Wu Robert, Liaqat Daniyal, de Lara Eyal, Son Tatiana, Rudzicz Frank, Alshaer Hisham, Abed-Esfahani Pegah, Gershon Andrea S
Division of General Internal Medicine, University Health Network, Toronto, ON, Canada.
Department of Medicine, University of Toronto, Toronto, ON, Canada.
JMIR Mhealth Uhealth. 2018 Jun 14;6(6):e10046. doi: 10.2196/10046.
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.
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.
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.
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.
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.
慢性阻塞性肺疾病（COPD）急性加重与肺功能加速下降、生活质量降低及死亡率升高相关。对患者进行主动监测以发现急性加重的早期迹象并尽早治疗，可预防这些后果。经济实惠的可穿戴技术的出现，使得能够近乎持续地监测心率和身体活动，以及记录音频，从而检测诸如咳嗽等特征。这些信号或许可用于预测分析以检测早期急性加重。然而，在全面开发之前，确定使用智能手表等可穿戴设备对COPD患者进行密集监测的可行性很重要。
我们开展了一项可行性研究，以确定COPD患者是否会持续佩戴并使用智能手表，以及他们是否会可靠地收集和传输传感器数据。
从3家医院招募COPD患者，并为其提供一款可记录音频、心率和加速度的智能手表。要求他们每天佩戴并充电，为期90天。还要求他们完成每日症状日记。在研究期结束时，询问参与者什么会促使他们定期使用可穿戴设备来监测其COPD。
在纳入的28名患者中，16名参与者完成了完整的90天研究。参与者的平均年龄为68.5岁，36%（10/28）为女性。调查、心率和活动数据的平均可用天数分别为64.5天、65.1天和60.2天。技术问题导致心率和活动数据分别约有13天和17天无法获取。参与者提供的反馈表明，他们希望积极使用智能手表，并获得有关其活动、心率以及如何更好地管理COPD的反馈。
一些COPD患者会佩戴并持续使用可被动监测音频、心率和身体活动的智能手表，且可穿戴设备能够可靠地获取近乎连续的患者数据。有必要进一步开展工作以提高可接受性并改善患者体验。
