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Wearable fitness and activity devices allow users to track health-related metrics, from recording walking pace and distance to measuring heart rate and blood oxygen levels.¹ The popularity of such devices has grown hugely in recent years, with usage rising from 28 million in 2014 to 533 million in 2021.² Along with popularity, the activity levels of users may also be improving: research suggests that using a tracker can increase walking by 1,500 steps per day.³ With an estimated 25% of adults in the UK owning an activity tracking device, and a third of those committing to daily use,⁴ is there an opportunity to use these devices to encourage better adherence to prescribed lifestyle changes, such as increased activity, in patients with rheumatic conditions?

In inflammatory conditions, such as rheumatoid arthritis, consistent patient monitoring for flare-up detection has been found to improve outcomes;³ accuracy of patient monitoring is therefore of great importance. As technology becomes increasingly integrated into the healthcare space, digital, remote patient monitoring is becoming more common, using tools such as wearable devices.

Data measured by wearable technology can provide more accurate insights for the clinician when compared with a patient’s personal account of metrics such as exercise duration and frequency, which can be impacted by conscious or unconscious self-editing, inaccurate memory or personal perspectives and/or biases.

Not only can such technology improve the accuracy of patient monitoring, the data gathered can also be used to predict events, such as flare-ups. In rheumatic care, one study found that by applying machine learning to activity tracking, patterns of physical activities could be used to predict flare-ups with a sensitivity and specificity of >95%.³

When data from wearables are integrated with other digital tools, such as an app that allows patients to report on, and more accurately track, physical and mental symptoms, the clinicians can piece together a much more complete picture of a patient’s situation, allowing them to make well-informed decisions about appropriate next steps.

While digital tracking is more accurate than self-reporting, it is important to also be aware of inconsistencies across activity trackers: different devices measure activity in different ways. And while trackers have the potential to improve compliance, there may be patients who are not consistently adherent to the tracker itself, making it more challenging to interpret the data at-hand. Further evidence exploring long-term use, effectiveness and accuracy is needed to fully understand whether the benefits outweigh such challenges.

Looking at the bigger picture, capturing accurate data from wearable technology can go beyond improving outcomes on an individual level: a plethora of data can be collected and analysed to improve knowledge about the role of adherence to prescribed exercise and/or activity. Armed with such data, rheumatologists may be able to improve outcomes for patients living with rheumatic conditions.³

While managing large pools of data has huge potential benefits, such a feat does not come without its challenges. As we live in an increasingly digital world, concerns around data privacy are unsurprisingly front-of-mind for many people, and digital wearables, especially those which track location and personal health information, are not exempt.

When communicating data collection from such technology, honing a robust feeling of transparency and honesty is critical. Patients should know how and why their data is being used, be able to revoke permission for its use and be made aware of how this data collection may benefit them and other patients in the rheumatology space.

Wearable activity trackers can also be motivational for patients, as they provide easily accessible information about steps and exercise, which patients can directly impact.⁵ Devices that encourage goal setting and allow users to track and review progress can empower patients to take ownership over their condition.^3,5 Prescribed physical activity adherence can then be self-monitored by the patient and/or externally by clinicians. By having access to this information, patients can track their own progress first-hand, which may prove motivational to support compliance over a longer period of time.

The benefits of wearable trackers are becoming more readily recognised: allowing patients to achieve autonomy over prescribed exercise and providing data that may help to improve outcomes. However, the use of such technology raises a key issue around access. Such benefits will be limited to patients who, firstly, can afford the necessary technology and, secondly, have the level of digital literacy needed to work and manage a device.

As the move towards prevention gathers speed, it is clear that such devices can help to empower patients to improve adherence to lifestyle changes that may reduce the risk of flare-ups or exacerbations of rheumatic conditions. Healthcare systems are being pushed to their limits, and any additions that can make better use of available resources are worth exploring. Further research is needed to cement our understanding of the benefits of wearable technology so that we can ascertain whether these outweigh the challenges, from data privacy and accuracy to ensuring equal access.