Telemedicine versus face-to-face care for treatment of patients with lower extremity ulcers

Alexander Gamus*, Elad Keren, Hanna Kaufman, Gila Brandin, Daniel Peles, Gabriel Chodick

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Objective: Lower extremity ulcers (LEUs) are associated with a decline in patients' quality of life (QoL). Better healthcare availability in remote regions, facilitated by telemedicine (TM), may improve patient wellbeing. The aim of this study was to compare the QoL of patients treated via synchronous video TM with that of patients treated with standard face-to-face (FTF) care. Method: The study was performed in a large health services provider in Israel (Maccabi Healthcare Services). TM was used in four remote locations; the FTF method was applied in two regional clinics. The treatment protocol was performed by a nurse and supervised by the regional physician in both treatment modes. A validated Wound-QoL questionnaire in Hebrew was used to assess patient outcomes. Results: A total of 83 patients were treated via TM and 94 patients were treated FTF. The mean QoL for patients treated via TM was 0.546±0.249 compared with 0.507±0.238 for the FTF group. A similarity relating to outcomes in both treatment methods was demonstrated by a difference of 0.039 (95% confidence interval -0.33-0.111) and p=0.291. The probability of the difference being within the limits of the interval in a replicated study was 83.4%. The equivalence/non-inferiority was established within the accepted Δ=0.12 range. Conclusion: The results indicated no reduced QoL for patients with LEUs treated with telemedicine versus with standard FTF care. Declaration of interest: The authors have no conflicts of interest.

Original languageEnglish
Pages (from-to)916-921
Number of pages6
JournalJournal of wound care
Issue number11
StatePublished - 2 Nov 2021


  • Face-to-face
  • Foot wound
  • Leg wound
  • Lower extremities ulcerations
  • Lower extremity ulcers
  • Quality of life
  • Standard care
  • Telemedicine
  • Ulcer
  • Video telemedicine
  • Wound
  • Wound care
  • Wound healing
  • Wounds


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