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

This 12-month, pragmatic, randomized controlled equivalency trial evaluated whether an online, collaborative connected-health model results in equivalent improvements in quality of life as compared to in-person care for psoriasis. 296 adults with physician-diagnosed psoriasis from ambulatory clinics were randomized to either online or in-person care; all were analyzed for outcomes. In the online group, patients and primary care providers (PCPs) 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 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%CI -5.18, 3.51) and was within the equivalence margin (±7.0). For the online group, the mean decline in Dermatology Life Quality Index (DLQI) was 1.64 (±4.34) compared with 1.18 (±4.77) for the in-person group. The difference in DLQI between the two groups was -0.45 (95%CI -1.29, 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 (PCORI) and registered on clinicaltrials.gov (NCT02358135).