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Luo J, Yang Z, Xie Y, He Y, Wu M, Fang X, Liao X. Emerging Trends in Teledermatology Research: A Scientometric Analysis from 2002 to 2021. Telemed J E Health 2024; 30:393-403. [PMID: 37449779 DOI: 10.1089/tmj.2023.0101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/15/2023] Open
Abstract
Background: With advances in technology, teledermatology (TD) research has increased. However, an updated comprehensive quantitative analysis of TD research, especially one that identifies emerging trends of TD research in the coronavirus disease 2019 (COVID-19) era, is lacking. Objective: To conduct a scientometric analysis of TD research documents between 2002 and 2021 and explore the emerging trends. Methods: CiteSpace was used to perform scientometric analysis and yielded visualized network maps with corresponding metric values. Emerging trends were identified mainly through burst detection of keywords/terms, co-cited reference clustering analysis, and structural variability analysis (SVA). Results: A total of 932 documents, containing 27,958 cited references were identified from 2002 to 2021. Most TD research was published in journals from the "Dermatology" and "Health Care Sciences & Services" categories. American, Australian, and European researchers contributed the most research and formed close collaborations. Keywords/terms with strong burst values to date were "primary care," "historical perspective," "emerging technique," "improve access," "mobile teledermoscopy (TDS)," "access," "skin cancer," "telehealth," "recent finding," "artificial intelligence (AI)," "dermatological care," and "dermatological condition." Co-cited reference clustering analysis showed that the recently active cluster labels included "COVID-19 pandemic," "skin cancer," "deep neural network," and "underserved population." The SVA identified two reviews (Tognetti et al. and Mckoy et al.) that may be highly cited in the future. Conclusion: During and after the COVID-19 era, emerging trends in research on TD (especially mobile TDS) may be related to skin cancer and AI as well as further exploration of primary care in underserved areas.
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Affiliation(s)
- Jianzhao Luo
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China
| | - Ziyu Yang
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yao Xie
- Department of Dermatovenerology, West China Hospital, Sichuan University, Chengdu, China
| | - Yang He
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China
| | - Miaomiao Wu
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China
| | - Xiang Fang
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaoyang Liao
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China
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Li Y, Pulminskas A, Collins O, de la Feld S, Yeung H. Patient and Clinician Satisfaction in Teledermatology: Key Factors for Successful Implementation. CURRENT DERMATOLOGY REPORTS 2023; 12:161-168. [PMID: 38495517 PMCID: PMC10939000 DOI: 10.1007/s13671-023-00404-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2023] [Indexed: 03/19/2024]
Abstract
Purpose of review Teledermatology has emerged as a promising solution for remote dermatologic care, especially during COVID-19 pandemic. It improves access to care through information and communication technologies. This paper explores patient and clinician satisfaction in teledermatology. Recent findings Patient satisfaction encompasses various aspects, including future willingness, the quality of care, technical quality, and access to care. Clinician satisfaction is influenced by quality of care, implementation, technical aspects, clinician-patient rapport, and financial considerations. It is important to evaluate patient and clinician satisfaction in different teledermatology models, including store-and-forward, live interactive, and hybrid interactive approaches. Summary By evaluating satisfaction within different teledermatology models and addressing the factors that impact satisfaction, teledermatology can ensure high-quality care and promote positive outcomes. With proper implementation and ongoing evaluation, teledermatology has the potential to become a widely accepted and valuable component of dermatologic care, offering enhanced access to specialized services.
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Affiliation(s)
- Yiwen Li
- Emory University School of Medicine, Atlanta, GA
- Department of Dermatology, Emory University School of Medicine, Atlanta, GA
| | - Anna Pulminskas
- Emory University School of Medicine, Atlanta, GA
- Department of Dermatology, Emory University School of Medicine, Atlanta, GA
| | - Olivia Collins
- Clinical Resource Hub, VA Veterans Integrated Service Network 7, Decatur, GA
| | - Salma de la Feld
- Department of Dermatology, Emory University School of Medicine, Atlanta, GA
- Clinical Resource Hub, VA Veterans Integrated Service Network 7, Decatur, GA
| | - Howa Yeung
- Department of Dermatology, Emory University School of Medicine, Atlanta, GA
- Clinical Resource Hub, VA Veterans Integrated Service Network 7, Decatur, GA
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Taslidere N, Kucuk OS. Investigation of the effectiveness of teledermatology in the diagnosis of skin lesions in pediatric patients. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:e20230253. [PMID: 37729222 PMCID: PMC10511282 DOI: 10.1590/1806-9282.20230253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 07/22/2023] [Indexed: 09/22/2023]
Abstract
OBJECTIVE Teledermatology is the use of communications technology to enable the remote evaluation of skin lesions. Dermatological complaints are common among pediatric patients and should be handled differently than adults. The aim of this study is to group the dermatological lesions of pediatric patients who visited a dermatology outpatient clinic and to investigate in which groups the teledermatology method is more effective. METHODS This is a prospective observational study. Images of skin lesions, which were examined face-to-face in a dermatology outpatient clinic, were transmitted to another dermatologist via telecommunication. The diagnoses by the physician who examined patients face-to-face were compared with the diagnoses by the teledermatologist. Informed consent was obtained from the parents or legal representatives of all patients participating in this study. RESULTS A total of 93 pediatric patients were evaluated. In our study, the diagnoses by a dermatologist who evaluated patients face-to-face and the diagnoses by a teledermatologist were in agreement with 74.2% of the time. There was 100% agreement between both dermatologists for the diagnosis of acne and scabies. The diagnosis for verruca was consistent with 91.7% of the time, and for atopic dermatitis, it was 72.7%. There was a 25% consistency between both dermatologists on the diagnosis of contact dermatitis. The diagnostic consistency between both physicians was 53% in the erythematous disease group, 89% in the papulopustular group, and 70% in the pigmented group. CONCLUSION Teledermatology is a reliable diagnostic method that shortens the waiting time of patients and provides a quick consultation with a dermatologist. When using the teledermatology method, it is important to know which skin lesions or disease groups are more accurately diagnosed.
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Affiliation(s)
- Nazan Taslidere
- Demiroglu Bilim University, School of Medicine, Department of Dermatology – Istanbul, Turkey
| | - Ozlem Su Kucuk
- Bezmialem Vakif University, School of Medicine, Department of Dermatology – Istanbul, Turkey
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Gill C, Fischer AK, Dicke K, Teigelake B, Brans R, Skudlik C, John SM, Symanzik C. Teledermatological Follow-Up Consultations in Individual Prevention of Occupational Dermatoses: A Monocentric Feasibility Study on Quality and Satisfaction by Patients and Physicians. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6127. [PMID: 37372714 DOI: 10.3390/ijerph20126127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/05/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023]
Abstract
Teledermatology has become very popular, and not only due to the SARS-CoV-2 pandemic. Patients with occupational skin diseases (OSDs) could also benefit from teledermatology services as part of their follow-up care, but the opportunities and challenges for patients and dermatologists, especially regarding quality and satisfaction, need exploration. In this single-center feasibility study, 215 patients taking part in a tertiary prevention program for OSD were invited to participate. After obtaining consent, a follow-up video consultation appointment with the center's dermatologists was made. Quality and satisfaction with the consultations were evaluated by fully standardized online questionnaires filled in by the patients and dermatologists. A total of 68 teledermatological follow-up consultations were conducted by 10 dermatologists on 42 patients. Half of the dermatologists (50.0%) and 87.6% of the patients were satisfied with the video consultations. However, the lack of physical examination seems to be a problem, especially from the physicians' point of view (75.8%). A total of 66.1% of the dermatologists and 87.5% of the patients saw video consultations as useful supplements to face-to-face consultations. The results of our feasibility study indicate general satisfaction of patients and physicians with teledermatological sessions in occupational dermatology, especially as a useful supplement to face-to-face consultation.
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Affiliation(s)
- Carina Gill
- Department of Dermatology, Institute for Health Research and Education, Environmental Medicine and Health Theory, University of Osnabrück, Am Finkenhügel 7a, 49076 Osnabrück, Germany
| | - Ann-Kristin Fischer
- Department of Dermatology, Institute for Health Research and Education, Environmental Medicine and Health Theory, University of Osnabrück, Am Finkenhügel 7a, 49076 Osnabrück, Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Am Finkenhügel 7a, 49076 Osnabrück, Germany
| | - Katja Dicke
- Department of Dermatology, Institute for Health Research and Education, Environmental Medicine and Health Theory, University of Osnabrück, Am Finkenhügel 7a, 49076 Osnabrück, Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Am Finkenhügel 7a, 49076 Osnabrück, Germany
| | - Björn Teigelake
- Berufsgenossenschaft für Gesundheitsdienst und Wohlfahrtspflege (BGW), Gesundheitscampus-Süd 29, 44801 Bochum, Germany
| | - Richard Brans
- Department of Dermatology, Institute for Health Research and Education, Environmental Medicine and Health Theory, University of Osnabrück, Am Finkenhügel 7a, 49076 Osnabrück, Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Am Finkenhügel 7a, 49076 Osnabrück, Germany
- Lower Saxony Institute of Occupational Dermatology at the University of Osnabrück, 49076 Osnabrück, Germany
| | - Christoph Skudlik
- Department of Dermatology, Institute for Health Research and Education, Environmental Medicine and Health Theory, University of Osnabrück, Am Finkenhügel 7a, 49076 Osnabrück, Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Am Finkenhügel 7a, 49076 Osnabrück, Germany
- Lower Saxony Institute of Occupational Dermatology at the University of Osnabrück, 49076 Osnabrück, Germany
| | - Swen Malte John
- Department of Dermatology, Institute for Health Research and Education, Environmental Medicine and Health Theory, University of Osnabrück, Am Finkenhügel 7a, 49076 Osnabrück, Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Am Finkenhügel 7a, 49076 Osnabrück, Germany
- Lower Saxony Institute of Occupational Dermatology at the University of Osnabrück, 49076 Osnabrück, Germany
| | - Cara Symanzik
- Department of Dermatology, Institute for Health Research and Education, Environmental Medicine and Health Theory, University of Osnabrück, Am Finkenhügel 7a, 49076 Osnabrück, Germany
- Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the University of Osnabrück, Am Finkenhügel 7a, 49076 Osnabrück, Germany
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Martora F, Fabbrocini G, Megna M, Scalvenzi M, Battista T, Villani A, Potestio L. Teledermatology for Common Inflammatory Skin Conditions: The Medicine of the Future? Life (Basel) 2023; 13:life13041037. [PMID: 37109566 PMCID: PMC10146182 DOI: 10.3390/life13041037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 04/09/2023] [Accepted: 04/16/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic period revolutionized daily clinical practice. Several strategies were adopted by clinicians to avoid reducing treatment for diseases without the risk of spreading the infection. Among the adopted strategies, telemedicine played a key role. In this scenario, several tools were used, including e-mails, phone calls, video calls, support groups, and messages. Fortunately, the COVID-19 pandemic period seems to be at an end. However, the use of teledermatology appears to be an excellent strategy for the future as well. Indeed, several patients may benefit from teledermatology. OBJECTIVE In this manuscript, we aim to investigate the use of telemedicine in the dermatological field to point out how this tool may become the mainstay of future medicine. Only the use of teledermatology with common inflammatory skin conditions have been reported herein. MATERIALS AND METHODS Investigated manuscripts included metanalyses, reviews, letters to the editor, real-life studies, case series, and reports. Manuscripts were identified, screened, and extracted for relevant data following the PRISMA (preferred reporting items for systematic reviews and meta-analyses) guidelines. RESULTS A total of 121 records were identified from the analyzed databases. However, only 110 articles were assessed for eligibility. Finally, 92 articles were selected at the end of the literature research for our review. CONCLUSIONS Teledermatology should be considered as a viable option for the dermatologist for the future. We believe that the pandemic has strengthened this service, and this will allow for ever better development in the future. Guidelines regarding the use of teledermatology are required as well as additional improvements for the future.
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Affiliation(s)
- Fabrizio Martora
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Napoli, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Napoli, Italy
| | - Matteo Megna
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Napoli, Italy
| | - Massimiliano Scalvenzi
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Napoli, Italy
| | - Teresa Battista
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Napoli, Italy
| | - Alessia Villani
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Napoli, Italy
| | - Luca Potestio
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Napoli, Italy
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Ruggiero A, Martora F, Fabbrocini G, Villani A, Marasca C, Megna M, Fornaro L, Comune R, Potestio L. The Role of Teledermatology During the COVID-19 Pandemic: A Narrative Review. Clin Cosmet Investig Dermatol 2022; 15:2785-2793. [PMID: 36569420 PMCID: PMC9783831 DOI: 10.2147/ccid.s377029] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022]
Abstract
Teledermatology represented one of the most important and useful tools during the COVID-19 pandemic era. Indeed, due to the severe restriction, and to reduce the spread of the infection, different measures were applied among different countries and hospitals to ensure a continuity of care for patients. In this scenario, teledermatology played a central role, especially in the management of patients suffering from chronic inflammatory skin diseases. The aim of this narrative review is to describe the role of teledermatology during the COVID-19 pandemic to analyze main strengths and limitations of this tool, as well as to provide future perspectives in clinical applications.
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Affiliation(s)
- Angelo Ruggiero
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy,Correspondence: Angelo Ruggiero, Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini, 5, Naples, 80131, Italy, Tel +39 - 081 - 7462457, Fax +39 - 081 - 7462442, Email
| | - Fabrizio Martora
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Alessia Villani
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Claudio Marasca
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Matteo Megna
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Luigi Fornaro
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Rosita Comune
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Luca Potestio
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
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Duan GY, Ruiz De Luzuriaga AM, Schroedl L, Rosenblatt AE. Disparities in telemedicine use during the COVID-19 pandemic among pediatric dermatology patients. Pediatr Dermatol 2022; 39:520-527. [PMID: 35302248 PMCID: PMC9115291 DOI: 10.1111/pde.14982] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 01/03/2022] [Accepted: 03/01/2022] [Indexed: 12/28/2022]
Abstract
BACKGROUND/OBJECTIVES The COVID-19 pandemic necessitated rapid implementation of telemedicine at medical centers across the United States. As telemedicine is expected to persist beyond the pandemic in subspecialties like pediatric dermatology, there is growing concern that socioeconomic factors may contribute to inequitable telemedicine access. This study aims to identify factors associated with disparities in telemedicine use among pediatric dermatology patients during the pandemic. METHODS In this single-center cross-sectional study, patients less than 18 years old who completed a visit with a pediatric dermatologist via a video telemedicine call or in-person office visit during the specified time periods were included. Univariate and multivariable analyses were performed to compare demographic factors for (1) patients who had a telemedicine visit versus office visit during June 1, 2020, to January 22, 2021, and (2) patients who had either visit type during June 1, 2020, to January 22, 2021, versus June 1, 2019, to January 2020. RESULTS The independent factors associated with lower odds of telemedicine include identifying as Black/African American, having a non-English preferred language, and having public insurance, whereas the independent factors reducing overall access to pediatric dermatology care during the pandemic include identifying as Hispanic/Latino and having public insurance. CONCLUSIONS Differential telemedicine use in vulnerable communities may be attributed to disparities in technology access and digital literacy and should be addressed at a structural level. If such disparities are identified and adequately remedied, telemedicine can serve as an important tool for expanding access in the field of pediatric dermatology.
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Affiliation(s)
- Grace Y. Duan
- Pritzker School of MedicineThe University of ChicagoChicagoIllinoisUSA
| | | | - Liesl M. Schroedl
- Department of MedicineNorthShore University HealthSystemEvanstonIllinoisUSA
| | - Adena E. Rosenblatt
- Section of DermatologyDepartment of MedicineUniversity of Chicago Medical CenterChicagoIllinoisUSA
- Section of DermatologyDepartment of PediatricsUniversity of Chicago Medical CenterChicagoIllinoisUSA
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Miller J, Jones E. Shaping the Future of Teledermatology: A Literature Review of Patient and Provider Satisfaction with Synchronous Teledermatology during the COVID-19 Pandemic. Clin Exp Dermatol 2022; 47:1903-1909. [PMID: 35775880 PMCID: PMC9349528 DOI: 10.1111/ced.15320] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2022] [Indexed: 11/30/2022]
Abstract
Following the onset of the COVID-19 pandemic, widespread adoption of synchronous teledermatology (e.g., live videoconferencing) has increased patient and provider familiarity. To our knowledge, no teledermatology reviews have exclusively characterized patient and provider satisfaction with synchronous models of teledermatology. This study determines the quantitative evaluation of patient and provider satisfaction through a literature review of synchronous teledermatology studies conducted during the COVID-19 pandemic. A review of the literature was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines within the PubMed database. Search terms included, but were not limited to, teledermatology, patient satisfaction, and provider satisfaction. Studies were evaluated for quality of evidence based on guidelines described by the Oxford Center for Evidence-based Medicine. Fifteen studies satisfied the inclusion criteria which described the satisfaction of 7871 patients and 146 providers with synchronous teledermatology during the COVID-19 pandemic. Patients and providers were overall satisfied with access measures, the patient- provider relationship and the ability of synchronous teledermatology to meet patient needs. Limitations of the virtual physical exam and image or video quality were two consistent limiting factors in patient and provider experience, respectively. Patients and providers perceive that synchronous teledermatology meets the needs of the patient. Patients perceived satisfactory patient-provider relationship through synchronous teledermatology. Practices can identify best applications and educate patients on expectations of the virtual examination in order to enhance utilization and sustainability of synchronous teledermatology beyond the pandemic.
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Affiliation(s)
- John Miller
- Department of Dermatology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Elizabeth Jones
- Department of Dermatology, Thomas Jefferson University, Philadelphia, PA, USA
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Sun MD, Kentley J, Wilson BW, Soyer HP, Curiel-Lewandrowski CN, Rotemberg V, Halpern AC. Digital skin imaging applications, part I: Assessment of image acquisition technique features. Skin Res Technol 2022; 28:623-632. [PMID: 35652379 PMCID: PMC9907654 DOI: 10.1111/srt.13163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 05/03/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND The rapid adoption of digital skin imaging applications has increased the utilization of smartphone-acquired images in dermatology. While this has enormous potential for scaling the assessment of concerning skin lesions, the insufficient quality of many consumer/patient-taken images can undermine clinical accuracy and potentially harm patients due to lack of diagnostic interpretability. We aim to characterize the current state of digital skin imaging applications and comprehensively assess how image acquisition features address image quality. MATERIALS AND METHODS Publicly discoverable mobile, web, and desktop-based skin imaging applications, identified through keyword searches in mobile app stores, Google Search queries, previous teledermatology studies, and expert recommendations were independently assessed by three reviewers. Applications were categorized by primary audience (consumer-facing, nonhospital-based practice, or enterprise/health system), function (education, store-and-forward teledermatology, live-interactive teledermatology, electronic medical record adjunct/clinical imaging storage, or clinical triage), in-app connection to a healthcare provider (yes or no), and user type (patient, provider, or both). RESULTS Just over half (57%) of 191 included skin imaging applications had at least one of 14 image acquisition technique features. Those that were consumer-facing, intended for educational use, and designed for both patient and physician users had significantly greater feature richness (p < 0.05). The most common feature was the inclusion of text-based imaging tips, followed by the requirement to submit multiple images and body area matching. CONCLUSION Very few skin imaging applications included more than one image acquisition technique feature. Feature richness varied significantly by audience, function, and user categories. Users of digital dermatology tools should consider which applications have standardized features that improve image quality.
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Affiliation(s)
- Mary D Sun
- Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Dermatology Service, Memorial Sloan Kettering, New York, New York, USA
| | | | - Britney W Wilson
- Dermatology Service, Memorial Sloan Kettering, New York, New York, USA.,Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - H Peter Soyer
- Dermatology Research Centre, The University of Queensland Diamantina Institute, Brisbane, Queensland, Australia
| | | | | | - Allan C Halpern
- Dermatology Service, Memorial Sloan Kettering, New York, New York, USA
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- Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Teledermatology and Inflammatory Skin Conditions during COVID-19 Era: New Perspectives and Applications. J Clin Med 2022; 11:jcm11061511. [PMID: 35329838 PMCID: PMC8950226 DOI: 10.3390/jcm11061511] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/08/2022] [Accepted: 03/08/2022] [Indexed: 02/04/2023] Open
Abstract
Background: The most frequent inflammatory skin diseases are psoriasis, atopic dermatitis, hidradenitis suppurativa, and acne. Their management is challenging for dermatologists since their relapsing chronic clinical course is associated with a great impact on quality of life. Nevertheless, the recent introduction of novel therapies, such as biological drugs and small molecules has been changing the history of these diseases. Methods: A systematic review of the scientific literature of case reports, case series, epidemiological studies, reviews, and systematic reviews regarding teledermatology and inflammatory skin disease. Studies were identified, screened, and extracted for relevant data following the PRISMA (preferred reporting items for systematic reviews and meta-analyses) guidelines. Results: A total of 69 cases articles were included in the review. Conclusions: As we have shown in the review, several experiences of teledermatology for patients affected by inflammatory skin diseases have been demonstrated to increase due to clinical access to hospital and specialized health care services, allowing better access to specialized dermatology care for people living in remote areas, and saving costs and money with health care.
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11
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Gu L, Lipner SR. Review of Telemedicine for Management of Acne Patients. J Cutan Med Surg 2022; 26:393-397. [DOI: 10.1177/12034754221083978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Accelerated by the COVID-19 pandemic, telemedicine has changed the landscape of dermatology practice. This manuscript aims to review the role of telemedicine in acne management and provide management recommendations. A literature search of the PubMed and Scopus databases was conducted using keywords “acne,” “telemedicine,” “teledermatology,” “telehealth,” “virtual,” and “video.” Eight articles directly related to telemedicine and acne management were included in the study. In-person vs. telemedicine management of acne patients had high diagnostic concordance and similar efficacy and remission rates. Survey-based studies of acne patients reported high interest and satisfaction and no safety concerns with acne management via telemedicine. Telemedicine was reported as an effective triage tool. Prescription patterns for acne medications during telemedicine vs. in-person visits varied. It is likely that dermatologists will continue to treat acne and other common skin conditions via teledermatology. Therefore, it is important for dermatologists to gain comfort in utilizing virtual visits to diagnose and manage acne patients. Further studies are needed to establish a standardized structural framework for telemedicine visits to optimize patient care and outcomes for acne patients.
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Affiliation(s)
- Lilly Gu
- Weill Cornell Medicine, New York, NY, USA
| | - Shari R. Lipner
- Department of Dermatology, Weill Cornell Medicine, New York, NY, USA
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Choi ECE, Heng LW, Tan SY, Phan P, Chandran NS. Factors influencing use and perceptions of teledermatology: A mixed-methods study of 942 participants. JAAD Int 2022; 6:97-103. [PMID: 35128487 PMCID: PMC8805506 DOI: 10.1016/j.jdin.2021.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2021] [Indexed: 11/29/2022] Open
Abstract
Background The protracted COVID-19 pandemic highlights the need for a sustainable telemedicine practice. Objective To understand patient perceptions toward teledermatology. Methods Convergent parallel mixed-methods study of 942 dermatology patients or their caregivers between June 2020 and April 2021. Results Multivariate regression found that youth, increased computer use, willingness to show body areas over photo/video, perceived quality of teledermatology, demand for social distancing and to reduce commute were associated with willingness to use teledermatology. The willingness to use teledermatology declined with the easing of COVID-19 movement restrictions, and 48.5% reported a poorer experience with teledermatology than with in-person consultations. Qualitative data from 26 interviews showed that willingness to use is influenced by pragmatic considerations, emotional factors, and data privacy concerns. These were moderated by the patient's perception of disease severity and need for an accurate diagnosis. Limitations Lack of data prior to the pandemic and during the initial lockdown period. Conclusion The willingness to use teledermatology is influenced by circumstantial factors, technology literacy, views toward teledermatology, and factors driving the purpose of consultation. The declining willingness to use teledermatology with the easing pandemic, lower willingness to pay full in-clinic prices, and poorer experience compared with in-person consultations highlights the need to optimize this mode of delivery.
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Tang H, Wang J, Zhang Y, Ni J, Liu L, Fang J. Knowledge and behaviour of community residents' face mask-wearing during the COVID-19 pandemic: a cross-sectional study in Shanghai, China. BMJ Open 2022; 12:e052497. [PMID: 35149563 PMCID: PMC8844952 DOI: 10.1136/bmjopen-2021-052497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES COVID-19 is an infectious disease spreading through respiratory droplets. Using a face mask correctly is one of the essential preventive measures. We launched a survey to discover the current face mask-wearing problems for better prevention and control of the pandemic. SETTING/PARTICIPANTS A cross-sectional study was conducted with 1240 residents in Shanghai during 18-28 February 2020. Stratified random sampling was adopted in the urban area, urban-rural fringe area and rural area. A mobile self-designed questionnaire was used. MAIN OUTCOME MEASURES Analysis of the demographic and sociological factors influencing residents' face mask type selection, disposable surgical mask-wearing behaviour, replacement time and the storage method for reuse of disposable surgical masks. RESULTS The accuracy of residents' face mask type selection was rated 41.61% (513/1233), and that of urban-rural fringe residents, low-education residents, elderly residents, were low, respectively (p<0.001). 96.67% of residents always wore face masks in crowded public places. Multiple-factor analysis showed that region, gender and education level were the influencing factors for entirely fitting the disposable surgical mask to the face. Region was an influencing factor for not touching the mask's external surface while wearing or removing it. Education level was an influencing factor for recognising the external and inner mask surface, upper and lower edge of a disposable surgical mask. The accuracy of the mask replacement time was 25.63% (316/1223). It was low with elderly, low-education residents, respectively (p<0.001).The accuracy of residents' storage method for reuse of disposable surgical mask was 3.81% (47/1233), and region, age and education level were influencing factors. CONCLUSIONS Shanghai residents recorded a high rate of wearing face masks. Selection of an appropriate type of face mask, disposable surgical mask-wearing behaviour, replacement time and storage method for reuse of disposable surgical masks should be particularly emphasised in future behaviour change interventions.
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Affiliation(s)
- Huiyun Tang
- Department of General Practice, Jinyang Community Health Service Center, Shanghai, China
| | - Jian Wang
- Department of General Practice, Zhongshan Hospital,Fudan University, Shanghai, China
| | - Yuan Zhang
- Department of General Practice, Xu Jiahui Community Health Service Center, Shanghai, China
| | - Jun Ni
- Department of General Practice, Xinhe Community Health Service Center, Shanghai, China
| | - Lei Liu
- Department of General Practice, Jinyang Community Health Service Center, Shanghai, China
| | - Jialiang Fang
- Department of General Practice, Jinyang Community Health Service Center, Shanghai, China
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14
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Villani A, Annunziata MC, Megna M, Scalvenzi M, Fabbrocini G. Long-term results of teledermatology for acne patients during COVID-19 pandemic. J Cosmet Dermatol 2022; 21:1356-1357. [PMID: 35090188 PMCID: PMC9305435 DOI: 10.1111/jocd.14805] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 01/24/2022] [Indexed: 12/01/2022]
Affiliation(s)
- Alessia Villani
- Dermatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Maria Carmela Annunziata
- Dermatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Matteo Megna
- Dermatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Massimiliano Scalvenzi
- Dermatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Gabriella Fabbrocini
- Dermatology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
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15
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Omboni S, Padwal RS, Alessa T, Benczúr B, Green BB, Hubbard I, Kario K, Khan NA, Konradi A, Logan AG, Lu Y, Mars M, McManus RJ, Melville S, Neumann CL, Parati G, Renna NF, Ryvlin P, Saner H, Schutte AE, Wang J. The worldwide impact of telemedicine during COVID-19: current evidence and recommendations for the future. CONNECTED HEALTH 2022; 1:7-35. [PMID: 35233563 PMCID: PMC7612439 DOI: 10.20517/ch.2021.03] [Citation(s) in RCA: 63] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
During the COVID-19 pandemic, telemedicine has emerged worldwide as an indispensable resource to improve the surveillance of patients, curb the spread of disease, facilitate timely identification and management of ill people, but, most importantly, guarantee the continuity of care of frail patients with multiple chronic diseases. Although during COVID-19 telemedicine has thrived, and its adoption has moved forward in many countries, important gaps still remain. Major issues to be addressed to enable large scale implementation of telemedicine include: (1) establishing adequate policies to legislate telemedicine, license healthcare operators, protect patients' privacy, and implement reimbursement plans; (2) creating and disseminating practical guidelines for the routine clinical use of telemedicine in different contexts; (3) increasing in the level of integration of telemedicine with traditional healthcare services; (4) improving healthcare professionals' and patients' awareness of and willingness to use telemedicine; and (5) overcoming inequalities among countries and population subgroups due to technological, infrastructural, and economic barriers. If all these requirements are met in the near future, remote management of patients will become an indispensable resource for the healthcare systems worldwide and will ultimately improve the management of patients and the quality of care.
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Affiliation(s)
- Stefano Omboni
- Clinical Research Unit, Italian Institute of Telemedicine, Solbiate Arno, Varese 21048, Italy
- Department of Cardiology, Sechenov First Moscow State Medical University, Moscow 119991, Russia
| | - Raj S. Padwal
- Department of Medicine, University of Alberta, Edmonton, Alberta T6G 2R3, Canada
| | - Tourkiah Alessa
- Biomedical Technology Department, College of Applied Medical Science, King Saud University, Riyadh 11362, Saudi Arabia
| | - Béla Benczúr
- First Department of Internal Medicine (Cardiology-Nephrology), Balassa Janos County Hospital, Szekszard 7100, Hungary
| | - Beverly B. Green
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington, WA 98101, USA
| | - Ilona Hubbard
- Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne 1011, Switzerland
| | - Kazuomi Kario
- Department of Cardiology, Jichi Medical University School of Medicine, Tochigi 329-0498, Japan
| | - Nadia A. Khan
- Department of Medicine, University of British Columbia, Vancouver, British Columbia V6T 1Z4, Canada
| | - Alexandra Konradi
- Almazov National Medical Research Centre, Saint Petersburg 197341, Russia
| | - Alexander G. Logan
- Department of Medicine, University of Toronto, Toronto, Ontario M5S 1A1, Canada
- Sinai Health System, Lunenfeld-Tanenbaum Research Institute, Toronto, Ontario M5G 1X5, Canada
| | - Yuan Lu
- Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, CT 06510, USA
| | - Maurice Mars
- Department of TeleHealth, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban 4041, South Africa
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia 5042, Australia
| | - Richard J. McManus
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX1 2JD, UK
| | - Sarah Melville
- Division of Cardiology, Saint John Regional Hospital, Saint John, New Brunswick E2L 4L2, Canada
| | | | - Gianfranco Parati
- Department of Medicine and Surgery, University of Milano-Bicocca, Milano 20126, Italy
- Istituto Auxologico Italiano, IRCCS San Luca, Milano 20149, Italy
| | - Nicolas F. Renna
- Unit of Hypertension, Hospital Español de Mendoza, School of Medicine, National University of Cuyo, IMBECU-CONICET, Mendoza 5500, Argentina
| | - Philippe Ryvlin
- Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne 1011, Switzerland
| | - Hugo Saner
- ARTORG Center for Biomedical Engineering Research and Institute for Social and Preventive Medicine, University of Bern, Bern 3012, Switzerland
| | - Aletta E. Schutte
- School of Population Health, University of New South Wales, The George Institute for Global Health, Sydney 2042, New South Wales, Australia
- Hypertension in Africa Research Team, South African Medical Research Council Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom 2520, South Africa
| | - Jiguang Wang
- The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
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16
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Giavina-Bianchi M, Azevedo MFD, Cordioli E. Clinical Features of Acne in Primary Care Patients Assessed Through Teledermatology. J Prim Care Community Health 2022; 13:21501319221074117. [PMID: 35098785 PMCID: PMC8808038 DOI: 10.1177/21501319221074117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction/Objectives: Acne is present in about 90% of teenagers and 12% to 14% of adults. Face and trunk are the most affected areas. Lesions can result in postinflammatory hyperpigmentation and scarring, leading to reduced quality of life. Asynchronous teledermatology has been increasingly used around the world, facilitating patient access to dermatologists. Our objectives were to assess: (1) clinical features of acne patients according to gender, age, severity, site of lesions, excoriation, postinflammatory hyperpigmentation (PIH), and atrophic scar (AS) and (2) how many referrals to in-person consultations with dermatologists could be avoided using asynchronous teledermatology in primary care attention? Methods: We analyzed images, demographic and clinical data of 2459 acne patients assisted by teledermatology, with the aim to confirm the diagnoses, to classify acne severity according to grades I to IV, and to search for the presence of postinflammatory hyperpigmentation, atrophic scars, and/or excoriated acne (EA). We compared the clinical and biological data, looking for associations among them. Results: Acne severity and age were associated with the most common sequels: postinflammatory hyperpigmentation (mainly on the trunk and in females, P < .0001) and atrophic scars (mainly on the face and in males, P < .0001). We also observed different frequencies according to age and sex: 13 to 24 years in males (P = .0023); and <12 (P = .0023) and 25 to 64 years old (P <.0001) for females; 68% of the patients had no need for in-person dermatologists’ referral, being kept at primary care attention with proper diagnosis and treatment. Conclusion: Clinical features of acne and its sequels differ according to gender, age, site, and severity. The new findings of PIH associated with women and AS, with men, may help offer a more personalized management to patients. Teledermatology was suitable for the majority of the acne cases in primary care.
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Affiliation(s)
| | | | - Eduardo Cordioli
- Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil
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17
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Ibrahim AE, Magdy M, Khalaf EM, Mostafa A, Arafa A. Teledermatology in the time of COVID-19. Int J Clin Pract 2021; 75:e15000. [PMID: 34714575 PMCID: PMC8646275 DOI: 10.1111/ijcp.15000] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 09/20/2021] [Accepted: 10/27/2021] [Indexed: 12/11/2022] Open
Abstract
AIMS The enormous spread of the novel Corona virus disease (COVID-19) represents a challenge to dermatological practice. Accumulating evidence has suggested a possible role of teledermatology in facing this challenge. In this article, we aimed to give a general overview of teledermatology in terms of models of practice, modes of delivery, advantages, limitations, ethical considerations and legislative challenges as well as discussing, using examples from literature, how dermatological practice can benefit from teledermatology during the time of the COVID-19 pandemic. DISCUSSION AND CONCLUSION Teledermatology could be an accessible, accurate and cost-effective substitute for conventional face-to-face dermatological consultations during the COVID-19 pandemic. However, teledermatology practice needs updated legislation and guidelines. More efforts should be done to encourage dermatologists, especially in underserved communities, to provide teledermatology services. Ethical issues and data security related to teledermatology have to be considered.
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Affiliation(s)
- Ahmed Elsayed Ibrahim
- Department of NeuropsychiatryFaculty of MedicineAlexandria UniversityAlexandriaEgypt
| | - Mayar Magdy
- Barnet HospitalThe Royal Free London NHS Foundation TrustLondonUK
| | - Eslam M. Khalaf
- Department of Critical MedicineFaculty of MedicineAlexandria UniversityAlexandriaEgypt
| | - Alshimaa Mostafa
- Department of DermatologyGraduate School of MedicineKyoto UniversityKyotoJapan
- Department of DermatologyFaculty of MedicineBeni‐Suef UniversityBeni‐SuefEgypt
| | - Ahmed Arafa
- Department of Public HealthGraduate School of MedicineOsaka UniversitySuitaJapan
- Department of Public HealthFaculty of MedicineBeni‐Suef UniversityBeni‐SuefEgypt
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18
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Gu L, Diaz SM, Lipner SR. Retrospective study of acne telemedicine and in-person visits at an academic center during the COVID-19 pandemic. J Cosmet Dermatol 2021; 21:36-38. [PMID: 34757675 PMCID: PMC8661784 DOI: 10.1111/jocd.14606] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 09/20/2021] [Accepted: 11/01/2021] [Indexed: 01/03/2023]
Affiliation(s)
- Lilly Gu
- Weill Cornell Medical College, New York, New York, USA
| | | | - Shari R Lipner
- Department of Dermatology, Weill Cornell Medicine, New York, New York, USA
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19
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Lowe A, Dawood S, Al-Tayeb A, Hancock P, Pararajasingam A, Ali F, Goodwin RG. Evaluating paediatric dermatology telephone clinics during COVID-19 from a dual clinician and patient perspective: a prospective study. Clin Exp Dermatol 2021; 47:553-560. [PMID: 34674296 PMCID: PMC8652731 DOI: 10.1111/ced.14990] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 10/18/2021] [Accepted: 10/20/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND The landscape of dermatology services, already rapidly evolving into an increasingly digital one, has been irretrievably altered by the COVID-19 (SARS-CoV-2) pandemic. Data are needed to assess how best to deliver virtual dermatology services in specific patient subgroups in an era of ongoing social distancing and beyond. Initial studies of teledermatology in paediatric populations suggest that many of the problems experienced in adult telemedicine are more apparent when treating children and come with additional challenges. AIM To evaluate the efficacy of a virtual paediatric dermatology telephone clinic in comparison to traditional face-to-face (FTF) clinics, both from the clinician and patient/parental perspective. METHODS We carried out a prospective service evaluation examining a single centre cohort of paediatric dermatology patients managed during the COVID-19 pandemic via a telephone clinic supported by images. The study period covered June-September 2020. Data on outcomes were collected from clinicians and a qualitative patient/parental telephone survey was undertaken separately. A five-point Likert scale was used to assess both satisfaction and levels of agreement regarding whether a telephone clinic was more convenient than an FTF clinic. RESULTS Of 116 patients included, 24% were new and 76% were follow-up patients, with a mixture of inflammatory dermatoses (75%) and lesions (25%). From the clinician's perspective, most consultations (91%) were successfully completed over the telephone. However, qualitative patient and parent feedback paradoxically illustrated that although nearly all (98%) respondents had no outstanding concerns, 52% felt highly unsatisfied and only 22% agreed that telephone clinics were more convenient. Most (65%) preferred FTF follow-up in the future. Statistical analysis using χ² test showed that among those with established follow-ups, the preference for future consultation type was independent of specific reasons for follow-up. CONCLUSIONS Our study demonstrates a clear discrepancy between the practical successes of a virtual service from the clinician's perspective compared with the patient/parental perspective. Parental anxiety appears to be less effectively allayed virtually than with FTF. This raises the question of whether there is a role for virtual paediatric telephone clinics in the postpandemic future, which may be better left to patients/parents to decide on an individual basis.
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Affiliation(s)
- A Lowe
- Department of Dermatology, Royal Gwent Hospital, Newport, Gwent, Wales, UK
| | - S Dawood
- Department of Dermatology, Royal Gwent Hospital, Newport, Gwent, Wales, UK
| | - A Al-Tayeb
- Department of Dermatology, Royal Gwent Hospital, Newport, Gwent, Wales, UK
| | - P Hancock
- Department of Dermatology, Royal Gwent Hospital, Newport, Gwent, Wales, UK
| | - A Pararajasingam
- Department of Dermatology, Royal Gwent Hospital, Newport, Gwent, Wales, UK
| | - F Ali
- Department of Dermatology, Royal Gwent Hospital, Newport, Gwent, Wales, UK
| | - R G Goodwin
- Department of Dermatology, Royal Gwent Hospital, Newport, Gwent, Wales, UK
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20
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Telehealth at scale can improve chronic disease management in the community during a pandemic: An experience at the time of COVID-19. PLoS One 2021; 16:e0258015. [PMID: 34587198 PMCID: PMC8480747 DOI: 10.1371/journal.pone.0258015] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 09/15/2021] [Indexed: 12/22/2022] Open
Abstract
Background During the COVID-19 pandemic, telehealth became a vital resource to contain the virus’s spread and ensure continuity of care of patients with a chronic condition, notably arterial hypertension and heart disease. This paper reports the experience based on a telehealth platform used at scale to manage chronic disease patients in the Italian community. Methods and findings Patients’ health status was remotely monitored through ambulatory blood pressure monitoring (ABPM), resting or ambulatory electrocardiogram (ECG), spirometry, sleep oximetry, and cardiorespiratory polysomnography performed in community pharmacies or general practitioners’ offices. Patients also monitored their blood pressure (BP), heart rate (HR), blood oxygen saturation (SpO2), body temperature, body weight, waist circumference, blood glucose, and lipids at home through a dedicated smartphone app. All data conveyed to the web-based telehealth platform were used to manage critical patients by doctors promptly. Data were analyzed and compared across three consecutive periods of 2 months each: i) before the national lockdown, ii) during the lockdown (from March 9 to May 17, 2020), and iii) after the end of the containment measures. Overall, 13,613 patients visited community pharmacies or doctors’ offices. The number of overall tests dropped during and rose after the lockdown. The overall proportion of abnormal tests was larger during the outbreak. A significant increase in the prevalence of abnormal ECGs due to myocardial ischemia, contrasted by a significantly improved BP control, was observed. The number of home users and readings exchanged increased during the pandemic. In 226 patients, a significant increase in the proportion of SpO2 readings and a significant reduction in the entries for all other parameters, except BP, was observed. The proportion of abnormal SpO2 and BP values was significantly lower during the lockdown. Following the lockdown, the proportion of abnormal body weight or waist circumference values increased. Conclusions Our study results support the usefulness of a telehealth solution to detect deterioration of the health status during the COVID-19 pandemic. Trial registration The study is registered with ClinicalTrials.gov at number NCT03781401.
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Affiliation(s)
- Cassandra B Yeboah
- Philadelphia College of Osteopathic Medicine, 4170 City Avenue, Philadelphia, PA 19131, USA
| | - Nailah Harvey
- Philadelphia College of Osteopathic Medicine, 4170 City Avenue, Philadelphia, PA 19131, USA
| | - Rohan Krishnan
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, 4170 City Avenue, Philadelphia, PA 19131, USA
| | - Jules B Lipoff
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, 4170 City Avenue, Philadelphia, PA 19131, USA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA.
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22
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Ceryn J, Niedźwiedź M, Skibińska M, Ciążyńska M, Lesiak A, Narbutt J. COVID-19 in Patients with Atopic Dermatitis Treated with Dupilumab: Three Cases and a Literature Review. Clin Cosmet Investig Dermatol 2021; 14:1131-1138. [PMID: 34475772 PMCID: PMC8407774 DOI: 10.2147/ccid.s321003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 07/14/2021] [Indexed: 12/30/2022]
Abstract
There are limited clinical data on the impact of the SARS-CoV2 infection on patients with dermatological conditions treated with biologics. Dupilumab is a recombinant human IgG4 human monoclonal antibody that inhibits IL4 and IL13 signaling, and is used for moderate–severe atopic dermatitis treatment. We present three patients with atopic dermatitis (AD) treated with dupilumab who contracted COVID-19. In all patients, the infection had a mild course, and only in one, as documented by SCORAD, EASI, and DLQI scores, the condition of the skin deteriorated, and a prolonged positive PCR COVID-19 test was observed. The mechanism of dupilumab action and more evidence for IL13 importance in lung damage caused by SARS-CoV2 suggest a possible explanation for a mild–moderate course of the infection in treated AD patients. Based on current knowledge, there is evidence to continue dupilumab treatment in AD patients with mild–moderate COVID-19; however, careful assessment is needed for each patient.
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Affiliation(s)
- Justyna Ceryn
- Department of Dermatology, Pediatric Dermatology and Dermatological Oncology, International Doctoral School of the Medical University of Lodz, Lodz, 91-347, Poland
| | - Michał Niedźwiedź
- Department of Dermatology, Pediatric Dermatology and Dermatological Oncology, International Doctoral School of the Medical University of Lodz, Lodz, 91-347, Poland
| | - Małgorzata Skibińska
- Department of Dermatology, Pediatric Dermatology and Dermatological Oncology, International Doctoral School of the Medical University of Lodz, Lodz, 91-347, Poland
| | - Magdalena Ciążyńska
- Department of Proliferative Diseases, Nicolaus Copernicus Multidisciplinary Centre for Oncology and Traumatology, Lodz, Poland
| | - Aleksandra Lesiak
- Department of Dermatology, Pediatric Dermatology and Dermatological Oncology, International Doctoral School of the Medical University of Lodz, Lodz, 91-347, Poland
| | - Joanna Narbutt
- Department of Dermatology, Pediatric Dermatology and Dermatological Oncology, International Doctoral School of the Medical University of Lodz, Lodz, 91-347, Poland
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23
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Ragamin A, de Wijs LEM, Hijnen DJ, Arends NJT, Schuttelaar MLA, Pasmans SGMA, Bronner MB. Care for children with atopic dermatitis in the Netherlands during the COVID-19 pandemic: Lessons from the first wave and implications for the future. J Dermatol 2021; 48:1863-1870. [PMID: 34459024 PMCID: PMC8652427 DOI: 10.1111/1346-8138.16130] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 06/21/2021] [Accepted: 08/15/2021] [Indexed: 12/23/2022]
Abstract
The first wave of the coronavirus disease 2019 (COVID‐19) pandemic had an enormous impact on health‐care services, including on care provision for children with atopic dermatitis (AD). We investigated the impact of COVID‐19 on the care for children with moderate to severe AD at our tertiary outpatient clinic and examined satisfaction with care. We reviewed outpatient records, comparing total number and types of consultations during the first COVID‐19 wave (March until July 2020) with the corresponding months of 2019 and 2018. In addition, we conducted a questionnaire‐based study investigating the impact of COVID‐19 on clinical and psychological symptoms, and satisfaction with care. A total number of 913 consultations (466 individual children) were conducted during the first COVID‐19 wave in 2020, while 698 (391 individual children) and 591 consultations (356 individual children) were conducted in 2019 and 2018. The proportion of remote consultations was higher (56.2%) compared to 14.0% in 2019 and 12.7% in 2018. Worsening of AD was reported by 9.7% of caretakers. Overall satisfaction with provided care was high (8.6; interquartile range [IQR] = 7.3–10.0). Caretakers receiving face‐to‐face consultation were significantly (p = 0.026) more satisfied (9.0; IQR = 8.0–10.0) than caretakers receiving remote consultation (7.9; IQR = 7.0–9.5). The COVID‐19 pandemic had an unprecedented impact on care provision for children with AD, particularly on the number of remote consultations. Overall satisfaction with care was high. The impact of COVID‐19 on disease severity remained limited. Remote consultations seem to be a useful tool that can be put into practice during the COVID‐19 pandemic.
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Affiliation(s)
- Aviël Ragamin
- Department of Dermatology-Center of Pediatric Dermatology, Erasmus MC University Medical Center Rotterdam-Sophia Children's Hospital-Kinderhaven, Rotterdam, The Netherlands.,Department of Dermatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Linde E M de Wijs
- Department of Dermatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Dirk-Jan Hijnen
- Department of Dermatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Nicolette J T Arends
- Department of Pediatric Pulmonology and Allergology, Erasmus MC University Medical Center Rotterdam-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Marie L A Schuttelaar
- Departments of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Suzanne G M A Pasmans
- Department of Dermatology-Center of Pediatric Dermatology, Erasmus MC University Medical Center Rotterdam-Sophia Children's Hospital-Kinderhaven, Rotterdam, The Netherlands.,Department of Dermatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Madelon B Bronner
- Department of Dermatology-Center of Pediatric Dermatology, Erasmus MC University Medical Center Rotterdam-Sophia Children's Hospital-Kinderhaven, Rotterdam, The Netherlands.,Department of Dermatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
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Dvornikov AS, Minkina OV, Grebenshchikova EG, Vvedenskaya EV, Mylnikova IS. Dermatology and telemedicine: goals, advantages and disadvantages. BULLETIN OF RUSSIAN STATE MEDICAL UNIVERSITY 2021. [DOI: 10.24075/brsmu.2021.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
COVID-19 pandemic has made changes to conventional health care. In view of the need for “social distancing”, telemedicine services became most in demand, which constituted a reform of the previous doctor-patient relationship format; dermatology was no exception. Increased use of teledermatology (TD) all over the world elevated the relevance of the set of challenges related to teledermatology potential and limits, particularly in the light of the expectations of the technology broader application during the post-pandemic period. The review addresses the issues related to accounting for quality of health care, understanding the social and humanitarian context of TD, as well as the impact on professional education.
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Affiliation(s)
- AS Dvornikov
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - OV Minkina
- Pirogov Russian National Research Medical University, Moscow, Russia
| | | | - EV Vvedenskaya
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - IS Mylnikova
- Pirogov Russian National Research Medical University, Moscow, Russia
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Abstract
The coronavirus disease 2019 (COVID-19) pandemic has fundamentally transformed the landscape of providing dermatologic care. In an age of lockdowns and social distancing, teledermatology (TD) has emerged as a powerful tool to deliver remote care. Here, we review literature on TD use during the pandemic to evaluate the positives and negatives of TD implementation. We especially consider the reception of TD in underserved communities and the developing world as well as the ethico-legal challenges wrought by the burgeoning utilization of this new paradigm of care. The potential of TD to occupy a more prominent role in dermatologic care in a post-COVID-19 world is also discussed.
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Affiliation(s)
- Morgan A Farr
- School of Medicine, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX, 77030, USA
| | - Madeleine Duvic
- Department of Dermatology, MD Anderson Cancer Center, Houston, TX, USA
| | - Tejas P Joshi
- School of Medicine, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX, 77030, USA.
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Kaunitz G, Yin L, Nagler AR, Sicco KL, Kim RH. Assessing Patient Satisfaction with Live-Interactive Teledermatology Visits During the COVID-19 Pandemic: A Survey Study. Telemed J E Health 2021; 28:591-596. [PMID: 34152849 DOI: 10.1089/tmj.2021.0200] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background: Coronavirus disease 2019 (COVID-19) has brought teledermatology to the forefront. Understanding patients' experiences will clarify its benefits and limitations. Materials/Methods: Patients evaluated through live-interactive teledermatology at New York University Langone Health March-June 2020 were surveyed. Patient demographics, satisfaction with, and preferences between teledermatology and in-person visits across four domains (visit preparation, provider communication, physical examination, and treatment plan/follow-up) were collected. Results/Discussion: Of 602 respondents, >70% indicated at least equal satisfaction compared with in-person visits across all domains. More than a quarter of patients were dissatisfied with the virtual examination and more than half preferred in-person examinations. Male gender was associated with treatment plan/follow-up satisfaction (p = 0.03). Patients ≥66 years preferred in-person visit preparation, communication, and treatment plan/follow-up (all p < 0.01). New patients were less satisfied with teledermatology communication (p = 0.02) and treatment plan/follow-up (p < 0.01) but preferred teledermatology visit preparation (p = 0.01). Conclusions: Patients were satisfied with live-interactive teledermatology during the COVID-19 pandemic, although preferred in-person physical examinations. Satisfaction and preferences varied between patient populations.
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Affiliation(s)
- Genevieve Kaunitz
- The Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, New York, USA
| | - Lu Yin
- The Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, New York, USA
| | - Arielle R Nagler
- The Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, New York, USA
| | - Kristen Lo Sicco
- The Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, New York, USA
| | - Randie H Kim
- The Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, New York, USA
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Handa S, Mehta H, Bishnoi A, Vinay K, Mahajan R, Narang T, Kumaran MS, De D, Dogra S, Parsad D. Teledermatology during the COVID-19 pandemic: Experience at a tertiary care centre in North India. Dermatol Ther 2021; 34:e15022. [PMID: 34089561 PMCID: PMC8209945 DOI: 10.1111/dth.15022] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 05/31/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Teledermatology has evolved as a valuable option to outpatient visits during the current pandemic. We set up a smartphone-based hybrid model of teledermatology services providing direct care to patients at our center. To analyse patient and physician-experience and acceptability for teledermatology over a 6-month-period, along with clinicodemographic profile of patients. METHODOLOGY Single-center, retrospective study conducted from May 20, 2020 to October 31, 2020. Patient satisfaction level for teledermatology was assessed on a 4-point scale and compared with the satisfaction level during their previous physical visits prior to COVID-19 pandemic. A physician assessment form was utilised to record the experience of dermatologists while providing teledermatology services. RESULTS Of 7530 patients registered, a successful consult was provided to 6125 patients (81.34%). Average number of teleconsultations/day rose from 23.60 in May 2020 to 77.96 in October 2020. Mean age of patients availing teledermatology services was 33.60 ± 16.99 years. Average distance to care and travel time were 100.90 ± 171.77 km and 135 ± 222.32 min, respectively. A definitive diagnosis could be ascertained in 5724 patients (93.45%) and in-person visit was recommended to 133 patients (2.2%). Out of 6125 patients, 5229 could be contacted for feedback, 935 (18.18%), 2230 (42.65%), 1749 (33.45%), and 300 patients (5.70%) reported being very satisfied, satisfied, partially satisfied, and unsatisfied, respectively. Of 1914 patients, who had availed in-person OPD facilities prior to the pandemic, 914 patients (49.62%) preferred in-person visits. Of 34 dermatologists surveyed, 88.2% felt comfortable providing teleconsultations and 82.4% felt the need to continue teledermatology services in the upcoming months. CONCLUSIONS Overall, teledermatology is a valid alternative for in-person dermatology visits during the current crisis; helping with initial triage and further patient management. Further refinement of the process could lead to even more acceptability.
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Affiliation(s)
- Sanjeev Handa
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Hitaishi Mehta
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Anuradha Bishnoi
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Keshavamurthy Vinay
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Rahul Mahajan
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Tarun Narang
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Muthu Sendhil Kumaran
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Dipankar De
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sunil Dogra
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Davinder Parsad
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Kasperkiewicz M, Yale M, Strong R, Zillikens D, Woodley DT, Recke A. COVID-19 pandemic and autoimmune bullous diseases: a cross-sectional study of the International Pemphigus and Pemphigoid Foundation. J Eur Acad Dermatol Venereol 2021; 35:e418-e421. [PMID: 33724560 PMCID: PMC8250878 DOI: 10.1111/jdv.17228] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 02/21/2021] [Accepted: 03/09/2021] [Indexed: 10/26/2022]
Affiliation(s)
- M Kasperkiewicz
- Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - M Yale
- International Pemphigus and Pemphigoid Foundation, Sacramento, CA, USA
| | - R Strong
- International Pemphigus and Pemphigoid Foundation, Sacramento, CA, USA
| | - D Zillikens
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - D T Woodley
- Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - A Recke
- Department of Dermatology, University of Lübeck, Lübeck, Germany
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Fluhr JW, Gueguen A, Legoupil D, Brenaut E, Abasq C, Araújo H, Misery L. Teledermatology in Times of COVID-19 Confinement: Comparing Patients' and Physicians' Satisfaction by the Standardized Brest Teledermatology Questionnaire. Dermatology 2021; 237:1-6. [PMID: 33567427 PMCID: PMC8018192 DOI: 10.1159/000514029] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 12/04/2020] [Indexed: 11/19/2022] Open
Abstract
The French government imposed the first COVID-19 pandemic lockdown from March 17 until May 11, 2020. Only emergency cases and teledermatology (TD) were allowed in outpatient settings. A standardized questionnaire was developed to compare the satisfaction level of patients and their treating physicians. Our main question was whether the patients would perceive TD as a valid alternative for direct physical face-to-face consultation. Eighty-two patients and their 4 treating dermatologists from one dermatology department participated in the study (43 females, 39 males) with a mean age of 46.6 years (SD ±23.9). The reason for TD was a chronic disease in the majority (87.8%), and mainly as a follow-up (96.3%). Regarding satisfaction, almost all categories rated around 9 on a 0-10 verbal analogue scale. The same level of global satisfaction could be seen between the patients and the physicians as well as for the quality of the patient-physician relation and whether all questions could be addressed during the TC. Physicians showed significantly higher scores than patients only for the category of "length" of the consultation. Gender, age, as well as distance between the clinic and home of the patient were not influencing factors for satisfaction. Regarding the technical parameters, the evaluation was mostly comparable for patients and physicians, but overall lower than the relational satisfaction parameters, especially for image quality. Patients were significantly more motivated to continue the TD after the lockdown than their treating dermatologists. We see an interest for implementing TD in specialized centers with chronic patients coming from remote places for regular follow-ups. TD cannot replace in-person patient-physician interaction, but was helpful during the lockdown. As a result, TD might become part of dermatology training to prepare for future lockdown situations.
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Affiliation(s)
- Joachim W Fluhr
- Univ Brest, LIEN, Brest, France,
- Department of Dermatology, CHRU Brest, Brest, France,
- Department of Dermatology, Charité - Universitätsmedizin, Berlin, Germany,
| | - Annie Gueguen
- Department of Dermatology, CHRU Brest, Brest, France
| | - Delphine Legoupil
- Univ Brest, LIEN, Brest, France
- Department of Dermatology, CHRU Brest, Brest, France
| | - Emilie Brenaut
- Univ Brest, LIEN, Brest, France
- Department of Dermatology, CHRU Brest, Brest, France
| | - Claire Abasq
- Univ Brest, LIEN, Brest, France
- Department of Dermatology, CHRU Brest, Brest, France
| | | | - Laurent Misery
- Univ Brest, LIEN, Brest, France
- Department of Dermatology, CHRU Brest, Brest, France
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Hamad J, Fox A, Kammire MS, Hollis AN, Khairat S. Evaluating the Experiences of New and Existing Teledermatology Patients During the COVID-19 Pandemic: Cross-sectional Survey Study. JMIR DERMATOLOGY 2021; 4:e25999. [PMID: 34028471 PMCID: PMC8104278 DOI: 10.2196/25999] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 01/21/2021] [Accepted: 04/17/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND As teledermatology has been widely adopted during the COVID-19 pandemic, it is essential to examine patients' experiences and satisfaction with teledermatology. OBJECTIVE We aimed to assess the teledermatology experiences of new and existing clinic patients in the context of the rapid shift toward teledermatology practices during the COVID-19 pandemic. METHODS We conducted a cross-sectional study of 184 teledermatology patients who were assessed during the COVID-19 pandemic at a major southeastern medical center from May 13 to June 5, 2020. The primary outcome was patient satisfaction levels among new and existing patients. The secondary outcome was patients' willingness to use teledermatology in the future. RESULTS Of the 288 teledermatology patients who were assessed during the study period, 184 (63.9%) completed the survey. Patients reported high overall satisfaction with teledermatology, with 86.4% (159/184) of participants reporting positive overall satisfaction and experiences with teledermatology. New patients had significantly higher Likert scores for overall satisfaction with teledermatology than those of follow-up patients (new patients: mean 4.70; existing patients: mean 4.43; P=.03). Overall, patients' satisfaction with teledermatology did not significantly differ based on age (P=.36), race and ethnicity (P=.46), education level (P=.11), residence (P=.74), or insurance status (P=.74). There were no significant differences in overall satisfaction between patients with and without prior telehealth experience (P=.53), between the video and telephone visit types (P=.17), and among platform types (P=.22). Prior telehealth experience was associated with higher odds of being willing to use telehealth in the future (odds ratio 2.39, 95% CI 1.31-4.35; P=.004). CONCLUSIONS This cross-sectional survey study demonstrates that during the rapid expansion of teledermatology, new clinic patients had significantly higher scores for overall satisfaction with their teledermatology experience compared to those of established clinic patients (P=.03). Prior telehealth experience was associated with higher odds of being willing to use teledermatology in the future. Overall, teledermatology expansion was met with high levels of patient satisfaction during the COVID-19 pandemic.
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Affiliation(s)
- Judy Hamad
- Department of Dermatology School of Medicine University of North Carolina at Chapel Hill Chapel Hill, NC United States
| | - Amy Fox
- Department of Dermatology School of Medicine University of North Carolina at Chapel Hill Chapel Hill, NC United States
| | - Maria Suzanne Kammire
- Department of Dermatology School of Medicine University of North Carolina at Chapel Hill Chapel Hill, NC United States
| | - Alison Nancy Hollis
- Department of Dermatology School of Medicine University of North Carolina at Chapel Hill Chapel Hill, NC United States
| | - Saif Khairat
- Carolina Health Informatics Program University of North Carolina at Chapel Hill Chapel Hill, NC United States
- Healthcare Systems School of Nursing University of North Carolina at Chapel Hill Chapel Hill, NC United States
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31
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Nlemadim A, Okoi-Obuli J, Odey F, Meremikwu M. Telemedicine for children with sickle cell anemia in a resource-poor setting during COVID-19 pandemic: An observational study. NIGERIAN JOURNAL OF MEDICINE 2021. [DOI: 10.4103/njm.njm_183_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Abstract
The first cases of coronavirus disease 2019 (COVID-19) in Iran were detected on February 19, 2020. Soon the entire country was hit with the virus. Although dermatologists were not immediately the frontline health care workers, all aspects of their practice were drastically affected. Adapting to this unprecedented crisis required urgent appropriate responses. With preventive measures and conserving health care resources being the most essential priorities, dermatologists, as an integral part of the health system, needed to adapt their practices according to the latest guidelines. The spectrum of the challenges encompassed education, teledermatology, lasers, and other dermatologic procedures, as well as management of patients who were immunosuppressed or developed drug reactions and, most importantly, the newly revealed cutaneous signs of COVID-19. These challenges have paved the way for new horizons in dermatology.
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Affiliation(s)
- Maryam Daneshpazhooh
- Department of Dermatology, Tehran University of Medical Sciences, Tehran, Iran; Autoimmune Bullous Diseases Research Center, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - HamidReza Mahmoudi
- Department of Dermatology, Tehran University of Medical Sciences, Tehran, Iran; Autoimmune Bullous Diseases Research Center, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Donnarumma M, Nocerino M, Lauro W, Annunziata MC, Marasca C, Fabbrocini G. Isotretinoin in acne treatment during the coronavirus disease 2019 (COVID-19): A retrospective analysis of adherence to therapy and side effects. Dermatol Ther 2020; 34:e14677. [PMID: 33320409 PMCID: PMC7883110 DOI: 10.1111/dth.14677] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 11/27/2020] [Accepted: 12/11/2020] [Indexed: 01/06/2023]
Affiliation(s)
- Marianna Donnarumma
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Mariateresa Nocerino
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Wanda Lauro
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Maria Carmela Annunziata
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Claudio Marasca
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
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34
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Ruggiero A, Marasca C, Ocampo-Garza SS, Fabbrocini G, Villani A. SMS support group in the management of acne: A useful tool to increase adherence to treatment. Dermatol Ther 2020; 34:e14663. [PMID: 33301224 DOI: 10.1111/dth.14663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 11/16/2020] [Accepted: 12/04/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Angelo Ruggiero
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Claudio Marasca
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Sonia Sofia Ocampo-Garza
- Dermatology Department, University Hospital "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Alessia Villani
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
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Elsner P. Teledermatologie in den Zeiten von COVID‐19 – ein systematisches Review. J Dtsch Dermatol Ges 2020; 18:841-847. [PMID: 32881258 PMCID: PMC7461179 DOI: 10.1111/ddg.14180_g] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 06/25/2020] [Indexed: 12/04/2022]
Abstract
Die COVID‐19‐Pandemie schränkt die Versorgung dermatologischer Patienten vielfach ein. Teledermatologische Leistungen wie die Videokonsultation oder die „Store‐and‐Forward “‐Teledermatologie könnten dies zumindest teilweise kompensieren. Diese systematische Übersicht fasst alle publizierten Studien zur Teledermatologie unter den Bedingungen der COVID‐19‐Pandemie zusammen. Sie stützt sich auf eine MEDLINE‐Recherche nach Artikeln aus dem Jahr 2020 in englischer und deutscher Sprache. Zwei Umfragen unter Dermatologen aus den USA und Indien ergaben, dass mehr als 80 % teledermatologische Versorgung anboten. Unter deutschen Dermatologen boten von 480 Antwortenden 17,5 % eine Online ‐Video‐Konsultation, 11,3 % eine Offline ‐Beratung (Store and Forward ) und 10,0 % beide Verfahren an. Fünf Kohortenstudien zur Teledermatologie während der Pandemie wurden identifiziert. Drei davon untersuchten teledermatologische Verfahren bei chronischen Dermatosen (Akne, entzündliche Hauterkrankungen), eine beschäftigte sich mit der Betreuung onkologischer Patienten mit dermatologischen Komplikationen, und eine analysierte Telekonsile bei COVID‐19‐Verdachtsfällen. In allen Studien konnten durch die Teledermatologie persönliche Konsultationen weitgehend reduziert werden. Die Ergebnisse sprechen dafür, dass die Einschränkungen persönlicher dermatologischer Betreuung von Patienten mit Hautkrankheiten während der COVID‐19‐Pandemie durch eine Erweiterung teledermatologischer Leistungen zumindest teilweise kompensiert werden kann. Erkenntnisse aus der Nutzung der Teledermatologie während der Pandemie sollten für eine weitere Verbesserung des Einsatzes und der Akzeptanz der Teledermatologie bei Patienten und Dermatologen genutzt werden.
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Affiliation(s)
- Peter Elsner
- Klinik für HautkrankheitenUniversitätsklinikum Jena
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36
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Elsner P. Teledermatology in the times of COVID-19 - a systematic review. J Dtsch Dermatol Ges 2020; 18:841-845. [PMID: 33448667 DOI: 10.1111/ddg.14180] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 06/25/2020] [Indexed: 12/11/2022]
Abstract
The COVID-19 pandemic restricts the care of dermatological patients in many ways. Teledermatology such as video consultation or "store-and-forward" teledermatology could at least partly compensate for this. This systematic review summarizes all published studies on teledermatology during the COVID-19 pandemic. It is based on a MEDLINE search for articles from 2020 in English and German. Two surveys among dermatologists from the USA and India showed that more than 80 % offered teledermatology. Among German dermatologists 17.5 % of 480 respondents offered online video consultation, 11.3 % offline consultation (store and forward) and 10.0 % both. Five cohort studies on teledermatology during the pandemic were identified. Three of them investigated teledermatology in chronic dermatoses (acne, inflammatory skin diseases), one dealt with the care of oncological patients with dermatological complications, and one analyzed teleconsultation in suspected COVID-19 cases. In all studies, teledermatology largely reduced the number of personal consultations. The results indicate that the limitations of personal dermatological care of patients with skin diseases during the COVID-19 pandemic can be at least partially compensated by an extension of teledermatology. Findings from the use of teledermatology during the pandemic should be employed to improve the use and acceptance of teledermatology by patients and dermatologists.
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Affiliation(s)
- Peter Elsner
- Department of Dermatology, University Hospital Jena, Germany
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37
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Lang E, Martin A, Frank J. Digitalisierung in der Medizin während der COVID-19-Pandemie – Möglichkeiten und Grenzen der Teledermatologie. KOMPASS DERMATOLOGIE 2020. [PMCID: PMC7705936 DOI: 10.1159/000512398] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Bei Hautkrankheiten handelt es sich initial oft um Blickdiagnosen. Daher bieten sich dermatologische Fragestellungen für telemedizinische Konsultationen an. Die Ergebnisse zahlreicher internationaler Studien weisen darauf hin, dass die Teledermatologie sowohl von den Patienten als auch den Ärzten in zunehmendem Maße angenommen wird. Nach der Lockerung des Verbots der ausschließlichen Fernbehandlung durch den Ärztetag im Jahr 2018 können Ärzte ihre Patienten auch ohne vorherigen persönlichen Erstkontakt ausschließlich telefonisch oder per Internet behandeln. Durch die Zulassung und den Ausbau der telemedizinischen Tätigkeit in verschiedenen deutschen Bundesländern wurde und wird die Teledermatologie insbesondere während der COVID-19-Pandemie erfolgreich eingesetzt.
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Affiliation(s)
- Estefania Lang
- Dermanostic Online-Praxis für Dermatologie, Düsseldorf, Deutschland
| | - Alice Martin
- Klinik für Dermatologie, Allergologie und Dermatochirurgie, HELIOS Universitätsklinikum Wuppertal, Universität Witten/Herdecke, Witten, Deutschland
| | - Jorge Frank
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Göttingen, Göttingen, Deutschland
- *Univ.-Prof. Dr. med. Jorge Frank, Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Göttingen, Robert Koch Str. 40, Göttingen, Deutschland,
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