Fortunato Michael, Adusumalli Srinath, Chokshi Neel, Harrison Joseph, Rareshide Charles, Patel Mitesh
Crescenz Veterans Affairs Medical Center, Philadelphia, PA, United States.
University of Pennsylvania, Philadelphia, PA, United States.
JMIR Form Res. 2020 Apr 7;4(4):e14508. doi: 10.2196/14508.
There is growing interest in using wearable devices to remotely monitor patient behaviors. However, there has been little evaluation of how often these technologies are used to monitor sleep patterns over longer term periods, particularly among more high-risk patients.
The goal of the research was to evaluate the proportion of time that patients with ischemic heart disease used wearable devices to monitor their sleep and identify differences in characteristics of patients with higher versus lower use.
We evaluated wearable device data from a previously conducted clinical trial testing the use of wearable devices with personalized goal-setting and financial incentives. Patients with ischemic heart disease established a sleep baseline and were then followed for 24 weeks. The proportion of days that sleep data was collected was compared over the 24 weeks and by study arm. Characteristics of patients were compared to groups with high, low, or no sleep data.
The sample comprised 99 patients with ischemic heart disease, among which 79% (78/99) used the wearable device to track their sleep. During the 6-month trial, sleep data were collected on 60% (10,024/16,632) of patient-days. These rates declined over time from 77% (4292/5544) in months 1 and 2 to 58% (3188/5544) in months 3 and 4 to 46% (2544/5544) in months 5 and 6. Sleep data were collected at higher rates among the intervention group compared with control (67% vs 55%, P<.001). In the main intervention period (months 3 and 4), patients with higher rates of sleep data were on average older (P=.03), had a history of smoking (P=.007), and had higher rates of commercial health insurance (P=.03).
Among patients with ischemic heart disease in a physical activity trial, a high proportion used wearable devices to track their sleep; however, rates declined over time. Future research should consider larger evaluations coupled with behavioral interventions.
ClinicalTrials.gov NCT02531022; https://clinicaltrials.gov/ct2/show/NCT02531022.
使用可穿戴设备远程监测患者行为的兴趣与日俱增。然而，对于这些技术在较长时间段内用于监测睡眠模式的频率，尤其是在高危患者中的使用频率，几乎没有评估。
本研究的目的是评估缺血性心脏病患者使用可穿戴设备监测睡眠的时间比例，并确定使用频率较高和较低的患者在特征上的差异。
我们评估了先前一项临床试验中可穿戴设备的数据，该试验测试了使用带有个性化目标设定和经济激励措施的可穿戴设备。缺血性心脏病患者建立了睡眠基线，然后随访24周。比较了24周内及按研究组收集睡眠数据的天数比例。将患者的特征与有高、低或无睡眠数据的组进行比较。
样本包括99例缺血性心脏病患者，其中79%（78/99）使用可穿戴设备追踪睡眠。在为期6个月的试验中，60%（10,024/16,632）的患者日收集到了睡眠数据。这些比率随时间下降，从第1和第2个月的77%（4292/5544）降至第3和第4个月的58%（3188/5544），再降至第5和第6个月的46%（2544/5544）。与对照组相比，干预组收集睡眠数据的比率更高（67%对55%，P<.001）。在主要干预期（第3和第4个月），睡眠数据比率较高的患者平均年龄更大（P=.03），有吸烟史（P=.007），商业健康保险覆盖率更高（P=.03）。
在一项体育活动试验中的缺血性心脏病患者中，很大一部分人使用可穿戴设备追踪睡眠；然而，比率随时间下降。未来的研究应考虑进行更大规模的评估并结合行为干预。
ClinicalTrials.gov NCT0
