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January 10, 2019

Minus human interaction, FitBit not so effective for heart patients

By: Dr. Jeff Alfonsi

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Home-based wearable activity monitors like FitBit continue to increase in popularity but their effectiveness may be limited when it comes to recovery for heart patients.

Exercise therapy is an essential component of managing peripheral artery disease (PAD), however a 2018 study in the Journal of the American Medical Association (JAMA) indicates that wearable devices might not actually improve recovery results in patients with PAD.

The Home-Based Monitored Exercise for PAD (HONOR) randomized clinical trial explored whether a FitBit-type device plus phone coaching would improve the walking ability of 200 PAD patients over nine months. Dr. Mary M. McDermott, Northwestern University Feinberg School of Medicine, and colleagues observed that the walking performance of patients in the intervention group did not improve compared with those who received usual care.

So what can we take away from the findings? Other studies have consistently shown that patients need a structured and interactive exercise program. They do best when led by a coach with ongoing interaction, either individually or in groups. In a world where technology use grows daily, maintaining a human connection becomes increasingly key, even when it comes to health.

For patients who are isolated or have limited one-on-one interaction, the human element may be even more critical to a successful recovery, according to Dr. Adam Power, a vascular surgeon with the University of Western Ontario, who commented on the trial. Devices like Fitbits actually further minimize or altogether remove that element of human connection. “The healthcare community should never overlook the social aspects of health and healing, which is perhaps, at times, underestimated,” says Dr. Power.

Some PAD patients benefit from the support of family and friends to stay motivated, but others need an additional boost from their doctor or healthcare team. Dr. Power draws on his own experience: weekly texts with one particular patient were enough contact and motivation to finally enable this patient to hit his weight loss goals.

“It’s also important for patients to have a coach they know, feel comfortable with, and respect. Having that human connection between a recovering patient and their coach assists in maintaining the patient’s motivation, particularly for those who struggle individually with self-motivation,” says Dr. Power, who stresses that while helpful as progress trackers, devices should not serve as a sole substitute for one-on-one or group coaching sessions.

Other forms of technology that foster social interaction could potentially be incorporated with benefit, such as social walk networks, FaceTime during walks, and connecting through online chats or forums.

About the author: Dr. Jeff Alfonsi is a practising internist and clinical pharmacologist, and Director of Medical Affairs at OTN.