The Journal of investigative dermatology · 2026
Impact of online versus in-person management of atopic dermatitis on QOL and access to care: A randomized controlled trial.
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Armstrong April W, Roberts Alyssa M, Kostandy Gina, Choudhury Farzana, Yee Danielle, Luu Minnelly, Jones Madison E, Alizadeh Elmar R, Cotliar Jonathan, Chren Mary-Margaret, Gelfand Joel M, Cockburn Myles, Doctor Jason N
Аннотация
BACKGROUND: Atopic dermatitis is a chronic skin disease that can significantly affect quality of life (QOL) and requires regular access to dermatologic care. However, traditional in-person visits often impose logistical challenges.
OBJECTIVES: The aim of this study was to evaluate whether an online, team-based connected health teledermatology model provides improvements in QOL equivalent to those provided by in-person management of atopic dermatitis and to examine access to care.
METHODS: We conducted a 12-month, pragmatic, randomized, controlled equivalence trial (NCT03981926) involving 300 participants aged ≥1 year with physician-diagnosed atopic dermatitis. Participants were randomized 1:1 to the online or in-person arm. QOL was assessed using the Dermatology Life Quality Index and EQ-5D-5L. Access was measured through the average time needed for evaluation.
RESULTS: For all QOL measures, the difference in mean change between arms fell within the prespecified equivalence margins: 0.12 (95% confidence interval = -0.18 to 0.42) for Dermatology Life Quality Index, 0.00 (95% confidence interval = -0.01 to 0.01) for utility index, and -0.11 (95% confidence interval = -0.70 to 0.48) for Visual Analog Scale. Team-based connected health significantly reduced the time needed for evaluation at baseline (P = .03).
CONCLUSION: For patients with atopic dermatitis, the online team-based connected health model resulted in equivalent improvements in QOL and reduced the time needed for evaluation at baseline.
OBJECTIVES: The aim of this study was to evaluate whether an online, team-based connected health teledermatology model provides improvements in QOL equivalent to those provided by in-person management of atopic dermatitis and to examine access to care.
METHODS: We conducted a 12-month, pragmatic, randomized, controlled equivalence trial (NCT03981926) involving 300 participants aged ≥1 year with physician-diagnosed atopic dermatitis. Participants were randomized 1:1 to the online or in-person arm. QOL was assessed using the Dermatology Life Quality Index and EQ-5D-5L. Access was measured through the average time needed for evaluation.
RESULTS: For all QOL measures, the difference in mean change between arms fell within the prespecified equivalence margins: 0.12 (95% confidence interval = -0.18 to 0.42) for Dermatology Life Quality Index, 0.00 (95% confidence interval = -0.01 to 0.01) for utility index, and -0.11 (95% confidence interval = -0.70 to 0.48) for Visual Analog Scale. Team-based connected health significantly reduced the time needed for evaluation at baseline (P = .03).
CONCLUSION: For patients with atopic dermatitis, the online team-based connected health model resulted in equivalent improvements in QOL and reduced the time needed for evaluation at baseline.