Smartwatches for Chronic Disease Prevention?

A Step in the Right Direction: Exploring the Potential Role of Smartwatches in Supporting Chronic Disease Prevention in Healthcare

In their thought-provoking article, "A Step in the Right Direction: The Potential Role of Smartwatches in Supporting Chronic Disease Prevention in Healthcare," The authors shed light on the pressing issue of chronic diseases in Australia and the need for a paradigm shift towards preventive healthcare. The authors emphasise the potential of smartwatches in contributing to a predict-prevent model of healthcare, highlighting the importance of clinical regulation as a crucial first step. The article presents an insightful analysis of the current role of smartwatches in chronic disease prevention, regulatory frameworks in Australia, and proposes a roadmap for integrating these devices into a digitally enabled precision prevention model of care.

The concept of predict-prevent healthcare is explored, leveraging real-world data to predict risks, intervene, and prevent adverse clinical outcomes. The authors assert that digital health innovations, such as smartwatches, play a vital role in enabling this proactive model of care. Smartwatches generate real-world data and have gained popularity among Australians, offering the potential to provide health information in real time. While acknowledging the varying accuracy of smartwatch data across metrics and manufacturers, the article highlights the positive impact of patient-generated real-world health data in enhancing patient engagement, trust with care providers, and autonomy.

The article explores the ability of smartwatches to track various health metrics, such as step count, heart rate, sleep stage estimation, and heart rate variability. Although the evidence supporting the use of smartwatches in chronic disease prevention is limited, the potential for individualised care and early detection of deteriorations related to chronic conditions is emphasised. Smartwatches can complement the predict-prevent model of healthcare by facilitating disease physiology understanding and providing lifestyle recommendations based on user data. However, the article acknowledges that to date, only one study has demonstrated a reduction in all-cause hospital re-admission using a smartwatch-based digital intervention.

The authors touch on the regulatory frameworks surrounding smartwatch applications in Australia. The Therapeutic Goods Administration (TGA) is responsible for regulating medical device software, including smartwatch applications. However, only a few smartwatch-enabled applications have received TGA approval, primarily as disease-focused diagnostic support tools. The example of the Apple Watch's electrocardiogram algorithm, which prompts users if an irregular heart rhythm is detected, is given. It clarifies that while this algorithm has potential diagnostic benefits, it cannot be used independently for diagnosis or treatment initiation. The need for improved accuracy, clarity, and trust in smartwatch applications, as well as the necessity for formal training for clinicians to interpret the vast amounts of data generated is emphasised.

To overcome the challenges associated with integrating smartwatches into existing models of chronic disease prevention, the authors propose a roadmap aligned with three horizons for precision prevention. The roadmap focuses on addressing issues such as data accuracy, interoperability, data familiarity, equity and accessibility, and implementation. The article highlights the importance of bridging the digital health divide between socio-economic groups to ensure equal access and benefits of digital health technologies. It also underscores the need for data protection laws to safeguard privacy and prevent financial discrimination by health insurers. 

In conclusion, the article provides valuable insights into the potential role of smartwatches in supporting chronic disease prevention in healthcare. It emphasizes the importance of clinical regulation and accuracy of smartwatch applications while outlining a roadmap for their integration into precision prevention models of care. By addressing the challenges identified and promoting further research and understanding, smartwatches have the potential to enhance autonomy, improve health outcomes, and contribute to the much-needed shift towards preventive healthcare in Australia. 

MNCLHD staff can read the full article via CiAP click on the tile linked below. SSO required.

A step in the right direction: the potential role of smartwatches in supporting chronic disease prevention in health care, by Mattison, Graeme: Canfell, Oliver J; Forrester, Doug; Dobbins, Chelsea; Smith, Daniel; Reid, David; Sullivan, Clair. Medical Journal of Australia, Issue: Volume 218(9), May 2023, p 384-388.

Honouring our Nurses.

 

In honour of International Nurses Day, it is important to highlight the crucial role that nurses have played during the COVID-19 pandemic. Two recent articles shed light on the challenges that nurses have faced during the pandemic and the need for their voices to be heard in decision-making processes.

The first article, "We're on mute! Exclusion of nurses' voices in national decisions and responses to COVID‐19: An international perspective" published in the Journal of Advanced Nursing in July 2022, highlights the exclusion of nurses from important decision-making processes during the pandemic. The article argues that nurses, who are on the frontlines of the pandemic response, have been marginalized and excluded from national discussions and decision-making processes. This exclusion has resulted in a lack of consideration for the practical realities of nursing care and has contributed to the burnout and frustration experienced by many nurses.

The second article, "The impact of the COVID-19 pandemic on Australian hospital-based nursing and midwifery educators" published in Collegian in June 2022, focuses on the impact of the pandemic on nursing and midwifery educators in Australia. The article highlights the agility demonstrated by educators in adjusting to the fast-changing requirements of providing education during the pandemic. However, the article also emphasises the need for continued occupational and psychosocial support for educators during the pandemic, as well as inclusion in discussions to inform hospitals' preparedness for managing the education of nurses and midwives during future pandemics.

Taken together, these articles highlight the important role that nurses play in responding to pandemics and the need for their voices to be heard in decision-making processes. The pandemic has exposed the vulnerabilities and gaps in healthcare systems around the world, and it is essential that nurses are included in discussions to ensure that future responses are more effective and equitable. On this International Nurses Day, it is important to recognise the contributions of nurses and advocate for their inclusion in decision-making processes to ensure that their expertise is valued and utilized.

Both articles are linked to the full-text pdf.

Celebrating International Nurses Day

International Nurses Day is celebrated annually on May 12th to honour the contribution of nurses towards improving the health and wellbeing of individuals and communities around the world. The theme for this year's celebration is "Nurses: A Voice to Lead - A Vision for Future Healthcare."

Nurses play a crucial role in the healthcare system, serving as the backbone of the healthcare workforce. They provide care and support to patients in various settings, including hospitals, clinics, nursing homes, and home care. Nurses are responsible for a wide range of tasks, from administering medication and monitoring vital signs to providing emotional support and educating patients and their families.

The COVID-19 pandemic has highlighted the importance of nurses in the healthcare system. Nurses have been at the forefront of the fight against the pandemic, working tirelessly to care for patients and save lives. They have faced numerous challenges and long hours of work but have continued to provide high-quality care.

This year's theme highlights the role of nurses as leaders in healthcare. Nurses have a unique perspective on healthcare and are well-positioned to advocate for policies and practices that improve patient outcomes. They can use their voices to push for changes that address the root causes of health disparities and improve access to care.

As we celebrate International Nurses Day this year, we should recognise the hard work and dedication of nurses around the world and reflect on the challenges they face and the need for greater investment in the nursing profession. By supporting nurses, we can build a stronger, more resilient healthcare system that delivers high-quality care to all individuals and communities.

Are you prescribing e-liquids for e-cigarettes?

What doctors should consider before prescribing e-liquids for e-cigarettes an article in the Medical Journal of Australia asks - An Australian standard for prescribing e-cigarette nicotine has arrived — are you prepared with the facts?

Various nicotine replacement therapies have been approved by the Therapeutic Goods Administration as safe and effective smoking cessation tools. Many smokers are now using e-cigarettes to reduce their tobacco consumption even though there is no clear unbiased data on whether and how effectively they help. There is however a growing body of evidence that shows they may cause harm. Evidence has emerged showing that using both tobacco cigarettes and e-cigarettes may be worse then doing either alone, particularly for heart health.

                                                                            Source: MJA

Read the whole very informative article that details the effects of flavourants on nictine absorbtion that could in fact increase nicotine addiction. They stress that it is critical for physicians to be aware of these effects and to recommend prescribing with structured behavioural support to promote tobacco cessation and ideally complete nicotine abstinence.

Medical Journal of Australia2022: 216(1) 14-16.

Find more evidence in this current review which summarizes the latest evidence in a clinically focused framework to facilitate translation of emerging knowledge to practice. “Youth vaping: a review and update on global epidemiology, physical and behavioral health risks, and clinical considerations” by Timothy D. Decker & Timothy R. Rice. European Journal ofPediatrics 2022:181(2) 453-462