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 Maverakis, Cory A. Dunnick, Mary Margaret Chren, Joel M. Gelfand, Caitlin M. Gibbons, Brittany M. Gibbons, Christianne J. Lane

Research output: Contribution to journalArticle

5 Scopus citations

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

ASJC Scopus subject areas

  • Biochemistry
  • Molecular Biology
  • Dermatology
  • Cell Biology

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    Armstrong, A. W., Ford, A. R., Chambers, C., Maverakis, E., Dunnick, C. A., Chren, M. M., Gelfand, J. M., Gibbons, C. M., Gibbons, B. M., & Lane, C. J. (2019). Online Care Versus In-Person Care for Improving Quality of Life in Psoriasis: A Randomized Controlled Equivalency Trial. Journal of Investigative Dermatology. https://doi.org/10.1016/j.jid.2018.09.039