Feasibility of Using a Smartwatch to Intensively Monitor Patients With Chronic Obstructive Pulmonary Disease: Prospective Cohort Study.

Background: Acute exacerbations of chronic obstructive pulmonary disease (COPD) are associated with accelerated decline in lung function, diminished quality of life, and higher mortality. Proactively monitoring patients for early signs of an exacerbation and treating them early could prevent these outcomes. The emergence of affordable wearable technology allows for nearly continuous monitoring of heart rate and physical activity as well as recording of audio which can detect features such as coughing. These signals may be able to be used with predictive analytics to detect early exacerbations. Prior to full development, however, it is important to determine the feasibility of using wearable devices such as smartwatches to intensively monitor patients with COPD. Objective: We conducted a feasibility study to determine if patients with COPD would wear and maintain a smartwatch consistently and whether they would reliably collect and transmit sensor data. Methods: Patients with COPD were recruited from 3 hospitals and were provided with a smartwatch that recorded audio, heart rate, and accelerations. They were asked to wear and charge it daily for 90 days. They were also asked to complete a daily symptom diary. At the end of the study period, participants were asked what would motivate them to regularly use a wearable for monitoring of their COPD. Results: Of 28 patients enrolled, 16 participants completed the full 90 days. The average age of participants was 68.5 years, and 36% (10/28) were women. Survey, heart rate, and activity data were available for an average of 64.5, 65.1, and 60.2 days respectively. Technical issues caused heart rate and activity data to be unavailable for approximately 13 and 17 days, respectively. Feedback provided by participants indicated that they wanted to actively engage with the smartwatch and receive feedback about their activity, heart rate, and how to better manage their COPD. Conclusions: Some patients with COPD will wear and maintain smartwatches that passively monitor audio, heart rate, and physical activity, and wearables were able to reliably capture near-continuous patient data. Further work is necessary to increase acceptability and improve the patient experience.