A new study suggests doctors can use information from their patients’ wearable devices to monitor the effectiveness of medications they prescribe to treat heart disease. Researchers at the University of Birmingham used consumer wearable devices that monitor heart rate and physical activity to compare responses to two treatments for atrial fibrillation and heart failure. The study found no difference between the two drugs they were testing and also indicated clinically useful data can be gathered from wearable devices, eliminating the need for costly and time-consuming in-person doctor visits for medication monitoring.
The study, which appears in the 15 July 2024 issue of Nature Medicine.
“People across the world are increasingly using wearable devices in their daily lives to help monitor their activity and health status,” said Dipak Kotecha, PhD, lead author of the study and a professor at the Institute of Cardiovascular Sciences at the University of Birmingham. “This study shows the potential to use this new technology to assess the response to treatment and make a positive contribution to the routine care of patients.”
The first wearable heart rate monitor was introduced in the 1970s and consisted of a chest strap transmitter and wrist receiver. The first Apple watch with heart rate monitoring was introduced in 2015. Since then, researchers and clinicians have been playing catch up with technology, trying to leverage their potential for clinical research and patient management. The authors of the current study highlighted both their research findings on the medications they were testing, but also on what they learned about the clinically relevant information they were able to collect from their patients’ wearables.
“The results of this study indicate that digoxin and beta-blockers have equivalent effects on heart rate in atrial fibrillation at rest and on exertion, and suggest that dynamic monitoring of individuals with arrhythmia using wearable technology could be an alternative to in-person assessment,” the authors wrote.
In the current study, Kotecha and his team examined if a commercially-available fitness tracker and smartphone could continuously monitor the response to medications and provide clinical information similar to in-person hospital assessment. The wearable devices, consisting of a wrist band and connected smartphone, collected a vast amount of data on the response to two different medications prescribed as part of a clinical trial called RATE-AF, funded by the National Institute for Health and Care Research (NIHR).
The researchers used artificial intelligence to help analyze over 140 million datapoints for heart rate in 53 individuals over 20 weeks. They found that digoxin and beta-blockers had a similar effect on heart rate, even after accounting for differences in physical activity. This was in contrast to previous studies that had only assessed the short-term impact of digoxin.
The team developed a neural network that took account of missing information to avoid an over-optimistic view of the wearable data stream. Using this approach, the team found that the wearables were equivalent to standard tests often used in hospitals and clinical trials that require staff time and resources. The average age of participants in the study was 76 years, highlighting possible future value regardless of age or experience with technology. That is important given the aging population of Western countries.
“Heart conditions such as atrial fibrillation and heart failure are expected to double in prevalence over the next few decades, leading to a large burden on patients as well as substantial healthcare cost,” Kotecha said. “This study is an exciting showcase for how artificial intelligence can support new ways to help treat patients better.”
