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Impact of online versus in-person management of atopic dermatitis on QOL and access to care: A randomized controlled
April W Armstrong1, Alyssa M Roberts2, Gina Kostandy3
1Division of Dermatology, Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California, USA; Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Background:
Atopic dermatitis is a chronic skin disease that can significantly affect quality of life (QOL) and requires regular access to dermatologic care. However, traditional in-person visits often impose logistical challenges.
Objectives:
The aim of this study was to evaluate whether an online, team-based connected health teledermatology model provides improvements in QOL equivalent to those provided by in-person management of atopic dermatitis and to examine access to care.
Methods:
We conducted a 12-month, pragmatic, randomized, controlled equivalence trial (NCT03981926) involving 300 participants aged ≥1 year with physician-diagnosed atopic dermatitis. Participants were randomized 1:1 to the online or in-person arm. QOL was assessed using the Dermatology Life Quality Index and EQ-5D-5L. Access was measured through the average time needed for evaluation.
Results:
For all QOL measures, the difference in mean change between arms fell within the prespecified equivalence margins: 0.12 (95% confidence interval = -0.18 to 0.42) for Dermatology Life Quality Index, 0.00 (95% confidence interval = -0.01 to 0.01) for utility index, and -0.11 (95% confidence interval = -0.70 to 0.48) for Visual Analog Scale. Team-based connected health significantly reduced the time needed for evaluation at baseline (P = .03).
Conclusion:
For patients with atopic dermatitis, the online team-based connected health model resulted in equivalent improvements in QOL and reduced the time needed for evaluation at baseline.