Jiang Li, Ph.D., is the Founder and CEO of Vivalink, Inc.
Wearable technology has become a valuable tool for managing patient conditions and gathering real-time data, whether in routine healthcare monitoring or decentralized clinical trials. However, ensuring patient adherence to wearables remains a primary challenge in remote patient monitoring (RPM).
Patient adherence to the technologies associated with remote data collection is crucial for the success of RPM and clinical trials. Reliable data collection hinges on patients following the directions for using RPM devices to fully maximize their potential. And the older the age group, the bigger the challenge with technology.
Historically, patients have grappled with adherence, with approximately 50% of prescribed medications for chronic diseases not being taken as directed. The challenge extends to medical devices, and ensuring patient adherence to wearables is equally important for successful healthcare.
Wearable device manufacturers and providers can implement measures to address patient adherence challenges. By introducing innovative solutions and prioritizing user-centric design, they play a crucial role in improving patient adherence, ultimately contributing to enhanced healthcare outcomes and advancements.
Factors Affecting Patient Adherence
To effectively tackle patient adherence obstacles, healthcare providers, researchers and developers must have a comprehensive grasp of the underlying factors. These key challenges include:
• Technology Complexity: The complexity of some wearable devices can be a significant barrier to patient adherence. Patients, especially those unfamiliar with mobile devices and wearables, may find the technology overwhelming, deterring them from effectively using them.
• Lifestyle Compatibility: A patient’s lifestyle plays a crucial role in adhering to wearables. For instance, if a device is bulky and must be removed before activities like showering, patients may find it inconvenient and opt to skip wearing it during such times.
• Physical Limitations: Physical limitations, often prevalent in older or chronically ill patients, can hinder their ability to use wearables effectively.
• Forgetfulness And Lack Of Motivation: Patients, no matter how well-intentioned, can sometimes forget to wear their devices or neglect them for various reasons. It’s not uncommon for a patient to overlook wearing a device, especially if they don’t perceive immediate benefits or if using the device disrupts their routine.
Age And Disease Considerations
Age significantly influences wearable usage and adherence, resulting in distinct challenges and preferences among age groups. Most users of medical-grade wearables are older individuals managing chronic conditions like cardiovascular issues, diabetes and respiratory ailments or following an acute procedure such as post-surgery.
Older patients may face initial hurdles in adhering to wearables, due in part to limited technology exposure and apprehension about the device. Younger, more tech-savvy patients are more likely to embrace wearables for health tracking and management.
However, individual proficiency levels can vary greatly. To effectively cater to the diverse needs of patients across different age groups, it’s crucial to avoid making sweeping assumptions and offer customized support and training across all patient demographics.
Patients’ disease states also influence wearable adherence. For example, chronic conditions like diabetes and hypertension require continuous monitoring and data sharing. Patients with such conditions are more likely to embrace wearables that facilitate daily health tracking and data sharing with providers.
Acute health issues from injuries or sudden illnesses may require temporary wearable devices for diagnostic or follow-up purposes, with varying degrees of adherence. Recognizing the interplay between age and disease states enables providers and researchers to customize their approach, enhancing the overall healthcare experience for patients.
Clinical Trials Vs. Healthcare
Patient adherence varies between clinical trials and healthcare settings. In clinical trials, researchers typically assess adherence after the trial concludes. Patients’ awareness of their participation may motivate them to follow the study protocol. However, incomplete or inaccurate data can compromise trial outcomes and conclusions. To maintain data integrity, researchers should consider employing strategies such as compliance monitoring and robust data analysis.
In healthcare, continuous or real-time data is more widely used, but it’s especially critical in acute situations in which active monitoring may be required over a continuous period. When patients experience their actions’ impact on their health and are engaged in managing their well-being, they’re more likely to adhere to using wearables and follow treatment plans.
Providers, researchers and developers must understand the differences in patient adherence between clinical trials and healthcare settings. They can develop tailored strategies and solutions for optimizing adherence, enhancing patient outcomes and improving trial data quality.
Addressing Adherence Challenges
Overcoming patient adherence challenges requires multifaceted solutions. Wearable manufacturers and developers must design easy-to-use interfaces. For older or less tech-savvy users, larger font sizes and clear instructions are essential accessibility features. Simplifying the setup process by bundling cellular connections can minimize technical challenges, ensuring users can activate their devices with ease.
Another crucial aspect of improving adherence is ensuring wearable technology aligns with patients’ lifestyles. Manufacturers typically offer a range of devices, each optimized to perform effectively in its intended scenario. Selecting the right wearable and considering factors like water resistance, durability and comfort is crucial. Manufacturers should customize their technology to specific customer needs, tailoring it to each study or application’s specific requirements.
To address physical limitations, especially in older or ill patients, healthcare professionals can apply wearables in the clinic, ensuring proper and comfortable device placement for patients. In cases in which physical limitations or remote locations pose challenges, clinicians could consider home visits. Patients with physical limitations can benefit from customizable devices, such as those equipped with adhesive patches and adjustable straps.
Integrated reminders, whether within wearable apps or as push notifications, encourage consistent device usage. In one study, atrial fibrillation patients who received smartwatch notifications alongside standard care were more likely to adhere to medication regimens. Compliance dashboards allow clinicians to track which devices have been active on specific days and assess the overall connectivity percentage, enabling prompt intervention when detecting non-adherence.
Patient Adherence And The Future Of Medical Wearables
Patient adherence is critical to unlocking medical wearables’ full potential. Without high adherence levels, devices can’t maximize remote patient monitoring and clinical trials. To further advance the field, ongoing research and development is imperative. Manufacturers must continue to innovate and customize solutions to overcome adherence challenges.
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