Smartphones vs. Wearable Devices for Remotely Monitoring Physical Activity

Study Questions:

Are smartphones or wearable devices sustainable for remotely monitoring physical activity among patients in the long-term?

Methods:

The present study was a secondary analysis for an ongoing randomized controlled trial. Data for this report were collected between January 23, 2017 and January 7, 2019, and included adults who were admitted to a medicine service in two Philadelphia hospitals. Participants had to be ambulatory, have a smartphone that was compatible with the Withings HealthMate application, and be discharged to home. Participants were randomized to a smartphone alone or smartphone with a wearable for 6 months. Duration of data transmission was estimated using the last day a step value was received and compared at 30, 90, and 180 days.

Results:

A total of 500 participants (250 in each arm), mean age 46.6 years, 64% women, and 46% black race were included in this analysis. Rates of death and overall dropout (including death) were similar between the study arms. The proportion of patients transmitting data among the smartphone group was not different than among the wearable group after 30 days (86.7% vs. 81.9%; p = 0.13), but was significant at 90 days (77.6% vs. 67.6%; difference, p = 0.01) and 180 days (61.2% vs. 46.5%; difference, p = 0.001). Patients in the smartphone group transmitted data for a significantly greater proportion of days during the 180-day period than patients in the wearable group (69.4% vs. 58.9%; difference, p = 0.001). Being male was associated with less likelihood of discontinuation, and Medicare insurance was associated with a greater likelihood of discontinuation.

Conclusions:

The investigators concluded that patients discharged from the hospital using smartphones transmitted data for a greater duration and proportion of time, with a 32% relative increase in patients completing the 180-day period compared with those using wearables.

Perspective:

The use of devices such as smartphones and wearables has increased greatly for the assessment of physical activity in research studies; however, as these results suggest, usability is important to assess. Why participants wear or do not wear such devices is critical to assess prior to conducting large-scale studies. Furthermore, the accuracy of such devices and the type of information collected will also inform on the use of such devices in clinical research.

Keywords: Cell Phone, Exercise, Patient Discharge, Physical Fitness, Primary Prevention


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