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A Randomized Trial to Evaluate the Efficacy of Online Follow-up Visits in the Management of Acne
Alice J. Watson, MBChB, MRCP, MPH;
Hagit Bergman, MD, MPH;
Christy M. Williams, MD;
Joseph C. Kvedar, MD
Arch Dermatol. 2010;146(4):406-411.
Objective To evaluate whether delivering acne follow-up care via an asynchronous, remote online visit (e-visit) platform produces equivalent clinical outcomes to office care.
Design A prospective, randomized controlled study.
Setting Two teaching hospitals in Boston between September 2005 and May 2007.
Participants A total of 151 patients with mild to moderate facial acne.
Interventions Subjects were asked to carry out 4 follow-up visits using either an e-visit platform or conventional office care. At 6-week intervals, subjects in the e-visit group were prompted to send images of their skin and an update, via a secure Web site, to their dermatologist. Dermatologists responded with advice and electronic prescriptions.
Main Outcome Measures The primary outcome measure was change in total inflammatory lesion count between the first and last visit. The major secondary outcomes were subject and dermatologist satisfaction with care and length of time to complete visits.
Results The mean age of subjects was 28 years; most were female (78%), white (65%), and college educated (69%). One hundred twenty-one of the initial 151 subjects completed the study. The decrease in total inflammatory lesion count was similar in the e-visit and office visit groups (6.67 and 9.39, respectively) (P = .49). Both subjects and dermatologists reported comparable satisfaction with care regardless of visit type (P = .06 and P = .16, respectively). Compared with office visits, e-visits were time saving for subjects and time neutral for dermatologists (4 minutes, 8 seconds vs 4 minutes, 42 seconds) (P = .57).
Conclusion Delivering follow-up care to acne patients via an e-visit platform produced clinical outcomes equivalent to those of conventional office visits.
Trial Registration clinicaltrials.gov Identifier: NCT00417456
Author Affiliations: Center for Connected Health, Boston, Massachusetts; Department of Dermatology, Massachusetts General Hospital, Boston; and Harvard Medical School, Boston.
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