A recent study in JAMA Network Open found that fewer than 1 in 4 people with or at risk for cardiovascular disease (CVD) use wearable devices, and only half of those who wear them do so consistently.

Wearable devices, such as those made by Apple and Fitbit, are becoming increasingly sophisticated in their ability to track heart rates, physical activity, and sleep, and obtain electrocardiograms, and several other measures—capabilities that can be especially helpful for monitoring the health of people with CVD.

The population-based, nationally representative study included 9,303 participants from the Health Information National Trends Survey (HINTS). Eighteen percent of people with established CVD and 26 percent at risk for CVD reported using wearable devices compared with 29 percent of the general population.

"We are so used to seeing data that lives in the healthcare setting, but increasingly people in the community have access to these devices and technologies that can provide a very well-rounded set of data points that can inform their clinical care," says the study's senior author Rohan Khera, MD, MS, assistant professor at Yale School of Medicine, and director of the Cardiovascular Data Science (CarDS) Lab.

"We wondered if we looked at a national survey of individuals, could we figure out who are the people who are actually using these devices? And if we looked at a specific population, those with cardiovascular diseases, what are we seeing?"

Older age, lower educational attainment, and lower household income were associated with significantly lower odds of wearable device use, likely due to these populations having less access to these devices or discomfort with using the technology.

"The people who stand to benefit the most tend to use them the least," says Khera. "I think part of it is awareness. People may not recognize the potential value that these devices can bring to the health side, especially since the evidence for their value to health is still evolving. And the other piece is of course their cost and the fact that people who have health disorders might have actually other costs to take care of, so these things may seem frivolous for them."

Identifying the obstacles among people who could benefit from wearable devices but aren't using them ultimately led the researchers to consider whether strategies should be put in place to ensure equitable adoption.

"If we are increasingly recognizing the health worth of these devices, says Khera, should we start having a societal debate about whether it remains a concierge technology only for the wealthy? Or do we start thinking about it as a medical intervention and therefore under the purview of insurance coverage and so forth?"

--Christina Frank, Yale School of Medicine