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Telemedicine produces same results as in-person care in patients with psoriasis
An online, collaborative connected-health model yielded many results that were statistically identical to adults receiving in-person care for their psoriasis, according to findings published in JAMA Network Open.
“The application of teledermatology has met with varied success,” April W. Armstrong, MD, MPH, of the department of dermatology at the Keck School of Medicine of the University of Southern California, and colleagues wrote. “Although ample evidence supports the diagnostic accuracy and reliability of asynchronous teledermatology, traditional consultative teledermatology has not been as widely adopted as previously expected.”
The lack of consistent access to specialty care may hinder many patients’ recovery from chronic skin diseases in much of the world, the researchers wrote.
Armstrong and colleagues developed a model that used the internet and a digital camera or a mobile phone with a video camera to allow 148 patients with psoriasis, and their primary care physicians, to access dermatologists online asynchronously. The dermatologist provided assessments, education, prescriptions and recommendations online while the same number of patients sought care from a dermatologist through an in-person office visit.
The mean change in the self-administered Psoriasis Area and Severity Index score between groups during the 12-month study period was –0.27 (95% CI, –0.85 to 0.31) and the mean change difference in body surface area affected by psoriasis was –0.05% (95% CI, –1.58 to 1.48), the researchers reported. The mean change difference in patient global assessment score was –0.11 (95% CI, –0.32 to 0.1), outside the realm of identical results, with patients in the online group showing greater improvement.
The online model had other benefits besides better patient scores, according to researchers.
“The online, collaborative connected-health model emphasized patient-centeredness by fostering increased patient engagement and providing comprehensive specialist support. The robust and responsive specialist support for patients and PCPs online was a substantial improvement from some of the existing modalities of specialty health care delivery,” Armstrong and colleagues wrote.
“Innovative telehealth delivery models that emphasize collaboration, quality and efficiency can be transformative to improving patient-centered outcomes among those with chronic diseases,” they wrote. – by Janel Miller
Disclosures: Armstrong reports serving as an investigator, consultant, adviser and/or speaker for AbbVie, Janssen, Leo, Lilly, Modmed, Modernizing Medicine, Novartis, Ortho Dermatologics, Pfizer, Regeneron, Sanofi and Science 37. Please see the study for all other authors’ relevant financial disclosures.
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