AFib patients are increasingly using consumer wearable devices for symptom monitoring, but a new JAHA study suggests that these devices’ often-publicized healthcare benefits are offset by their negative impacts on patient anxiety and healthcare overuse.
The researchers analyzed 9-month EHR records of 172 propensity‐matched patients with AFib (avg. age: 72), including 83 who used wearable devices (mainly Apple Watch or Fitbit), finding that wearable users…
- Consistently tracked their biometrics, including 45% who checked their heart rate or ECG daily, versus 19% who only checked in response to cardiac symptoms.
- Reported high rates of “intense fear and anxiety” (20% of users) or “always feeling anxious, scared, or concerned” (15% of users).
- Commonly contacted their doctor after receiving a “possible AF” notification, including 20% who “always” notified their doc.
- Were far more concerned about the efficacy of their AF treatments (QoL treatment concern scores: 77.71 vs. 84.11)
As a result, the wearable patients used far more AF-specific health care resources (mean uses: 4.05 vs. 2.7), including more outpatient clinic visits (2.04 vs. 1.33) and more rhythm‐related diagnostic tests and procedures (1.84 vs. 1.00) over the 9 months.
- That includes ECGs (P=0.003), echo exams (P=0.04), and ablation procedures (P=0.03).
The wearable users were also significantly more likely to use informal health care resources such as portals and messaging (5.52 vs. 3.90), sending far more messages to providers (3.59 vs. 2.41) and receiving twice as many responses.
Some might be tempted to chalk this up to the attributes of people who choose to use wearables, but the two groups didn’t differ in education, socioeconomics, AF status/history, or psychiatric status/history.
- In other words, it could be that merely using a wearable is more likely to make AF patients anxious about their conditions, preoccupied with their device metrics, and more likely to seek and receive care.
The Takeaway
Whether clinicians like it or not, wearables are playing a growing role in their patients lives, sometimes helping with early detection, while apparently risking their psychological wellbeing and driving more healthcare use.
As a result, clinicians will likely have to build their expertise in directing care for wearable-detected AFib abnormalities, and helping their patients deal with the psychological aspects of having all this information literally within arms reach.
