Division of Population Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom.
Health Services Research and Primary Care, National Institute for Health Research School for Primary Care Research, Manchester, United Kingdom.
J Med Internet Res. 2022 Aug 30;24(8):e36337. doi: 10.2196/36337.
Current evidence supports the use of wearable trackers by people with cardiometabolic conditions. However, as the health benefits are small and confounded by heterogeneity, there remains uncertainty as to which patient groups are most helped by wearable trackers.
This study examined the effects of wearable trackers in patients with cardiometabolic conditions to identify subgroups of patients who most benefited and to understand interventional differences.
We obtained individual participant data from randomized controlled trials of wearable trackers that were conducted before December 2020 and measured steps per day as the primary outcome in participants with cardiometabolic conditions including diabetes, overweight or obesity, and cardiovascular disease. We used statistical models to account for clustering of participants within trials and heterogeneity across trials to estimate mean differences with the 95% CI.
Individual participant data were obtained from 9 of 25 eligible randomized controlled trials, which included 1481 of 3178 (47%) total participants. The wearable trackers revealed that over the median duration of 12 weeks, steps per day increased by 1656 (95% CI 918-2395), a significant change. Greater increases in steps per day from interventions using wearable trackers were observed in men (interaction coefficient -668, 95% CI -1157 to -180), patients in age categories over 50 years (50-59 years: interaction coefficient 1175, 95% CI 377-1973; 60-69 years: interaction coefficient 981, 95% CI 222-1740; 70-90 years: interaction coefficient 1060, 95% CI 200-1920), White patients (interaction coefficient 995, 95% CI 360-1631), and patients with fewer comorbidities (interaction coefficient -517, 95% CI -1188 to -11) compared to women, those aged below 50, non-White patients, and patients with multimorbidity. In terms of interventional differences, only face-to-face delivery of the tracker impacted the effectiveness of the interventions by increasing steps per day.
In patients with cardiometabolic conditions, interventions using wearable trackers to improve steps per day mostly benefited older White men without multimorbidity.
PROSPERO CRD42019143012; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=143012.
目前的证据支持心血管代谢疾病患者使用可穿戴追踪器。然而，由于健康益处较小且存在异质性，因此仍然不确定哪些患者群体最受益于可穿戴追踪器。
本研究旨在检查可穿戴追踪器在心血管代谢疾病患者中的作用，以确定受益最大的亚组患者，并了解干预措施的差异。
我们从截至 2020 年 12 月之前进行的可穿戴追踪器随机对照试验中获得了个体参与者数据，这些试验将每天的步数作为主要结局指标，纳入了包括糖尿病、超重或肥胖以及心血管疾病在内的心血管代谢疾病患者。我们使用统计模型来解释试验内参与者的聚类和试验间的异质性，以估计平均值差异及其 95%置信区间。
从 25 项符合条件的随机对照试验中获得了个体参与者数据，其中包括 3178 名总参与者中的 1481 名。可穿戴追踪器显示，在中位数为 12 周的干预期间，每天的步数增加了 1656 步（95%置信区间 918-2395），这是一个显著的变化。使用可穿戴追踪器的干预措施中，男性（交互系数-668，95%置信区间-1157 至-180）、50 岁以上的患者（50-59 岁：交互系数 1175，95%置信区间 377-1973；60-69 岁：交互系数 981，95%置信区间 222-1740；70-90 岁：交互系数 1060，95%置信区间 200-1920）、白人患者（交互系数 995，95%置信区间 360-1631）和合并症较少的患者（交互系数-517，95%置信区间-1188 至-11）与女性、50 岁以下、非白人患者和合并多种疾病的患者相比，每天的步数增加更多。在干预措施的差异方面，只有面对面交付追踪器才能增加每天的步数，从而提高干预措施的效果。
在心血管代谢疾病患者中，使用可穿戴追踪器来提高每天的步数，主要使无多种合并症的老年白人男性受益。
PROSPERO CRD42019143012；https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=143012。
