You are absolutely right about the outpatient and the QA part in such studies. When I was in college I was "study subject" for testing medication or procedures a few times (in U.S.). They paid thousands of dollars for some in-facility procedures!
Yes, there are a lot of question/answer times in an outpatient procedure follow up. The serious drug studies require even drawing blood even every 15 minutes to see the flow of medication in the body. Right after each procedure (blood draw, taking med, or in this case applying cream) there is always a questionnaire to document the result of the procedure at that moment.
For skin cream, however, I expect an outpatient procedure every time the cream needs to be applied again would be sufficient (maybe the first few in the facility to get to know the subjects and their level of commitment to the study).
In U.S. the outpatient is done in the health care facilities unless the patient is not able to make it there. But, I can understand that in other countries those administer these procedures want to go to patients house to make sure the procedures are done on time and without any delay. They just don't want to risk losing any lazy subjects as it would further delay the trial result.
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