mHealth Wearables Increase Healthcare Use Among Arrhythmia Patients

A study published in the Journal of the American Medical Association (JAMA) has found that using mHealth wearable devices such as smartwatches can increase healthcare use in patients diagnosed with atrial fibrillation (AF).

The study, conducted by a team of researchers from the University of Utah, Dartmouth College, the University of Colorado, Vanderbilt University, and the Tennessee Valley Healthcare System, focused on 16,320 patients diagnosed with AF who regularly monitored their pulse rates. Of that group, 348 used mHealth wearables.

According to researchers, there was no apparent difference in the pulse rates between the two groups, but those patients who used wearables were more likely to access healthcare services.

The study monitored healthcare actions that could be triggered by information from a wearable, such as cardioversions or prescriptions. It included professional services but not in-patient services while the patient was hospitalized.

The study touches on a common complaint about mHealth wearables such as smartwatches, fitness bands, and smartphone apps. Some feel that those tools can cause users to monitor too much and to overuse healthcare resources. Without proper clinical oversight, they’ve said, mHealth devices can lead to unnecessary treatments and excessive costs.

That’s not always the case, especially when those users have chronic medical conditions that greatly benefit from monitoring.

In this study, researchers said, those patients using wearables sought healthcare services when those wearables indicated something was amiss. Often that’s a good sign - the study noted that patients using wearables had a higher rate of ablation procedures than those who didn’t use mHealth, an indication that the devices were picking up on health issues that required medical attention.

But by the same token, unless they’re being monitored by a healthcare provider, patients who use wearables are apt to seek out healthcare for any inconsistency. That’s why it’s important to combine the wearable with oversight from a care provider who can set parameters.

The study also found that those using wearables trend toward younger, healthier, and socioeconomically better populations. Younger generations are more likely to embrace wearables, which bodes well for their health outcomes over the long run.

But it also hints at the persistent problem that those who would most benefit from wearables - older and underserved populations, and those with one or more chronic conditions - aren’t wearing them, either because they can’t afford them or haven’t been prescribed them by a care provider.

The researchers did note that their study focused on a specific population - those diagnosed with AF. When mHealth devices are worn or prescribed specifically to help people with AF, they hold great promise in detecting abnormal readings and alerting users to potential health concerns. This, in turn, leads to better health outcomes, possibly even helping users avoid a stroke.

In addition, many studies have used mHealth devices to help detect abnormal heart rhythms and to help providers identify AF in people who hadn’t been diagnosed. 

“Wearables are an increasing part of health care delivery, particularly in the fields of electrophysiology and cardiology,” the study concludes. “Many patients with or without AF use wearables for self-directed management or in conjunction with the health care delivery system, so it is important to understand the association of these devices with health outcomes and health care use. This study’s finding suggests that wearable use among patients with AF is associated with increased health care use and support the need for randomized clinical trials to measure the impact of wearables on health outcomes and use among patients with AF.”