JMIR Publications

ABSTRACT

Background:

Cardiovascular diseases (CVDs) are a major global health burden, yet effective risk management can substantially reduce their impact. Digital biomarkers, collected through sensor-based digital health technologies (sDHTs), enable continuous, non-invasive monitoring and are considered promising tools for improving cardiovascular risk management (CVRM). However, despite growing evidence that aligning technologies with patient-defined needs is critical for adoption and impact, patient perspectives remain insufficiently integrated into digital biomarker development.

Objective:

To identify meaningful aspects of health, care needs and preferences for sDHTs among Dutch patients in CVRM care pathways guided by the digital biomarkers that matter framework.

Methods:

Eighty-five adults in the CVRM care pathway completed a cross-sectional survey (May–June 2023) including single-choice, multiple-choice, and open-ended questions. Exploratory subgroup analyses were conducted by genetic risk (yes/no) and treatment status (treated/untreated). Open-ended responses were thematically coded and quantified. Group differences were analyzed using generalized linear models: bias-reduced binomial models for coded open-ended data, multinomial logistic regression for multiple-choice items, and binomial models for single-choice items. Post hoc estimated marginal means were used for pairwise comparisons; p<.05 was considered statistically significant.

Results:

Perceived burdens differed significantly (χ²=35.76, p<.001), with untreated respondents primarily reporting fear and uncertainty, and treated respondents reporting physical and pharmacotherapy-related burdens (p=.008). Activity priorities also differed (χ²=46.11, p<.001; interaction χ²=23.19, p<.001); untreated respondents more often reported no desired activities, whereas sports and moderate-intensity exercise were most frequently mentioned overall. Frequently reported health goals included improving exercise capacity and lifestyle change. Care-related burdens and improvement needs were heterogeneous; although “nothing” was the most frequently reported single theme, most respondents described specific issues, particularly pharmacotherapy-related burdens and a need for more personalized care. Digital health technology use was common (89.0%); most respondents desired access to their data (97.1%) and were willing to share these with HCPs (86.9%). However, a minority reported limited perceived value or stress related to continuous monitoring. Overall, 82.9% considered sDHTs also useful for lifestyle management.

Conclusions:

Digital biomarkers for CVRM should be aligned with patient-prioritized domains and support more personalized care delivery. In particular, the expressed need for tailored treatment and at-home monitoring highlights an opportunity for sDHTs to enable individualized, context-specific insights beyond clinic-based assessments. Realizing this potential will require that such technologies deliver meaningful, actionable outputs and are effectively integrated into clinical care pathways and research settings. Clinical Trial: Cardiovascular Diseases; Digital Biomarkers; Wearable sensors; patient-centric care; Survey and Questionnaires; digital outcome measure