Bottom Line: An online model for follow-up care of atopic dermatitis (eczema) that gave patients direct access to dermatologists resulted in equivalent clinical improvement compared to patients who received traditional in-person care.
Author: April W. Armstrong, M.D., M.P.H., of the University of Colorado, Denver, and colleagues.
Background: There are not enough dermatologists in the United States to meet the demand for services. Teledermatology is a chance to improve access to care.
How the Study Was Conducted: The authors conducted a one-year randomized controlled equivalency trial that included adults and children with atopic dermatitis who had access to the Internet, computers and digital cameras. The study included 156 patients: 78 patients visited dermatologists at their offices for follow-up care, while the remaining 78 patients accessed care online, which included electronically transmitting clinical pictures to dermatologists who evaluated them, provided treatment recommendations and prescribed medications. The severity of the atopic dermatitis was measured by patient-oriented eczema measure (POEM) and investigator global assessment (IGA).
Results: Between baseline and 12 months, the average difference in POEM score in patients in the online group was -5.1 and -4.86 in the in-person follow-up group. The percentage of patients achieving clearance or near clearance of their atopic dermatitis (IGA score of 0 or 1) was 38.4 percent in the online group and 43.6 percent in the in-person group.
Discussion: “Health services delivery in dermatology is an exciting and evolving field. With the changing health care environment and a growing demand for dermatologic services, technology-enabled health care delivery models have the potential to increase access and improve outcomes. … As with any novel health services delivery models, comparative effectiveness studies investigating health outcomes are critical to evaluate these new models in an evidence-based approach.
(JAMA Dermatology. Published online October 22, 2014. doi:10.1001/jamadermatol.2014.2299.