JMIR Publications

ABSTRACT

Background:

Current evidence supports the use of wearable trackers in people with cardiometabolic conditions. However, as the health benefits are small and conflicted by heterogeneity, there remains uncertainty of which patient groups wearable trackers are most helpful.

Objective:

This study examined the effects of wearable trackers in patients with cardiometabolic conditions to identify subgroups of patients who benefit most and understand interventional differences.

Methods:

We obtained individual participant data (IPD) from RCTs before December 2020 on wearable trackers measuring the primary outcome ‘steps/day’ in participants with cardiometabolic conditions, including diabetes, overweight/obesity, and cardiovascular disease. We used statistical models accounting for clustering of participants within trials and heterogeneity across trials to estimate mean differences with 95% confidence intervals (CIs).

Results:

IPD were obtained from nine of the 25 eligible RCTs comprising 1,481/3,178 (47%) participants. Wearable trackers showed significant increases in physical activity over median 12 weeks by 1,656 (95%CI 918, 2,395) steps/day. Men (coefficient=-668, 95%CI -1,157, -180), those aged over 50 (50-59years=1,175, 95%CI 377, 1973; 60-69years=981, 95%CI 222, 1740; 70-90years=1060, 95%CI 200, 1920), white patients (coefficient=995, 95CI% 360, 1631) and patients with fewer comorbidities (coefficient=-517, 95%CI -1188, -11) achieved greater increases in physical activity from interventions using wearable trackers compared to women, those aged below 50, non-white patients and patients with multimorbidity. In terms of interventional differences, only face-to-face delivery of the tracker impacted the effectiveness of the interventions by increasing physical activity.

Conclusions:

In patients with cardiometabolic conditions, interventions using wearable trackers to improve physical activity mostly benefit older white men without multimorbidity. Clinical Trial: PROSPERO CRD42019143012.