Adherence vs Acceptability of Wearable Devices

By Raggy Bains, Commercial Director

The experience which Activinsights has attained in the past decade and in conjunction with 800+ peer-reviewed publications and participating in 100+ clinical trials, has provided insights into the very real question regarding patient adherence vs acceptability of wearable devices.

We have concluded that there are a couple of dimensions to the discussion that will have different weights depending on the specific application:

• There is a difference between acceptability and adherence that is not frequently recognised in this space but always included in product design thinking. What a participant says they will / will not do is different to what actually happens in the field. We hear opinions and have seen some papers about increased acceptability of a wearable with a watch-face (which is obvious if you think about the likely answers to an acceptability questionnaire), but we have not seen anything that demonstrates better adherence. The data we are publishing on long-term adherence at EHRA from SafeHeart is, as far as we know, novel and demonstrates >90% adherence for a non-watch wearable.
• In public health, when using large numbers of wearables across a representative sample, ensuring that the wearable has no inherit value to the participant (i.e., no watch face) has been seen as a way to improve device return rates.
• Providing a sensing wearable without an everyday function limits the probability that the device itself is an intervention that alters behaviour.
• Watches are as much lifestyle objects as functional items for telling the time. When we make a professional sensing wearable more like these lifestyle devices, we risk them being rejected by participants on aesthetic grounds or for a design to be polarising. Consumer lifestyle products manage this by providing different variants of colour or design – we may not want to take on the cost and complexity of this with professional medical grade wearables.
• There is also the very practical question of how they are worn. A participant who doesn’t wear watch is probably not asking for this functionality. A participant who wears a watch will either have to replace their watch with the professional wearable or wear two watches (one on either wrist). We have not seen research that tackles these questions for short-term or long-term wear.

In conclusion, Activinsights are guided by our in-depth peer reviewed publications over the past decade, as well as strong supportive evidence as emanating from recent clinical studies to continue to pursue our strategy based on collecting physical objective movement data, mainly at the wrist.