Study: Heart patients monitored with Fitbits keep up with device use

By Dave Muoio
12:09 pm

Consumer-grade wearables may not have the same precision as their medical-grade counterparts, but they certainly seem to by favored by patients.

In a newly published study investigating adherence to continuous tracking device use, researchers observed a high rates of adherence and very low attrition among a group of mid-risk cardiovascular patients instructed to wear Fitbit devices. These rates of compliance are superior to those of previous literature examining other monitoring devices, and suggest a clear approach to improving patient compliance with remote monitors.

“Studies have indicated that device fatigue limits adherence, a phenomenon known as the law of attrition,” researchers wrote in the Journal of the American Medical Informatics Association. “Little work has been done to demonstrate how readily available commercial devices may limit intervention burden by automating data collection, such as passive accelerometry. However, previous studies have shown that activity trackers are capable of accurately documenting health indicators such as physical activity, are a popular low-cost option with older patients, and often have higher adherence rates than other devices.”

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In the study, researchers enrolled and collected data from 186 Cedars-Sinai Medical Center patients with ischemic heart disease. All participants received a Fitbit Charge 2 to monitor their activity, heart rate, and sleep, as well as validated questionnaires pertaining to various areas of their health that they completed at the end of the 90-day study period. The primary endpoint of the study was adherence to the monitoring devices as determined by heart rate monitor readings. Another measurement in line with the protocols of prior accelerometer studies (NHANES) was also used to enable easier comparison.

Device usage rates varied by adherence calculation methodology: heart rate-based median adherence percentages were 90 percent and 83.7 percent when using measurement intervals of an hour and a minute, whereas NHANES measurements 43.8 percent or, if accounting for eight hours of sleep, 77.1 percent. The researchers also noted a 0.09 percent daily attrition rate (as measured by hourly heart rate data), and significantly positive correlations between summary statistics collected by the devices and participant responses to the standardized questionnaires.

These rates of device adherence are “substantially higher” than what has been reported in similarly designed studies that incorporated a variety of monitoring devices, the researchers wrote. Meanwhile, the high correlation between summary statistics and the questionnaires suggest that these devices could effectively highlight a patient that requires an intervention for care teams.

"This study demonstrates that consumer-grade continuous-time activity trackers with HR monitors may be an effective tool for telemonitoring applications, as patients have demonstrated a high level of adherence and relatively low attrition over 90 days. … Future studies should investigate the utility of this real-time tracking as a basis for patient health surveillance and as a means for using feedback to overcome the attrition seen in eHealth studies,” the researchers concluded.

An increasing number of health investigations are relying on Fitbit’s devices. One study, published late last year, found that Fitbits could potentially be used to predict readmission rates after cancer surgery, while another investigation exploring patients’ reactions to chemotherapy was recently presented at the American Society of Clinical Oncologists’ annual conference in Chicago. Notably, the NIH announced in November that it would be using Fitbit’s devices to collect data in its ambitious All of Us Research Program.


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