Response to Ranpariya et al's “Direct-to-consumer teledermatology platforms may have inherent conflicts of interest”

Karim, Maria; Klein, Elizabeth J.; Gutiérrez, Daniel; Adotama, Prince; Sicco, Kristen Lo

doi:10.1016/j.jaad.2021.11.063

Cited by 3 publications

(5 citation statements)

References 5 publications

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“… 15 DTC platforms have been criticized for selling non-evidence-based therapies such as biotin. 16 In our study population, only 17% of the finasteride patients were taking biotin. This rather low proportion suggests that the focus of DTC treatment is on the use of evidence-based treatments such as finasteride and minoxidil.…”

Section: Discussionmentioning

confidence: 90%

“… 18 A shortcoming of DTC platforms, as described in the literature, is that patients can only be offered well-known treatment options and may be denied off-label treatments. 16 Currently, DTC teledermatology cannot provide the same level of personalized care as traditional in-person visits. However, from our perspective, DTC platforms offer the great advantage of providing insights into the side-effect profile of prescribed drugs using standardized medical questionnaires for follow-up and patient monitoring.…”

Section: Discussionmentioning

confidence: 99%

“…This also enables the long-term care of patients in telemedicine, which is often criticized as a shortcoming of DTC platforms. 16 …”

Section: Discussionmentioning

confidence: 99%

“…The use of objective measures, such as trichoscopy, to confirm the diagnosis or assess treatment response is not possible in a pure telemedicine setting. 16 However, in AGA treatment, subjective patient satisfaction with the treatment response is very important and should be considered when deciding whether to continue or discontinue finasteride therapy. 17 …”

Section: Discussionmentioning

confidence: 99%

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Patient-reported treatment outcomes and safety of direct-to-consumer teledermatology for finasteride treatment in male androgenetic alopecia: A cross-sectional study

von Büren,

Hansen,

Kött

et al. 2023

DIGITAL HEALTH

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Objective The use of direct-to-consumer (DTC) teledermatology platforms has increased, particularly for androgenetic alopecia (AGA). However, little is known about the efficacy and safety of these platforms. This study aimed to investigate the patient-reported treatment outcomes and safety of DTC teledermatology for the finasteride treatment of male AGA. Methods This retrospective, cross-sectional study used data from a German DTC platform for finasteride treatment between December 2021 and January 2023. Patient-reported outcomes were collected through voluntary follow-up questionnaires provided to the patients six weeks after the first prescription to assess treatment outcomes and safety. Results Data collection included 2269 patients. Of all patients who answered the follow-up questionnaire ( n = 191), 79% (150 out of 191) self-reported positive changes in hair appearance, and 59% (113 out of 191) reported an improvement in self-esteem under treatment. Patients with self-reported positive changes in hair appearance were more likely to report improved self-esteem ( P < 0.0001). Treatment-related adverse events occurred in 12% (22 out of 191) of the patients. Full treatment adherence was reported in 87% (167 out of 191) of patients. Conclusion From the patient's perspective, DTC teledermatology has the potential to improve hair appearance and self-esteem. Our results suggest that it may be an effective and safe treatment option for men with AGA, justifying low-threshold access. However, treatment-related adverse events should be closely monitored during follow-up. Further studies are required to evaluate the long-term effects of the DTC teledermatology treatment. By collecting real-world data, teledermatology platforms could be useful beyond their primary focus and could play an important role in the context of future research.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

“…This also enables the long-term care of patients in telemedicine, which is often criticized as a shortcoming of DTC platforms. 16 …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Patient-reported treatment outcomes and safety of direct-to-consumer teledermatology for finasteride treatment in male androgenetic alopecia: A cross-sectional study

von Büren,

Hansen,

Kött

et al. 2023

DIGITAL HEALTH

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show abstract

“…To the Editor: We thank Karim et al 1 for their expanded discussion surrounding direct-toconsumer (DTC) teledermatology companies. Given the likely growing importance of DTC in dermatology, we must continue to review the limitations of DTC in relation to traditional inperson care.…”

mentioning

confidence: 99%