Teledermatology Versus Usual Care on Delay Before Diagnosis and Treatment of Dermatologic Conditions

NCT02122432 | Completed

• 1 other identifier: DMG002
• Study Type: interventional
• Target: 109
• Locations: 1 country
• Sites: 1

Brief Summary

In France, there is usually a long delay (approximately 6 weeks) before a general practitioner can obtain a specialized advice by dermatologists for diagnosis of "unusual" dermatologic conditions of their patients. Previous studies have shown that teledermatology is a reliable way for diagnosis in dermatology. We hypothesize that a teledermatology advice could reduce delay before diagnosis and therefore treatment for patients.

Conditions

Dermatologic Conditions

Keywords

teledermatology; dermatology; general practice; organization of care

Outcome Measures

Primary Outcomes (1)

• Delay before expertise by a dermatologist

  Delay, in days, between a patient's consultation with his general practitioner and expertise by a dermatologist (teledermatology or classic consultation) that allows either diagnostic and/or initiation of treatment. For example: in the teledermatology group, if the specialist needs to see the patient because the photographs cannot be analyzed correctly, date of expertise is the date of the consultation with the dermatologist. Data is censured after 3 months.

  3 months

Secondary Outcomes (1)

• Patient's satisfaction

  1 month after expertise by dermatologist

Other Outcomes (2)

• Physicians satisfaction with teledermatology

  3 months

• Number of non usable photographs in teledermatology group

  3 months

Study Arms (2)

Teledermatology

EXPERIMENTAL

General practitioner takes 3 photographs per dermatologic lesion using either a telephone with a 3Mega Pixel minimum camera or a standard camera following recommendations of the practice guidelines for teledermatology (2007) of the American Telemedicine Association and sends them to the dermatologist using a secured email server. Dermatologist answer is standardized.

Other: Teledermatology

Usual care

NO INTERVENTION

Usual care for dermatologic conditions requiring an expertise from a dermatologist involves the general practitioner 1) giving the patient a paper letter containing at least the following information: date of symptoms, symptomatology, topography of lesions, description of lesions, extension, recent drug intakes) and 2) telling him to see the dermatologist of his choice (patient manages his appointments alone).

Interventions

Teledermatology OTHER

General practitioner takes 3 photographs per dermatologic lesion using either a telephone with a 3Mega Pixel minimum camera or a standard camera following recommendations of the practice guidelines for teledermatology (2007) of the American Telemedicine Association. Photographs are sent by email using a secured mail server with at least the following information=date of symptoms, symptomatology, topography of lesions, description of lesions, extension, recent drug intakes) Photographs are read and analyzed by a single dermatologist who gives an expert answer (diagnosis and/or treatment). Answer is sent back to the general practitioner by email (using a secured mail server). Answer contains at least the following information= are photographs usable? What is the diagnosis? If necessary, which treatment should the general practitioner begin ? If necessary, does the patient need a consultation with a dermatologist ?

Teledermatology

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Consultation with a general practitioner for any motive during which, the general practitioner deems necessary to obtain a dermatologic expertise for a skin lesion (for diagnosis or treatment)

You may not qualify if:

• Emergency, assessed by the general practitioner (needs care or quick telephonic advice in the next 24 hours)
• Patients for which diagnosis and/or treatment are known by the general practitioner (the GP needs a dermatologic advice for a specific treatment (for example= laser, instrumental treatment...))
• Patient cannot go the dermatologic consultation by himself (for example: dependant patients...)
• Cognitive or psychiatric impairment (cannot give informed consent)

Sponsors & Collaborators

• University Paris 7 - Denis Diderot: lead

Study Sites (1)

University paris Diderot

Paris, France

Location

Related Publications (1)

• Piette E, Nougairede M, Vuong V, Crickx B, Tran VT. Impact of a store-and-forward teledermatology intervention versus usual care on delay before beginning treatment: A pragmatic cluster-randomized trial in ambulatory care. J Telemed Telecare. 2017 Sep;23(8):725-732. doi: 10.1177/1357633X16663328. Epub 2016 Aug 5.

  PMID: 27496852 DERIVED

Study Officials

• Viet Thi Tran, MD

  University paris Diderot

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: DIAGNOSTIC
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: MD

Study Record Dates

• First Submitted: April 22, 2014
• First Posted: April 24, 2014
• Study Start: April 1, 2014
• Primary Completion: January 1, 2015
• Study Completion: January 1, 2015
• Last Updated: June 22, 2015

Record last verified: 2015-06

Locations

FR (1)