Social media inaction amplifies public perception of pharmaceutical risk

A new empirical study has demonstrated that proactive engagement with patient complaints on social media significantly influences how users perceive potential pharmaceutical crises. The study, titled “Digital Crisis Management: How Proactive Online Engagements on Patient Complaints Influence Social Media Users’ Perceptions”, was published in Frontiers in Communication. It provides rare quantitative evidence on how engagement strategies during a paracrisis, a publicly visible but not yet full-blown crisis, can shape public sentiment and downstream consumer behavior in the pharmaceutical industry.

Using an experimental simulation based on a real-life FDA warning over fluoroquinolone antibiotics, the research examined how social media users reacted to a pharmaceutical company’s Facebook responses to side-effect complaints. The findings underscore that highly engaged social media users responded more favorably when the company acknowledged and addressed complaints, while the absence of such engagement heightened perceptions of looming crisis. These effects, in turn, influenced users’ willingness to spread negative information and their likelihood to purchase future products from the company.

How early digital engagement shapes public perception of pharmaceutical crises

The study addresses a growing phenomenon in crisis communication: the rise of paracrises, or situations that do not yet require full crisis response but possess the power to escalate if mishandled. In this specific case, patient complaints about severe side effects were posted to a fictional pharmaceutical company’s Facebook page. Some posts received official company responses that included apologies and practical advice, while others were left unanswered. The researchers then measured users’ perception of how likely the situation was to evolve into a full-scale crisis.

The results showed a stark difference in perception based on user engagement levels. Highly engaged users, those who frequently comment and participate in discussions, were less likely to see the situation as a crisis when the company actively responded. Conversely, these same users were more likely to anticipate crisis when no response was given. This bifurcation did not occur with low-engagement users, who were comparatively indifferent to whether the company responded or not.

The implications are significant. Public perception of crisis likelihood is a strong predictor of reputational damage. If users, especially those active on social platforms, perceive that a company is ignoring complaints about drug side effects, they are more inclined to treat the situation as evidence of corporate irresponsibility. On the other hand, a measured and responsive communication strategy can help defuse potential backlash before it becomes a full-blown reputational disaster.

How perceived crisis likelihood mediates downstream consumer behavior

Beyond perception, the study also investigated behavioral outcomes, particularly users’ intention to engage in negative electronic word-of-mouth (eWOM) and their future purchase intentions. While no direct link was observed between user engagement and these behavioral outcomes, further analysis revealed that perceived crisis likelihood played a key mediating role.

Specifically, when the pharmaceutical company responded to complaints and the users were highly engaged, the perceived risk of crisis declined. This reduction in perceived crisis then indirectly led to a lower likelihood of users spreading negative eWOM and a higher likelihood of them purchasing from the company in the future. In contrast, low-engagement users showed little change in behavioral intention regardless of whether the company engaged.

This finding contributes a deeper understanding of how online engagement operates in a crisis-prevention context. It suggests that engagement strategies work not simply by offering content or apologies but by shaping how users evaluate the severity of unfolding events. The perception of being in control or acting responsibly can dampen the momentum of a paracrisis, thereby averting broader reputational damage.

Importantly, the study demonstrates a case of moderated mediation. That is, the effect of company engagement on consumer behavior is mediated by perceived crisis likelihood and moderated by user engagement levels. This dual mechanism emphasizes that crisis communication on digital platforms is not one-size-fits-all; it must account for the behavioral dynamics of different user groups.

What this means for digital crisis communication strategies in high-risk industries

The research delivers clear takeaways for communication professionals and crisis managers in industries vulnerable to public backlash, especially pharmaceuticals. First, it affirms that waiting to respond until a crisis erupts is no longer viable. In a digital age, where paracrises can go viral in hours, early and empathetic engagement is vital to crisis prevention. The study provides empirical backing for the idea that companies must monitor and respond to negative consumer petitions even before those petitions escalate.

Second, not all users carry equal weight in shaping a public relations crisis. Highly engaged users are not only more likely to detect reputational threats early but are also more influential in spreading those perceptions. By engaging these users proactively, companies can leverage their role as informal opinion leaders to steer public discourse in a favorable direction.

Third, while the study focused on Facebook, it raises broader questions about platform-specific dynamics. Social media environments differ in their norms and user behavior. Twitter’s brevity, Reddit’s anonymity, or TikTok’s video-centric communication may require customized engagement tactics. Companies should tailor their crisis communication strategies to suit platform-specific engagement metrics and user characteristics.

In addition to pharmaceuticals, industries like finance, healthcare, and food, all sectors with high reputational sensitivity, must recognize the value of preemptive, digital-native crisis frameworks. The findings suggest that strategies like apology, transparency, and information dissemination, when deployed early, can neutralize potential crises before they metastasize.