Heather Kornmehl1, Sanminder Singh2, Mary Ann Johnson3, April W Armstrong4,5. 1. 1 Drexel University College of Medicine , Philadelphia, Pennsylvania. 2. 2 University of California , Davis School of Medicine, Sacramento, California. 3. 3 Department of Dermatology, Mercy Medical Group , Eldorado Hills, California. 4. 4 Southern California Clinical and Translational Science Institute (CTSI) , Los Angeles, California. 5. 5 Department of Dermatology, Keck School of Medicine, University of Southern California , Los Angeles, California.
Abstract
BACKGROUND:Atopic dermatitis (AD) is a chronic disease requiring regular follow-up. To increase access to dermatological care, online management of AD is being studied. However, a critical knowledge gap exists in determining AD patients' quality of life in direct-to-patient online models. In this study, we examined quality of life in AD patients managed through a direct-access online model. MATERIALS AND METHODS: We randomized 156 patients to receiving care through a direct-access online platform or in person. Patients were seen for six visits over 12 months. At each visit, the patients completed Dermatology Life Quality Index/Children's Dermatology Life Quality Index (DLQI/CDLQI), and Short Form (SF-12). RESULTS: Between baseline and 12 months, the mean (standard deviation, SD) within-group difference in DLQI score in the online group was 4.1 (±2.3); for the in-person group, the within-group difference was 4.8 (±2.7). The mean (SD) within-group difference in CDLQI score in the online group was 4.7 (±2.8); for the in-person group, the within-group difference was 4.9 (±3.1). The mean (SD) within-group difference in physical component score (PCS) and mental component score (MCS) SF-12 scores in the online group was 6.5 (±3.8) and 8.6 (±4.3); for the in-person group, it was 6.8 (±3.2) and 9.1(±3.8), respectively. The difference in the change in DLQI, CDLQI, SF-12 PCS, and SF-12 MCS scores between the two groups was 0.72 (95% confidence interval [90% CI], -0.97 to 2.41), 0.23 (90% CI, -2.21 to 2.67), 0.34 (90% CI, -1.16 to 1.84), and 0.51 (90% CI, -1.11 to 2.13), respectively. All differences were contained within their equivalence margins. CONCLUSION:Adult and pediatric AD patients receivingdirect-access online care had equivalent quality of life outcomes as those see in person. The direct-access online model has the potential to increase access to care for patients with chronic skin diseases.
RCT Entities:
BACKGROUND:Atopic dermatitis (AD) is a chronic disease requiring regular follow-up. To increase access to dermatological care, online management of AD is being studied. However, a critical knowledge gap exists in determining ADpatients' quality of life in direct-to-patient online models. In this study, we examined quality of life in ADpatients managed through a direct-access online model. MATERIALS AND METHODS: We randomized 156 patients to receiving care through a direct-access online platform or in person. Patients were seen for six visits over 12 months. At each visit, the patients completed Dermatology Life Quality Index/Children's Dermatology Life Quality Index (DLQI/CDLQI), and Short Form (SF-12). RESULTS: Between baseline and 12 months, the mean (standard deviation, SD) within-group difference in DLQI score in the online group was 4.1 (±2.3); for the in-person group, the within-group difference was 4.8 (±2.7). The mean (SD) within-group difference in CDLQI score in the online group was 4.7 (±2.8); for the in-person group, the within-group difference was 4.9 (±3.1). The mean (SD) within-group difference in physical component score (PCS) and mental component score (MCS) SF-12 scores in the online group was 6.5 (±3.8) and 8.6 (±4.3); for the in-person group, it was 6.8 (±3.2) and 9.1(±3.8), respectively. The difference in the change in DLQI, CDLQI, SF-12 PCS, and SF-12 MCS scores between the two groups was 0.72 (95% confidence interval [90% CI], -0.97 to 2.41), 0.23 (90% CI, -2.21 to 2.67), 0.34 (90% CI, -1.16 to 1.84), and 0.51 (90% CI, -1.11 to 2.13), respectively. All differences were contained within their equivalence margins. CONCLUSION: Adult and pediatric ADpatients receiving direct-access online care had equivalent quality of life outcomes as those see in person. The direct-access online model has the potential to increase access to care for patients with chronic skin diseases.
Authors: Adam R Ford; Caitlin M Gibbons; Josefina Torres; Heather A Kornmehl; Sanminder Singh; Paulina M Young; Cindy J Chambers; Emanual Maverakis; Cory A Dunnick; April W Armstrong Journal: Telemed J E Health Date: 2018-09-14 Impact factor: 3.536
Authors: April W Armstrong; Adam R Ford; Cindy J Chambers; Emanual Maverakis; Cory A Dunnick; Mary-Margaret Chren; Joel M Gelfand; Caitlin M Gibbons; Brittany M Gibbons; Christianne J Lane Journal: J Invest Dermatol Date: 2018-11-24 Impact factor: 8.551
Authors: April W Armstrong; Cindy J Chambers; Emanual Maverakis; Michelle Y Cheng; Cory A Dunnick; Mary-Margaret Chren; Joel M Gelfand; David J Wong; Brittany M Gibbons; Caitlin M Gibbons; Josefina Torres; Andrea C Steel; Elizabeth A Wang; Caitlin M Clark; Sanminder Singh; Heather A Kornmehl; Reason Wilken; Aleksandra G Florek; Adam R Ford; Chelsea Ma; Nazanin Ehsani-Chimeh; Sucharita Boddu; Mayumi Fujita; Paulina M Young; Cesar Rivas-Sanchez; Brenda I Cornejo; Laura C Serna; Eric R Carlson; Christianne J Lane Journal: JAMA Netw Open Date: 2018-10-05