Bridging the gap through telemedicine: Pilot study on the acceptance and use of teledermatology for urticaria

Abstract

Background: Chronic spontaneous urticaria (CSU) significantly impairs patients' quality of life. Despite advances in diagnosis and therapy, treatment is still unsatisfactory. Telemedicine offers a promising solution to improve treatment. This pilot study assesses the acceptability and utilization of a digital health model for CSU, examines its impact on disease management, and identifies technical challenges.

Patients and methods: In this prospective pilot study, CSU patients at a university hospital in Germany were included. Over 12 months, participants interacted with physicians via a telemedicine platform, which was the study-specific intervention. After each three-month digital visit, symptoms and quality of life were assessed using electronic patient reported outcomes (ePROs) and online questionnaires. In the end, patients and doctors rated the overall satisfaction, the user-friendliness of the platform and the technical challenges.

Results: 24 patients completed the study. The majority (92%) reported that the digital concept could be a promising alternative to traditional consultations. Analysis from baseline to end of study revealed that disease control remained stable while quality of life improved. All physicians found the digital application reliable and time-saving.

Conclusions: This pilot study demonstrates the feasibility and high acceptance of a digital health model for the management of CSU. Further research with larger cohorts is needed and planned to determine broader applicability.

Keywords: Chronic Urticaria; teledermatology; telemedicine; urticaria control test.

FIGURE 1

Study flow chart and time points of questionnaires: Flowchart showing the enrollment of 34 patients, with 25 registering on the platform. Questionnaires assessing disease control (UCT) and quality of life (DLQI) were administered after each visit and at the end of the study for overall satisfaction. Abbr.: UCT, Urticaria Control Test; DLQI, Dermatology Life Quality Index; n, number

FIGURE 2

Patient perceptions and acceptance of the digital care concept: Summary of patients' perception of the digital application and highlights its effectiveness as an alternative to face‐to‐face consultations, its trustworthiness, and its benefits for disease management.

FIGURE 3

UCT score over time: Boxplots of UCT scores at each visit. The Wilcoxon Signed‐Rank Test with continuity correction indicated a decrease in UCT scores from a mean of 13.67 at month ‐1 to 12.58 at month 12 (V  =  77, p  =  0.35), suggesting no significant change in symptom control over the study period.

FIGURE 4

DLQI score over time: Boxplots of DLQI scores at each visit. The Wilcoxon Signed‐Rank Test with continuity correction indicated a decrease in DLQI scores from a mean of 7.25 at month ‐1 to 3.54 at month 12 (V  =  108.5, p  =  0.04), suggesting an improvement in the quality of life over the study period.

FIGURE 5

Happiness score over time: Boxplots of Happiness Scores at each visit. The Wilcoxon Signed‐Rank Test with continuity correction showed no significant difference in Happiness Scores, with means of 6.42 at month ‐1 and 6.67 at month 12 (V  =  94.5, p  =  0.71), suggesting no significant change in patients' happiness over the study period.