Pandemic boom in wearable device use bares disparities in healthcare access

Despite the uptick in digital cardiology care during the coronavirus disease 2019 (COVID-19) pandemic, several key barriers to wearable device use remain, including high costs and limited technology knowledge, according to a recent study.

“Demographic and socioeconomic disparities negatively impact wearable health devices and telemedicine adoption within cardiovascular clinic patients,” the researchers said. “Although telemedicine use increased after COVID-19, this effect was not observed for wearables, reflecting significant economic and digital literacy challenges underlying wearables acceptance.”

A total of 299 participants (mean age 54 years, 50.8 percent women) were cross-sectionally surveyed. All were receiving care at a cardiology clinic. Ninety-nine patients noted that they had started using wearable devices amid COVID-19, while 107 noted that they had been using such devices even before the pandemic. [Cardiovasc Digit Health 2021;doi:10.1016/j.cvdhj.2021.10.007]

Participants who were using wearables were significantly younger than those who opted not to use such devices (mean age, 49.7 vs 56.7 years; p=0.0019). Device use also differed significantly according to race, with 42.6 percent of Caucasians vs 26.4 percent of African-Americans reporting the use of wearables (p=0.0184). No such effect was reported for sex (p=0.0688).

Moreover, participants with lower educational levels had significantly lower rates of using wearable devices as opposed to their more educated counterparts (p<0.0001).

Multivariate logistic regression modelling confirmed that younger age (odds ratio [OR], 0.975, 95 percent confidence interval [CI], 0.955–0.995; p=0.01) and higher educational attainment (OR, 1.479, 95 percent CI, 1.012–2.161; p=0.04) were significant correlates of using wearables.

Despite men and women using wearables at comparable rates, statistical modelling showed that women were nearly 80 percent more likely to use such devices than men (OR, 1.77, 95 percent CI, 1.007–3.135; p=0.04). Having previously been diagnosed with COVID-19, in contrast, did not predict the use of wearable devices.

The online survey also collected patients’ opinions on the use of wearables. Views were mostly positive, with majority (60.1 percent) believing that such devices could supplement routine tests and 33 percent saying that they could even replace such tests.

However, important barriers to adoption still exist. Ten percent of participants noted that lack of technical knowledge hindered them from using wearables, while 17.1 percent cited high costs as a major detriment.

“Our findings highlight that expanding digital health tools by industry and healthcare systems is not sufficient to fully explore their potential in personalized and remote clinical care,” the researchers said. “Promoting wearables and telemedicine use in a population that is older, more impoverished, and experiencing more risk factors and comorbidities can generate a much greater public health impact and reduce healthcare costs, especially during challenging healthcare landscapes.”

“Given the increasing trend in digital tools implementation in healthcare systems, our data supports a swift intervention to minimize digital health disparities before it exacerbates with time and magnifies unequal access to quality healthcare,” they added.