Wearable technology interventions in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis

Abstract

Chronic obstructive pulmonary disease (COPD) is the third leading cause of death and is associated with multiple medical and psychological comorbidities. Therefore, future strategies to improve COPD management and outcomes are needed for the betterment of patient care. Wearable technology interventions offer considerable promise in improving outcomes, but prior reviews fall short of assessing their role in the COPD population. In this systematic review and meta-analysis we searched ovid-MEDLINE, ovid-EMBASE, CINAHL, CENTRAL, and IEEE databases from inception to April 2023 to identify studies investigating wearable technology interventions in an adult COPD population with prespecified outcomes of interest including physical activity promotion, increasing exercise capacity, exacerbation detection, and quality-of-life. We identified 7396 studies, of which 37 were included in our review. Meta-analysis showed wearable technology interventions significantly increased: the mean daily step count (mean difference (MD) 850 (494–1205) steps/day) and the six-minute walk distance (MD 5.81 m (1.02–10.61 m). However, the impact was short-lived. Furthermore, wearable technology coupled with another facet (such as health coaching or pulmonary rehabilitation) had a greater impact that wearable technology alone. Wearable technology had little impact on quality-of-life measures and had mixed results for exacerbation avoidance and prediction. It is clear that wearable technology interventions may have the potential to form a core part of future COPD management plans, but further work is required to translate this into meaningful clinical benefit.

Supporting self-management for patients with Interstitial Lung Diseases: Utility and acceptability of digital devices

“…The risk of disease progression depends on the specific type of ILD, as well as the individual patient’s disease course [ 45 ]. Early access to digital devices during the treatment pathway, while individuals are actively seeking information and education, has the potential to provide greater benefits and encourage positive lifestyle changes [ 16 ]. The use of digital devices is becoming integral to the overall monitoring and support framework and standard of care for patients.…”

“…Innovative approaches to healthcare emerged during the COVID-19 pandemic with increased interest in more readily available and affordable digital devices [ 7 , 19 ]. Remote monitoring programs are increasingly embedded in clinical care [ 7 , 13 , 14 , 16 , 20 ], e.g. in the UK the ‘COVID Oximetry@home’ service remotely monitors peripheral oxygen saturation (SpO 2 ) in patients at risk of deterioration due to ‘silent’ hypoxia to target care and greater efficient use of National Health Service (NHS) resources [ 21 ].…”

“…This enables the development of personalized treatment approaches in this cohort [6,[8][9][10][11][12]15]. Supported self-management measures monitor the progression of a patient's condition objectively, with digital technologies and subjectively, through the completion of patient-reported measures capturing symptom experiences and health-related qualityof-life (HRQOL) [6,12,16]. The use of digital devices, in this context, aligns with the need for early intervention and cost-effective management, reinforcing their relevance and utility for patients with ILD [6,12,15].…”