Feasibility of Using a Smartwatch to Intensively Monitor Patients With Chronic Obstructive Pulmonary Disease: Prospective Cohort Study (Preprint)

BACKGROUND Acute exacerbations of chronic obstructive pulmonary disease (COPD) are associated with accelerated decline in lung function, diminished quality of life, and higher mortality. Proactively monitoring patients for early signs of an exacerbation and treating them early could prevent these outcomes. The emergence of affordable wearable technology allows for nearly continuous monitoring of heart rate and physical activity as well as recording of audio which can detect features such as coughing. These signals may be able to be used with predictive analytics to detect early exacerbations. Prior to full development, however, it is important to determine the feasibility of using wearable devices such as smartwatches to intensively monitor patients with COPD. OBJECTIVE We conducted a feasibility study to determine if patients with COPD would wear and maintain a smartwatch consistently and whether they would reliably collect and transmit sensor data. METHODS Patients with COPD were recruited from 3 hospitals and were provided with a smartwatch that recorded audio, heart rate, and accelerations. They were asked to wear and charge it daily for 90 days. They were also asked to complete a daily symptom diary. At the end of the study period, participants were asked what would motivate them to regularly use a wearable for monitoring of their COPD. RESULTS Of 28 patients enrolled, 16 participants completed the full 90 days. The average age of participants was 68.5 years, and 36% (10/28) were women. Survey, heart rate, and activity data were available for an average of 64.5, 65.1, and 60.2 days respectively. Technical issues caused heart rate and activity data to be unavailable for approximately 13 and 17 days, respectively. Feedback provided by participants indicated that they wanted to actively engage with the smartwatch and receive feedback about their activity, heart rate, and how to better manage their COPD. CONCLUSIONS Some patients with COPD will wear and maintain smartwatches that passively monitor audio, heart rate, and physical activity, and wearables were able to reliably capture near-continuous patient data. Further work is necessary to increase acceptability and improve the patient experience.

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Sensitivity, Accuracy, and Reproducibility of Biosensing (mHealth) Devices in Monitoring of Physical Activity and Respiratory Function in Smokers with and Without Respiratory Symptoms or Chronic Obstructive Pulmonary Disease (Preprint)

10.2196/preprints.20347 ◽

2020 ◽

Author(s):

Almaz Sharman ◽

Baurzhan Zhussupov ◽

Saule Nurakysh

Keyword(s):

Physical Activity ◽

Chronic Obstructive Pulmonary Disease ◽

Heart Rate ◽

Pulmonary Disease ◽

Respiratory Function ◽

Respiratory Symptoms ◽

Chronic Obstructive ◽

Grey Zone ◽

Obstructive Pulmonary Disease ◽

Home Setting

BACKGROUND Chronic obstructive pulmonary disease (COPD) is a global public health problem, and continuous monitoring is essential for both its management as well as the management of other chronic diseases. Telemonitoring using mobile health (mHealth) devices has the potential to promote self-management, improve control, increase quality of life, and prevent hospital admissions. OBJECTIVE This feasibility and proof-of-concept study aims to assess utility (sensitivity, accuracy, and reproducibility) of biosensing (mHealth) devices in monitoring of physical activity and respiratory function in smokers with and without respiratory symptoms/COPD. METHODS A total of 3 cohorts, with 9 participants in each, used mHealth devices for 90 days while undergoing the current standard of care. These groups were: 9 “non-COPD,” otherwise healthy, smokers; 9 “grey zone” smokers (forced expiratory volume in 1 second/ forced vital capacity ≥0.70 after bronchodilator treatment; COPD Assessment Test ≥10); and 9 smokers diagnosed with Stage 1-3 COPD. Rates of recruitment, retention, and adherence will be measured. Overall, two mHealth devices were utilized in the study: (1) the AnaMed Original Equipment Manufacturer device (OEM) that measures distance, energy expenditure, heart rate, and heart rate variability by using photoplethysmographic method and displays the results on a watchface, smartphone or a tablet, and (2) the Air Next mobile spirometry device portable device that performs spirometric measurements (FEV1, FVC and FEV1/FVC) ratio by a turbine mechanism and displays the results on a smartphone or a tablet. The mHealth devices were compared against industry standards. Additionally, a questionnaire will be administered to assess the participants’ perceptions of the mHealth technologies used. RESULTS The AnaMed device was demonstrated as precise in measuring heart rate, and less so when measuring number of steps and meters. It is unreliable in measuring SpO2. It is easy to use, requires no significant technical support. The Air-Next Spirometer is a simple and very precise instrument for detecting obstructive airway diseases which was confirmed when compared with the industry standard. It is easy to use, which could make it especially useful non-specialized care and in-home setting and other areas. CONCLUSIONS We demonstrated that both devices, AnaMed and AirNext can provide precise measurements or heart rate and spirometric data, and it is feasible to incorporate them into a large-scale study. However, such task would require serious efforts to hire technical staff and to provide additional training for the clinical investigators to take care of technical and logistical issues, i.e. sending reminders, synching devices with smartphones, communication efforts. CLINICALTRIAL ClinicalTrials.gov NCT04081961; https://clinicaltrials.gov/ct2/show/NCT04081961

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