A pragmatic randomized clinical equivalence trial (n=300, ≥1 year old) comparing a team-based connected health (TCH) asynchronous online telehealth model to conventional in-person care for atopic dermatitis (AD) over 12 months across 8 California dermatology clinics (August 2019–May 2024).
Online TCH care was equivalent to in-person care on all primary and secondary outcomes: EASI difference −0.01 (95% CI, −0.22 to 0.20), POEM difference 0.38 (95% CI, 0.03–0.73), and vIGA difference 0.06 (95% CI, 0.00–0.11) — all within prespecified equivalence margins.
Single-state (California) recruitment may limit geographic generalizability. The asynchronous model may not capture all clinical nuances compared to real-time interaction. Full-text access was unavailable, so details on dropout rates, treatment protocols, and subgroup analyses could not be verified.
Clinicians can confidently offer asynchronous online telehealth as an alternative to in-person visits for managing AD — outcomes are equivalent at 12 months. This model may meaningfully expand access for patients in underserved or remote areas.
