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Trial Testing Mobile Telemedicine for Skin Diseases

Nora on smartphone

(Science 37)

1 Oct. 2019. A university medical center has a clinical trial underway testing the utility of telemedicine with mobile devices in treating atopic dermatitis, also known as eczema. The study by University of Southern California’s medical school is funded by a five-year, $3.4 million grant from National Institute of Arthritis and Musculoskeletal and Skin Diseases, part of National Institutes of Health.

Atopic dermatitis is a disorder that turns the skin red and itchy. The condition occurs most often in children, but can happen at any age, as a chronic condition that also flares up periodically. At present there is no cure for atopic dermatitis, with treatments like medicated creams and ointments designed to relieve the itching. The condition, while not considered dangerous, can lead to infections and disrupted sleep. The researchers cite data showing some 32 million people in the U.S. are affected by atopic dermatitis, with skin diseases overall accounting for 30 percent of doctors’ office visits.

The project is led by April Armstrong, professor of dermatology at USC and the school’s associate dean for clinical research. Armstrong and colleagues are testing team-based connected health, with the team in this case being the patient, primary care provider, and dermatologist acting to treat the patient’s skin condition. With team-based connected health, the parties use asynchronous online interactions, enabling the parties to consult with each other independent of time, sending and receiving images, text messages, and data. Within the team, researchers expect more interactions between patient and dermatologist, but primary care providers can also choose to manage the patient’s condition with this technology.

Part of that technology is a smartphone-based system called Network Oriented Research Assistant, or Nora, developed by Science 37, a contract research and clinical trial technology company in Los Angeles. Nora uses a smartphone’s connectivity and camera to record and transmit a patient’s condition in real time, in this case the state of a patient’s atopic dermatitis. Science 37 also provides central data capture and analytical tools, as well as clinical trial support functions as needed by study investigators and sponsors.

The clinical trial is recruiting 300 participants, both children and adults, with atopic dermatitis. Participants are then randomly assigned to receive care with team-based connected health or conventional in-person care. The team will primarily evaluate patients’ progress in treating atopic dermatitis with a standard rating scale, the Eczema Area and Severity Index, every three months, up to 12 months. The researchers are also measuring disease severity on other rating scales every 3 months, as well as quality of life measures, and indicators of health care use and costs.

The study aims to determine if team-based connected health can produce outcomes equivalent to conventional care for atopic dermatitis. “Our experts are committed to exploring innovative ways to provide advanced care for our patients,” says David Peng, chair and professor of clinical dermatology at USC in a Science 37 statement. “This includes examining how technology-enabled health care delivery can be used to allow patients to more easily access the care they need.”

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