An important aspect of managing chronic disease is for patients to take charge of their health – whether by checking their weight or tracking their physical activity, heart rate or blood sugar levels.
Smart watches, Owned by around one in three AustraliansThese systems can provide an easy-to-use, continuous, and integrable monitoring platform, making this process much easier. But they are not without their drawbacks.
Australian pharmacist This article explores the pros, cons, and potential uses of smartwatches in healthcare, and how pharmacists can better support patients to use them in chronic disease management.
There is an app for this.
There are many smart watch apps on the market, which can track A variety of health measures like:
- Number of steps
- Heart rate
- sleep stage estimation
- peripheral oxygen saturation
- Heart rate variability.
Some of them have been verified by Therapeutic Goods Administrationincluding AppleWatch’s ECG algorithm — which alerts users if an irregular heartbeat (atrial fibrillation) is detected.
With smartwatches being able to detect how fast a person is moving, studies have been conducted on their use, supported by machine learning, Early detection of Parkinson’s disease.
These tracking and monitoring functions can help facilitate the management of a variety of chronic diseases, including:
- Diabetes
- Hypertension
- Cardiovascular diseases
- Respiratory conditions
- Movement disorders.
Traditionally, many chronic disease monitoring activities have been recorded on a simple piece of paper, says Professor Sepehr Shakib, professor of clinical pharmacology at the University of Adelaide’s Faculty of Health and Medical Sciences. But smartwatches are much better at capturing the data.
“They are then able to monitor this information and look at trends or changes over time. By making this data readily available, patients can then more easily communicate it with healthcare professionals such as pharmacists,” he added.
Sync with other devices
Professor Shakib said there are a variety of monitoring devices readily available in pharmacies that can be synced with smart watches, including:
- Automatic blood pressure monitors
- Continuous glucose monitoring devices
- Smart Scales
- Ovulation tracker.
Since the average patient sees the pharmacist much more often than their GP, the pharmacist can facilitate patient self-monitoring using connected devices.
For example, a veteran with diabetes might see a pharmacist every 11 days to get medications or test strips.
“If a patient is recording their health data, having a doctor involved every 11 days, including answering questions about monitoring or management, can be very powerful,” said Professor Shakib.
When home devices are synced with smart watches, pharmacists also have the opportunity to check the accuracy of these devices.
“They can then confirm to the patient whether or not their device is accurate and provide reassurance about that.” [technique],’ He said.
Smartwatch data interpretation
Pharmacists play an important role in helping patients understand smartwatch data on chronic conditions, such as high blood pressure.
“This type of condition lends itself well to self-management, because you can measure your blood pressure, upload the data to an app and track it,” said Professor Shakib. “When you can tell that your blood pressure is rising, you don’t have to wait three to six months to see your GP.”
But the main issue in assessing self-blood pressure is understanding variability.
“Patients may feel stressed when their blood pressure goes up, and feel falsely reassured when it goes down again. They may not understand how volatile their blood pressure data is,” said Professor Shakib.
Here pharmacists can rest assured that it is the average that matters.
With patients’ medication history at their fingertips, they can also advise whether it is necessary to see their GP, or if there is a problem with how their blood pressure is measured.
Pharmacists can also suggest lifestyle and dietary modifications when overall blood pressure is high.
“Simple things like reducing salt and alcohol intake and increasing physical activity can make a big difference,” he added.
This doesn’t have to involve hitting the gym, but eating more “exercise snacks” throughout the day, such as increasing your walking by parking farther away from your work.
“When the pharmacist reiterates this point, and follows up with self-monitoring apps, it is a powerful way to improve behaviour,” said Professor Shakib.
Interface difficulties
Smartwatch apps have user interfaces designed by IT experts who test their underlying technology functions, Professor Shakib added.
For example, smartwatches have fall identifiers that could be useful for older people, so if someone suddenly falls, they can trigger an alert that says, “It looks like you fell. Do you want to call 000?” he said.
“This requires intelligence.” [perception] “Deceleration patterns to detect falls as opposed to someone kneeling on the ground.”
But the user interface is not always suitable for people with poor health or lack of technology knowledge.
‘[Considering whether] “The user interface is suitable for older people’s eyesight, and the colours are suitable for people with cataracts, but it doesn’t tend to capture people’s imagination as much as it does with its beautiful appearance and the cool things it might be able to do,” said Professor Shakib.
Using multiple tracking apps and connecting other devices to smartwatches also requires patients to have some level of technical expertise.
“Using apps instead of paper to record health data requires the patient to know how to use them and enter the information in the correct way,” said Professor Shakib.
Here pharmacists need a clear understanding of the role they should play.
“If a patient provides data, helping them understand it clinically is what pharmacists should do, for example if a patient asks, ‘I’ve been checking my blood glucose levels, I’m not sure what that means,’” he said.
“But it shouldn’t be up to the pharmacist to show patients how to [sync] Device, enter data and deal with the application.
Interoperability Challenges
Despite the ability to track many different signs of chronic diseases, the flip side is Incompatibility between smartwatch apps.
While Apple’s Health app allows other devices and apps to connect and send data through it, it’s difficult to take multiple diseases into account — at least at this point.
For example, a diabetic patient’s physical activity might be recorded on one app, anxiety levels on another, and blood sugar levels on a third.”
‘When you measure data in three separate systems, it’s not easy to put them together to determine whether the stress of an upcoming event, for example, is throwing everything out of balance.’
While smartwatches have extensive health tracking capabilities, their accuracy is also unclear.
“A lot of them have not been properly validated, so there are questions about their accuracy,” said Professor Shakib.
Learn more about the role of smart watches in healthcare at Atrial Fibrillation: Can Your Watch Save Your Life? Session titled PSA24, led by Prof. Sebehr Shakib.
