Quality, reliability, and content analysis of short videos concerning lipid-lowering drugs on TikTok and Bilibili in China

Lipid-lowering therapy is crucial for cardiovascular disease prevention, yet adherence is suboptimal due to concerns about side effects. Short video platforms are key health information sources in China, but content quality regarding pharmacotherapy remains under-investigated. This study aimed to systematically evaluate the quality, reliability, and content of short videos regarding "lipid-lowering drugs" on TikTok and Bilibili. A cross-sectional study was conducted in December 2025. The top 150 videos retrieved via the keyword "lipid-lowering drugs" from each platform were screened. A total of 199 videos meeting inclusion criteria were analyzed. Two independent researchers evaluated uploader profiles, content coverage, and interaction metrics. Video quality was assessed using the Global Quality Scale (GQS) and reliability via the modified DISCERN (mDISCERN) tool. Medical professionals dominated the ecosystem (90%), reaching 100% on TikTok. While videos frequently covered mechanisms (63.8%) and indications (54.3%), critical safety information regarding drug interactions (11.6%) and contraindications (11.1%) was systematically omitted. TikTok videos demonstrated significantly higher GQS scores than Bilibili (median 3.00 vs 2.00, P = .007), yet evidentiary reliability (mDISCERN) remained moderate across both (median 2.00). Crucially, user interaction metrics correlated significantly with production quality (GQS) but showed no association with reliability (mDISCERN). Despite professional dominance, online lipid-lowering drug information suffers from a "safety silence," lacking comprehensive contraindication warnings. A "popularity paradox" exists where engagement reflects presentation skills rather than medical reliability. Healthcare providers must prioritize safety profiles in digital education, and patients should be cautioned against judging accuracy by popularity.