Association Between Patient Factors and the Effectiveness of Wearable Trackers at Increasing the Number of Steps per Day Among Adults With Cardiometabolic Conditions: Meta-analysis of Individual Patient Data From Randomized Controlled Trials

Alexander Hodkinson, Evangelos Kontopantelis, Salwa S Zghebi, Christos Grigoroglou, Brian McMillan, Harm van Marwijk, Peter Bower, Dialechti Tsimpida, Charles F Emery, Mark R Burge, Hunter Esmiol, Margaret E Cupples, Mark A Tully, Kaberi Dasgupta, Stella S Daskalopoulou, Alexandra B Cooke, Ayorinde F Fayehun, Julie Houle, Paul Poirier, Thomas YatesJoseph Henson, Derek R Anderson, Elisabeth B Grey, Maria Panagioti

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Abstract

BACKGROUND: Current evidence supports the use of wearable trackers by people with cardiometabolic conditions. However, as the health benefits are small and confounded by heterogeneity, there remains uncertainty as to which patient groups are most helped by wearable trackers.

OBJECTIVE: This study examined the effects of wearable trackers in patients with cardiometabolic conditions to identify subgroups of patients who most benefited and to understand interventional differences.

METHODS: We obtained individual participant data from randomized controlled trials of wearable trackers that were conducted before December 2020 and measured steps per day as the primary outcome in participants with cardiometabolic conditions including diabetes, overweight or obesity, and cardiovascular disease. We used statistical models to account for clustering of participants within trials and heterogeneity across trials to estimate mean differences with the 95% CI.

RESULTS: Individual participant data were obtained from 9 of 25 eligible randomized controlled trials, which included 1481 of 3178 (47%) total participants. The wearable trackers revealed that over the median duration of 12 weeks, steps per day increased by 1656 (95% CI 918-2395), a significant change. Greater increases in steps per day from interventions using wearable trackers were observed in men (interaction coefficient -668, 95% CI -1157 to -180), patients in age categories over 50 years (50-59 years: interaction coefficient 1175, 95% CI 377-1973; 60-69 years: interaction coefficient 981, 95% CI 222-1740; 70-90 years: interaction coefficient 1060, 95% CI 200-1920), White patients (interaction coefficient 995, 95% CI 360-1631), and patients with fewer comorbidities (interaction coefficient -517, 95% CI -1188 to -11) compared to women, those aged below 50, non-White patients, and patients with multimorbidity. In terms of interventional differences, only face-to-face delivery of the tracker impacted the effectiveness of the interventions by increasing steps per day.

CONCLUSIONS: In patients with cardiometabolic conditions, interventions using wearable trackers to improve steps per day mostly benefited older White men without multimorbidity.


Original languageEnglish
Article numbere36337
Number of pages16
JournalJournal of Medical Internet Research
Volume24
Issue number8
DOIs
Publication statusPublished (in print/issue) - 30 Aug 2022

Bibliographical note

©Alexander Hodkinson, Evangelos Kontopantelis, Salwa S Zghebi, Christos Grigoroglou, Brian McMillan, Harm van Marwijk, Peter Bower, Dialechti Tsimpida, Charles F Emery, Mark R Burge, Hunter Esmiol, Margaret E Cupples, Mark A Tully, Kaberi Dasgupta, Stella S Daskalopoulou, Alexandra B Cooke, Ayorinde F Fayehun, Julie Houle, Paul Poirier, Thomas Yates, Joseph Henson, Derek R Anderson, Elisabeth B Grey, Maria Panagioti. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 30.08.2022.

We thank the authors who agreed to participate and supply their individual participant data: CFE, MRB, HE, MEC, MAT, KD,
SSD, ABC, AFF, EBG, JH, PP, TY, and JH. This study was funded by the Evidence Synthesis Working Group (project 390),
which is supported by the National Institute for Health Research School for Primary Care Research. The National Institute for
Health Research Greater Manchester Patient Safety Translational Research Centre has partly funded the time of MP.

Keywords

  • Systematic Review
  • Individual patient data
  • meta-analysis
  • Steps/day
  • wearable tracker
  • cardiometabolic conditions
  • diabetes
  • obesity
  • cardiovascular disease

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