the main cause of social stigma

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 TEENS

Majority of the teenagers writing in social media are undiagnosed or

confused with other diseases for cold sore

Types of disease management Diagnostic discussions by age group

N = 51
19

18

17

50%

Age
16

Undiagnosed 15

14

13 Tested Undiagnosed

39%
Self Assumptions Overview

• More than 50% of the teenagers were trying to

7% diagnose their symptoms on social media rater than
Diagnosed by tests
visiting a physician
• Patients who are shared their condition with parents

4% are most likely to visit a physician and get it confirmed

Diagnosed by via valid tests.
physician
• Senior teenagers are tend to talk more about physician
visits an diagnostic tests

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 TEENS

Theme of conversation around diagnosis of cold sore among teenagers

Not diagnosed Confused with other diseases

“Please do help me on finding out if i've
“ Since no tests are accusing a bacteria
got herpes type one or type two …… because
anymore, or an UTI, could this be herpetic
from what i understand; herpes caught from
urethritis, an inner outbreak of herpes? ”
oral sex…”

“Since I have not had any recurring outbreaks, “ What is the likely hood that this could
does this make it more likely that I have HSV- be herpes. And could I have gotten a yeast
1 genital or not at all? Also, do you any idea infection from oral sex after my guy drank beer
how I could have contracted herpes?…” all night?”

Self assumptions Visit to specialist

“I've been having a tingling sensation in my “When I finished the antibiotics, the small
labia and sometimes on the skin in my pelvic bump was still there so I went back to
region . I googled this symptom and all that the doctor. ”
has come up is herpes prodrome ”

“I am a 19 year old woman and I have been

“ Over the course of three days, I started self-
having the weirdest symptoms for the past 6
medicating since I did not want to tell
weeks.I have now gone to 4 doctors all of
my Motherbecause I do not want to disclose my
whom say they see nothing wrong.”
sexual history.…”

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 TEENS

SOV of treatment of cold sore among teenagers

Age group Current modality of treatment

N =10
19 3
10
9
18 3
8 30%

No. of mentions
7 27%
17 2
6
5 17%
16 1
4 13% 13%
3
15 1 2
1
14 0 0
Vaccination Anti virals OTC Vitamines Cold sore brands
13 0

N = 10

• Most of the teenage discussions around cold sore are stuck in diagnosis. Very few are talking about
treatment option available.
• Around 20% of the patients are interested in knowing as well as trying the vaccination for herpes.
Some are unsatisfied by using it because the disease is recurring.
• Many of the teenagers doesn’t want to share their problems with parents or physician. So they
are looking for OTC medicine via forums
• Antiviral creams are the most commonly used medicines for cold sore among teenagers

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 TEENS

Impact of cold sore on teenagers’ emotional, sexual and social life

Quality of life N = 91
Have Cold sore symptoms effected your…

Greatly Moderately Slightly Not at all

Emotional

Emotional health (nervousness, depression)? 12 3 5 1

Feeling ignored? 3 2 4 3

Avoiding due to transmission fear?

Sexual

12 15 6 5

Loosing the trust in partner? 7 1 3 5

Lack of confidence to face the public? 7 3 1 1

Social

Social stigma? 9 3 2 7

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 TEENS

Unmet needs from cold sore teens which need to get addressed to
improve the quality of their life
Unmet needs (N=89) Seeking information about transmission
N = 83
Sharing cosmetics 3

41%
38% Sharing water
3 1
bottles
Knowledge about
Sharing food 4 2
Disease transmission
Sharing toilet 3 1
19%
Kissing 17 9
Misdiagnosis
Touching 4 4

17% Intercourse 18 14

Emotional support Female Male

14% “If a patient requests a specific test for a lifelong,

incurable disease, why would a doctor stall like that?”
Treatment options
“I feel like I can not talk to any of them about it,
my mother and sister just pity me and start crying
9% before I do.”
Awareness campaigns
in schools “school clinics that provide counselling and free testing
for teens up to the age of 21”

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 TEENS

Key insights and recommendations on the Teenage segment

What? So what? Now what?

Gyn/Obs interviews on
Least amount of
brand website and
The least amount of conversations in the
engaging patient
conversations were treatment phase indicates
advocates on forums
reported in the a need to create more
such as the Medhelp and
treatment of the patient awareness programs on
Honeycomb to increase
journey as compared to the treatment options and
awareness on the various
other stages the type of HCPs that
medications available in
provide them
the market

Patients in this age group The huge social stigma Teens are very
are reluctant to share attached with this disease comfortable in sharing
their disease information is the main reason for their experience in
neither with their parents this. When you describe social media. We need
nor with physicians. But your disease you need to to provide patient
they are comfortable to give your sexual history specific total disease
share and seek advice as well. Teenagers are awareness solution via
anonymously through not comfortable with forums, blogs and other
forums this social media platforms

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Agenda

Mother Specific
Analysis

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 MOTHERS

Mothers seek and share advice about both their own and their teens’
cold sore on forums

Mothers’ online conversations on Cold Mothers’ social media discussions on different

Sore platforms
N = 18 N = 20

Teens Cold
11 4
Sore

Own Cold
1 2
Sore 67% 27% 6% 0%

Seeking Sharing

Mothers talking about own cold

• Social media conversations around mothers of
sore
teens are comparatively less.
17%
• Around 83% of the mothers are seeking
peers help to handle their kids situation via
forums 83%
• Mothers are mostly using Honeycomb to seek
or share their concerns about cold sore Mothers talking about teen’s cold
sore

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 MOTHERS

Total themes of conversation around various cold sore treatment

options discussed by teens Mothers

Current modality of treatment

10 N = 18

26% 26%
8
23%
No. of Mentions

6
16%
13%
4
10%
6%
2
3% 3%
0%
0
Vaccination Anti viral cream OTC Drugs Complementary Cold sore brands*
medicines
For Moms For Teens

• Majority of the Mothers were talking about using anti-viral creams and vitamin supplements like zinc
or lysine for the symptoms of cold sore
• 23% of mothers are going for OTC medicines and self medicating before consulting a physician or
going for tests.
• Mothers are really curious about trying vaccinations for their teens. They are hoping to give life time
protection from cold sore to their teens
• Around 13% of the mothers are following the treatment regimen prescribed by a physician. They are
opting mainly for branded medicines

*Cold sore brands includes Abreva, Acyclovir, Valtrex etc. 23

 MOTHERS

Mothers are discussing mainly about educating their teens about cold
sore
Unmet needs (N=18)
“I wanted to educate her the way no one educated me. I
had just joined here and learned so many facts it really
gave me confidence in disclosing my genital h2”
38%
38%
Educating teens about
cold sore
“…. reporting my experience for 13 yr old daughter,…. we
have the second injection prior to age 15 or the vaccination
19% would require a 3rd injection”
Long term curing
options
“used toilet paper from the ground that was clearly already
18% used by another girl on her menstrual cycle. Is my
daughter at risk for herpes?”
Cold sore transmission

16% “I personally believe ppl freak out because they were never
Awareness campaigns taught these facts in high school sex education classes”
in schools

9% “We just got the diagnosis yesterday for my daughter. You

know the dive we took. Life looks a little different now.
Emotional support She's 17 and her whole life ahead of her”

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 MOTHERS

Key insights and recommendations on the Mothers’ segment

What? So what? Now what?

Mothers talk about this
Encourage teens to talk Urologists interviews
mainly in two scenarios.
comfortably with their on website and engaging
In first case her teen has
Mothers about their cold patient advocates on
oral herpes and teen
sore. Educate Mothers forums such as the
had a word with Mother
to better handle the ICNetwork and
about it. In second case
situation and support HysterSisters to
Mother has herpes and
their teens when they increase awareness on the
she wanted to know how
come forward to share diagnostic tests for
susceptible her teen for
their condition OAB
this?

Patients in this phase also Urologists identified by

Unfocused and
reported on unfocused Astellas can increase
frustrated interactions
and frustrated awareness on the
with GPs indicate a lack
interactions with General diagnosis of OAB on
of knowledge among the
Practioners (GPs) physician platforms such
GPs and the need to
Mothers looking as ‘CureTogether’ and
create awareness on the
forward for new ‘MedHelp’
diagnosis of the disease
vaccines

25
Agenda

Brand Insights

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Comparative analysis of Brand sentiments and purchase behaviour
analysis of cold sore patients
Discussions around brands Decision making and Purchases
N=8 N = 61
37% 26%

Teens themselves
Abreva
Mom for teen
Acyclovir
Partner for teen
Valtrex 26% 20%
Teens persuading mom
52%
37%

2%

• Total conversations around band usage and associated sentiments and loyalty are very minimal in
teenage segment of cold sore patients. There is no specific brand sentiments visible.

• More than half of the teenagers prefer to keep their cold sore and associated history for themselves
and take decisions for themselves. There is a visible discomfort in sharing those information with
their Mothers

• There were hardly any conversation around teens persuading their Mothers to buy medicines for me.

• In most of the cases if Mother is aware of the disease she is taking the decisions and teens didn’t
express much resistance to it.

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Agenda

Insights and
Recommendations

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Key decision making insights and recommendations for brand
messaging (1/2)

What? So what? Now what?

Among the identifiable group Awareness hashtags on
Majority of identifiable
of patients, most Twitter (#menoupauseoab),
conversation are by women
conversations on drug Facebook pages for this
in the age group from 41 – 60
therapy were from women patient segment along with
indicating that brands must
in the menopausal age partnering with menopause
target this segment
group (41 – 60) seeking patient group’s* digital
separately for awareness
info on transmission and platforms
programs
support

More than 25% of OAB Optimize website for keywords

Among the identifiable group
patients are males online such as ‘OAB in men’ to
of patients, 26% of the
indicates that brands must increase traffic on brand
conversations were reported
target more males in their website, separate section on
by males in the age group of
DTC campaigns and OAB for men on websites and
41 – 60 Mother talk
awareness programsmom Twitter and Facebook
less ,teen girls talk more
scared of hteir disease campaigns
srpead

Switchovers were reported Incidence of switchovers YouTube videos by

from most brands from most brands indicate urologists sponsored by
(maximum switchovers lack of awareness among Astellas educating patients on
were reported from VESIcare the patients on the treatment the importance of
due to its inefficacy and side regime to be followed behavioral therapy along
effects) senior teens are (behavioral therapy along with with drug therapy (linked to
asking more drug therapy) brand websites)

29
Key decision making insights and recommendations for brand
messaging (2/2)

What? So what? Now what?

Among the identifiable group Majority of identifiable Awareness hashtags on
of patients, most conversation are by women Twitter (#menoupauseoab),
conversations on drug in the age group from 41 – 60 Facebook pages for this
therapy were from women indicating that brands must patient segment along with
in the menopausal age target this segment partnering with menopause
group (41 – 60) platforms separately for awareness patient group’s* digital
to talk programs platforms

Optimize website for keywords

Among the identifiable group More than 25% of OAB such as ‘OAB in men’ to
of patients, 26% of the patients are males online increase traffic on brand
conversations were reported indicates that brands must website, separate section on
by males in the age group of target more males in their OAB for men on websites and
41 – 60 treatment- brand DTC campaigns and Twitter and Facebook
data awareness programs campaigns

Incidence of switchovers YouTube videos by

Switchovers were reported
from most brands indicate urologists sponsored by
from most brands
lack of awareness among Astellas educating patients on
(maximum switchovers
the patients on the treatment the importance of
were reported from VESIcare
regime to be followed behavioral therapy along
due to its inefficacy and side
(behavioral therapy along with with drug therapy (linked to
effects) QOL
drug therapy) brand websites)

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Thank you

31