1 Drexel University College of Medicine , Philadelphia, Pennsylvania.
2 University of California , Davis School of Medicine, Sacramento, California.
Telemed J E Health. 2017 Sep;23(9):726-732. doi: 10.1089/tmj.2016.0249. Epub 2017 Jun 1.
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.
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).
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.
Adult and pediatric AD patients 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.
特应性皮炎（AD）是一种需要定期随访的慢性疾病。为了增加获得皮肤科护理的机会，正在研究在线管理 AD。然而，在直接面向患者的在线模式中，确定 AD 患者生活质量方面存在一个关键的知识差距。在这项研究中，我们检查了通过直接访问在线模式管理的 AD 患者的生活质量。
我们将 156 名患者随机分配到通过直接访问在线平台或亲自接受护理。患者在 12 个月内接受了 6 次就诊。每次就诊时，患者都完成了皮肤病生活质量指数/儿童皮肤病生活质量指数（DLQI/CDLQI）和简短形式（SF-12）。
在基线和 12 个月之间，在线组的 DLQI 评分的组内差异平均值（标准差，SD）为 4.1（±2.3）；在亲自组中，组内差异为 4.8（±2.7）。在线组的 CDLQI 评分的组内差异平均值（SD）为 4.7（±2.8）；在亲自组中，组内差异为 4.9（±3.1）。在线组的 SF-12 物理成分评分（PCS）和心理成分评分（MCS）的组内差异平均值（SD）分别为 6.5（±3.8）和 8.6（±4.3）；在亲自组中，它分别为 6.8（±3.2）和 9.1（±3.8）。两组之间 DLQI、CDLQI、SF-12 PCS 和 SF-12 MCS 评分变化的差异为 0.72（95%置信区间[90%CI]，-0.97 至 2.41），0.23（90%CI，-2.21 至 2.67），0.34（90%CI，-1.16 至 1.84）和 0.51（90%CI，-1.11 至 2.13），分别。所有差异均在其等效范围内。
接受直接访问在线护理的成人和儿科 AD 患者的生活质量结果与亲自就诊的患者相当。直接访问在线模式有可能增加慢性皮肤病患者获得护理的机会。
