Economic Evaluation in Teledermatology

Study Overview
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Brief Summary
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Introduction: Previous studies confirm that teledermatology allows the generation of a quick response from the specialist's consultation, reduction of unnecessary travels, early diagnosis and priority in the attention to the most urgent cases. Despite these advantages and that teledermatology has experienced exponential growth since its introduction approximately 16 years ago in Spain, in Andalusia, its use is still very limited. The objective of this project will be to carry out an analysis of the quality of life related to health, costs, cost-utility and informal care of teledermatology services in Primary Care compared to conventional monitoring carried out at the Hospital de Poniente. Methodology: A randomized, controlled, unmasked, inter-level clinical trial (Primary Care-Hospital de Poniente) and multicentre (all health centers attached to the Poniente Health District of Almería) will be carried out with a 6-month follow-up. Patients will be assigned to the teledermatology group (experimental) or the conventional monitoring group in the hospital (control). The patients included in the experimental group will be monitored asynchronously. Baseline characteristics, number of visits to the hospital, health-related quality of life, costs, informal care and satisfaction from the perspective of the Andalusian Public Health System and patients and their caregivers will be analyzed. The generic EuroQol-5D questionnaire (EQ-5D) will be administered to assess health-related quality of life and the SKINDEX-29 quality of life dermatological questionnaire. A cost-utility analysis will be performed to assess whether tele-dermatology is cost-effective in terms of additional cost for additional quality-adjusted life years (QALYs).

Official Title
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Economic Evaluation in Dermatology: Teledermatology Versus Conventional Monitoring of Patients in the Hospital

Conditions
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Skin Diseases

Intervention / Treatment
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* Other: Teledermatology


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 1. Be over 18 years old. 2. Having any skin disease. 3. Accept to participate in the study. Exclusion Criteria: 1. Non-dermatological disease. 2. Be participating in another study. 3. Refuse to participate in the study.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Teledermatology<br>The 221 patients who are included in this group will be monitored from the Primary Care centers. | Other: Teledermatology<br>* The experimental group will be made up of dermatological patients monitored asynchronously.<br>|
| No Intervention: Conventional monitoring<br>The 221 patients included in this group will have to visit the dermatologist at the hospital. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| EuroQol-5Dimensions questionnaire | From -1 [the poorest imaginable health state] to 1 [perfect health] | 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Clinical features | Patient's age; sex; diagnosis; origin; indication (type of dermatological problem); number of visits | 6 months | 
| Dermatological Quality of Life Questionnaire | 0 (no effect on quality of life) up to 100 (maximum effect on quality of life) | 6 months | 
| Healthcare costs | Costs paid by the Public Health System | 6 months | 
| Informal cost | Costs paid by the patients | 6 months | 
| In-depth interviews on the healthcare received in Primary Care centers | 1) healthcare center, 2) procedure to make an appointment, 3) medical consultation, 4) nursing consultation | 6 months | 
| Health Care Communication Questionnaire | The 5-point Likert scale, ranging from 1 (not at all) to 5 (very much). | 6 months |