Online Care Versus In-Person Care for Improving Quality of Life in Psoriasis: A Randomized Controlled Equivalency Trial

April W. Armstrong, Adam R. Ford, Cynthia Chambers, Emanual Michael Maverakis, Cory A. Dunnick, Mary Margaret Chren, Joel M. Gelfand, Caitlin M. Gibbons, Brittany M. Gibbons, Christianne J. Lane

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

This 12-month, pragmatic, randomized controlled equivalency trial evaluated whether an online, collaborative connected-health model results in equivalent improvements in quality of life compared with in-person care for psoriasis. Overall, 296 adults with physician-diagnosed psoriasis from ambulatory clinics were randomly assigned to either online or in-person care; all were analyzed for outcomes. In the online group, patients and primary care providers sought dermatologists’ care directly and asynchronously online. The in-person group sought care face to face. Interventions did not allow blinding of participants; investigators were blinded during analysis. Across 12 months, for the online group, the mean ± standard deviation decline in Skindex-16 from baseline across follow-up visits was 9.02 ± 20.67 compared with 10.55 ± 23.50 for the in-person group. The difference in Skindex-16 between the two groups was –0.83 (95% confidence interval = –5.18 to 3.51), and this was within the equivalence margin (±7.0). For the online group, the mean ± standard deviation decline in Dermatology Life Quality Index was 1.64 ± 4.34 compared with 1.18 ± 4.77 for the in-person group. The difference in Dermatology Life Quality Index between the two groups was –0.45 (95% confidence interval = –1.29 to 0.38) and was within the equivalence margin (±2.5). In conclusion, the online model was as effective as in-person care in improving quality of life among psoriasis patients. This study was funded by the Patient-Centered Outcomes Research Institute and is registered on clinicaltrials.gov (NCT02358135).

Original languageEnglish (US)
JournalJournal of Investigative Dermatology
DOIs
StatePublished - Jan 1 2019

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Dermatology
Psoriasis
Randomized Controlled Trials
Quality of Life
Health
Patient Outcome Assessment
Confidence Intervals
Primary Health Care
Patient Care
Research Personnel
Physicians

ASJC Scopus subject areas

  • Biochemistry
  • Molecular Biology
  • Dermatology
  • Cell Biology

Cite this

Online Care Versus In-Person Care for Improving Quality of Life in Psoriasis : A Randomized Controlled Equivalency Trial. / Armstrong, April W.; Ford, Adam R.; Chambers, Cynthia; Maverakis, Emanual Michael; Dunnick, Cory A.; Chren, Mary Margaret; Gelfand, Joel M.; Gibbons, Caitlin M.; Gibbons, Brittany M.; Lane, Christianne J.

In: Journal of Investigative Dermatology, 01.01.2019.

Research output: Contribution to journalArticle

Armstrong, April W. ; Ford, Adam R. ; Chambers, Cynthia ; Maverakis, Emanual Michael ; Dunnick, Cory A. ; Chren, Mary Margaret ; Gelfand, Joel M. ; Gibbons, Caitlin M. ; Gibbons, Brittany M. ; Lane, Christianne J. / Online Care Versus In-Person Care for Improving Quality of Life in Psoriasis : A Randomized Controlled Equivalency Trial. In: Journal of Investigative Dermatology. 2019.
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abstract = "This 12-month, pragmatic, randomized controlled equivalency trial evaluated whether an online, collaborative connected-health model results in equivalent improvements in quality of life compared with in-person care for psoriasis. Overall, 296 adults with physician-diagnosed psoriasis from ambulatory clinics were randomly assigned to either online or in-person care; all were analyzed for outcomes. In the online group, patients and primary care providers sought dermatologists’ care directly and asynchronously online. The in-person group sought care face to face. Interventions did not allow blinding of participants; investigators were blinded during analysis. Across 12 months, for the online group, the mean ± standard deviation decline in Skindex-16 from baseline across follow-up visits was 9.02 ± 20.67 compared with 10.55 ± 23.50 for the in-person group. The difference in Skindex-16 between the two groups was –0.83 (95{\%} confidence interval = –5.18 to 3.51), and this was within the equivalence margin (±7.0). For the online group, the mean ± standard deviation decline in Dermatology Life Quality Index was 1.64 ± 4.34 compared with 1.18 ± 4.77 for the in-person group. The difference in Dermatology Life Quality Index between the two groups was –0.45 (95{\%} confidence interval = –1.29 to 0.38) and was within the equivalence margin (±2.5). In conclusion, the online model was as effective as in-person care in improving quality of life among psoriasis patients. This study was funded by the Patient-Centered Outcomes Research Institute and is registered on clinicaltrials.gov (NCT02358135).",
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