The Impact of an Electronic Best Practice Advisory on Patients' Physical Activity and Cardiovascular Risk Profile.
Margaret M McCarthy, Adam Szerencsy, Jason Fletcher and 9 others
PMID 37467192WHAT IT FOUND
Fitbit step counts did not rise after 12 weeks.
Patients who also got provider counseling and activity surveys reported more activity and walked farther. All three happened together.
Key findings
01Fitbit step counts did not change significantly from week 2 to week 12, but self-reported moderate-to-vigorous activity increased from 43±86 to 114±157 minutes per week.
02Six-minute walk distance improved from 469±108 to 494±132 meters, and 23 participants (42%) improved by at least 25 meters.
03Total cholesterol fell from 163±51 to 148±45 mg/dl, and HDL cholesterol fell from 48±17 to 43±18 mg/dl.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for RNs
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What it does not show
This was a pilot study, so it was designed to test preliminary change rather than prove the care bundle works. The paper states that not all providers documented the best practice advisory, so the amount of counseling received is unclear. The sample was mostly White and highly educated, which limits generalizability. The study did not assess changes in lipid or blood pressure medication dosages or diet, which could affect risk-factor results. Participants were enrolled over 10 months, and the study did not assess weather or season as possible influences on activity. Some participants may have increased activity between their cardiology visit and enrollment, which could affect measured change. The decrease in HDL cholesterol was unexplained in the paper.
Declared interests
No conflict-of-interest statement appears in the supplied article text. The supplied publication types list NIH extramural support.
The easy way to misread this
Do not conclude that the electronic best practice advisory or the Fitbit caused the walk-test or self-report gains. The patients also received provider counseling, counseling was not fully documented, and this was a pilot study. Also, Fitbit steps did not change significantly, and HDL cholesterol fell.