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A prospective study on the use of teledermatology in psychiatric patients with chronic skin diseases
Author(s) -
Seghers Amelie C,
Seng Kok Han,
Chio Martin TW,
Chia Emileen,
Ng See Ket,
Tang Mark BY
Publication year - 2015
Publication title -
australasian journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.67
H-Index - 53
eISSN - 1440-0960
pISSN - 0004-8380
DOI - 10.1111/ajd.12297
Subject(s) - medicine , teledermatology , adverse effect , prospective cohort study , dermatology , pediatrics , psychiatry , telemedicine , health care , surgery , economics , economic growth
Background To compare the use of live interactive teledermatology versus conventional face‐to‐face consultation in long‐term, institutionalised psychiatric patients with chronic skin diseases. Methods All institutionalised psychiatric patients at the I nstitute of M ental H ealth with follow‐up appointments at the N ational S kin C entre were assessed for eligibility and invited to participate. Recruited patients were first seen by a dermatologist via videoconferencing, and then by another dermatologist in person, within 1 week. Clinical outcome measures were then assessed by a third independent dermatologist. The following outcome measures were assessed for each paired patient visit: inter‐physician clinical assessment, diagnosis, management plan, adverse events and total patient turnaround time ( PTAT ) for each consultation. Results There were a total of 13 patients (mean age, 64.6 years; range 44–80) with 27 patient visits. All were male patients with chronic schizophrenia. The predominant skin condition was chronic eczema and its variants (62%), followed by cutaneous amyloidosis (23%) and psoriasis (15%). The level of complete and partial agreement between the teledermatology and face‐to‐face consultation was 100% for history‐taking and physical examination and 96% for the investigations, diagnosis, management plan and the treatment prescribed. The PTAT for teledermatology was 23 min, compared to 240 min for face‐to‐face consultations. No adverse events were reported. Conclusion Teledermatology was as effective as face‐to‐face consultation and reduced the PTAT by 90%, resulting in increased patient convenience, operational efficiency and reduced manpower need. Our study supports the safe and cost‐effective use of teledermatology for the follow‐up of chronic skin conditions in psychiatric patients.