Implementing Remote Patient Monitoring of Physical Activity in Clinical Practice.
Margaret McCarthy, David Jevotovsky, Devin Mann and 4 others
PMID 37723623WHAT IT FOUND
Cardiology patients often kept using remote physical-activity devices, but diabetes step counts did not improve and self-report overestimated activity.
These pilots show feasibility, not treatment effect.
Key findings
01In the diabetes pilot, mean weekly steps were similar at the end of monitoring, and self-reported activity was greater than Fitbit-recorded steps.
02In cardiology, 93% of patients remained for 12-week monitoring, but best-practice advisory signing varied from 2% to 65%.
03In stroke and traumatic brain injury, patients averaged 3689±1779 steps per day and reported more concerns with the wrist-worn monitor.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for RNs
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What it does not show
These are small pilot use cases, not trials of whether remote physical activity monitoring improves health. Full reports of the pilot studies had not yet been published or were in review. Three pilots took place in one large academic medical center, so smaller or rural hospitals may lack resources or electronic health record support. The cystic fibrosis study is ongoing, so its planned outcomes are not yet known. Wearable step data may be less reliable for people with slow or non-stereotypical gait or obesity, and devices are not standardized. Patients with lower income, older age, rural residence, limited health literacy, or limited English proficiency may face digital access barriers.
The easy way to misread this
Do not conclude that remote physical activity monitoring improves step counts or diabetes control. In the diabetes pilot, mean weekly steps were similar at the end, and hemoglobin A1c remained 8.1±1.6 (65mmol/mol) at baseline and 8.1±1.5 (65mmol/mol) at 12 weeks.