A Randomised Controlled Trial of ePROM-Guided Flexible Scheduling in Dermatology

The goal of this clinical trial is to evaluate whether an electronic patient-reported outcome measure (ePROM)-guided flexible scheduling system can improve outpatient clinic resource utilisation in patients attending dermatology outpatient clinics for routine follow-up. The main questions it aims to answer are:

• Does the intervention reduce the number of actualised outpatient visits over 12 months compared with standard fixed scheduling?
• Does the intervention group achieve higher adherence to monthly ePROM monitoring, as measured by the proportion of completed ePROM submissions?

Study Overview

• Status: Not yet recruiting
• Conditions: Psoriasis; Eczema; Urticaria; Chronic Dermatological Conditions
• Intervention / Treatment: Behavioral: Flexible ePROM-guided Scheduling System; Behavioral: electronic patient reported outcome measures (ePROMs)

• Study Type: Interventional
• Enrollment (Estimated): 250
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Ellie Choi, MBBS; Phone Number: 65 6908 2222; Email: dermatology@nuhs.edu.sg

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Dermatology outpatients otherwise due for a follow-up appointment within six months.
• Ability to independently navigate and complete ePROMs.
• Ability to provide informed consent (including parental consent for minors).

Exclusion Criteria:

• Patients who require fixed or scheduled in-person visits, including those needing skin cancer surveillance, bedside procedures (e.g., liquid nitrogen therapy), surgical interventions, or routine blood tests for immunosuppressive therapy.

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Intervention Arm; Participants in the intervention arm will not receive routine follow-up appointments at the end of their consultation. Instead, their monthly ePROM responses will feed a two-layer Bayesian decision system to determine appointment need.	Behavioral: Flexible ePROM-guided Scheduling System; Monthly ePROM responses will feed a Bayesian decision system to determine appointment need, which will then be used to make recommendations to patients for scheduling of appointments.; Behavioral: electronic patient reported outcome measures (ePROMs); Monthly electronic patient reported outcome measures (ePROMs) surveys will be sent to patients' mobile devices to capture self-reported disease severity data.
Active Comparator: Control Arm; Participants in the control arm will continue standard care, with follow-up appointments scheduled at the end of each consultation. The ePROM responses may be used by patients for self-tracking and will be available to clinicians to inform decision-making at subsequent visits.	Behavioral: electronic patient reported outcome measures (ePROMs); Monthly electronic patient reported outcome measures (ePROMs) surveys will be sent to patients' mobile devices to capture self-reported disease severity data.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of actualised outpatient visits	Difference in actualised outpatient visits (in-person + teleconsult) over 12 months (effectiveness outcome).	baseline to week 52
Proportion of completed monthly ePROMs	Difference in proportion of completed monthly ePROMs (implementation outcome)	baseline to week 52

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
No-show rate	Number of appointments missed without prior rescheduling or cancellation	baseline to week 52
Cancelled or rescheduled appointments	Appointments booked but cancelled or rescheduled before the actual appointment date	baseline to week 52
Urgent care or unscheduled visits	Emergency department visits or other urgent care visits related to patient's dermatological condition	baseline to week 52
Skin-specific Quality of Life Impairment	Changes in quality of life using the Dermatology Life Quality Index (DLQI). Minimum Score: 0 (no impact on quality of life). Maximum Score: 30 (extremely large impact on quality of life).	baseline, 6 months, 12 months
Clinician-assessed disease severity	Clinician-assessed disease severity using body surface area and the investigator global assessment on a 0-5 NRS	baseline to week 52
Acceptability of the intervention	Assessed using the Theoretical Framework of Acceptability	week 52
Perceived burden of engaging with the intervention	Research questionnaire assessing perceived burden of intervention use	baseline, 6 months, 12 months
Fidelity to the scheduling algorithm	The extent to which algorithm-generated recommendations were followed, overridden, or superseded	baseline to week 52
Barriers and facilitators to implementation	Explored through semi-structured qualitative interviews	week 52
Bayesian Decision-layer outputs	Decision-layer outputs, including monthly posterior summaries and posterior predictive probabilities for each appointment category	baseline to week 52

Collaborators and Investigators

• Sponsor: National University Hospital, Singapore
• Investigators: Principal Investigator: Ellie Choi, MBBS, National University Hospital, Singapore

Study record dates

Study Major Dates

• Study Start (Estimated): September 1, 2026
• Primary Completion (Estimated): June 1, 2029
• Study Completion (Estimated): December 1, 2029

Study Registration Dates

• First Submitted: March 15, 2026
• First Submitted That Met QC Criteria: March 15, 2026
• First Posted (Actual): March 18, 2026

Study Record Updates

• Last Update Posted (Actual): March 18, 2026
• Last Update Submitted That Met QC Criteria: March 15, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Keywords: dermatology; outpatient care; randomised controlled trial; implementation science; health services research; healthcare utilisation; electronic patient-reported outcomes; flexible scheduling; patient initiated follow up; ePROMs; Bayesian decision support; appointment no-shows; value-based care
• Additional Relevant MeSH Terms: Immune System Diseases; Hypersensitivity, Immediate; Hypersensitivity; Skin Diseases, Papulosquamous; Skin Diseases; Skin Diseases, Vascular; Skin Diseases, Eczematous; Dermatitis; Skin and Connective Tissue Diseases; Psoriasis; Eczema; Urticaria
• Other Study ID Numbers: 2023/00698

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: IPD shared includes de-identified demographics, disease outcomes and measures.
• IPD Sharing Time Frame: IPD and supporting information will be available from the time of publication and for four years thereafter.
• IPD Sharing Access Criteria: IPD and supporting information will be available from the study team on a case-by-case basis upon request.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; ICF; ANALYTIC_CODE

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No