Study: Tech, behavioral interventions didn't improve outcomes following a heart attack
- A system of medication reminders, financial incentives and social support did not improve outcomes after a heart attack, compared with usual care, a new study in JAMA Internal Medicine concluded.
- Patients were randomized to an integrated plan using wireless pill bottles, lottery-based incentives and social support or usual care to determine whether the additional prompts would increase medication adherence. All of the patients were on at least two or four drugs — statin, aspirin, beta blocker or antiplatelet agent.
- After 12 months, researchers found no statistically significant differences between the two groups in time to first rehospitalization for a vascular event or death, time to first all-cause hospitalization, total number of repeat hospitalizations, medication adherence or medical costs.
The researchers offer a handful of reasons why the intervention did not improve outcomes, including that patients’ determination in both groups to avoid another heart attack was motivating enough or that the process of enrolling in a clinical trial would discourage all but the truly motivated. Another factor could be the delay in starting the intervention, they say. The need to verify patient identifies via insurance claims meant patients didn’t enroll until on average 40.8 days after discharge from the hospital.
There’s been a lot of hype around wearable devices’ potential to change patient behavior, but so far the results have been mixed. A study published last year in JAMA found patients wearing devices with access to a web-based interface lost no more weight than patients with access to a standard website with fitness tracking functionality.
In a subsequent study, researchers at Cleveland Clinic found wide variation in different wearable wrist technologies’ accuracy in measuring heart rate. The researchers compared Apple Watch, Fitbit, Charge HR, Mio Alpha and Basis Peak in healthy adults and compared the results to an electrocardiogram. Accuracy ranged from a high of 90% with Apple Watch to the low 80 percentile for the other wearables.
Meanwhile, efforts like population health management continue to fuel interest in wearable technologies. Royal Philips launched a suite of medical-grade wearables designed for people whose lifestyle puts them at risk of chronic conditions like diabetes and obesity. And Medtronic has partnered with Fitbit to integrate health and activity data for patients with type 2 diabetes, their doctors and care teams. Fitbit is also offering sleep-tracking capabilities on some of its devices.