The Views and Needs of People With Parkinson Disease Regarding Wearable Devices for Disease Monitoring: Mixed Methods Exploration

Abstract

Background Wearable devices can diagnose, monitor, and manage neurological disorders such as Parkinson disease. With a growing number of wearable devices, it is no longer a case of whether a wearable device can measure Parkinson disease motor symptoms, but rather which features suit the user. Concurrent with continued device development, it is important to generate insights on the nuanced needs of the user in the modern era of wearable device capabilities. Objective This study aims to understand the views and needs of people with Parkinson disease regarding wearable devices for disease monitoring and management. Methods This study used a mixed method parallel design, wherein survey and focus groups were concurrently conducted with people living with Parkinson disease in Munster, Ireland. Surveys and focus group schedules were developed with input from people with Parkinson disease. The survey included questions about technology use, wearable device knowledge, and Likert items about potential device features and capabilities. The focus group participants were purposively sampled for variation in age (all were aged >50 years) and sex. The discussions concerned user priorities, perceived benefits of wearable devices, and preferred features. Simple descriptive statistics represented the survey data. The focus groups analyzed common themes using a qualitative thematic approach. The survey and focus group analyses occurred separately, and results were evaluated using a narrative approach. Results Overall, 32 surveys were completed by individuals with Parkinson disease. Four semistructured focus groups were held with 24 people with Parkinson disease. Overall, the participants were positive about wearable devices and their perceived benefits in the management of symptoms, especially those of motor dexterity. Wearable devices should demonstrate clinical usefulness and be user-friendly and comfortable. Participants tended to see wearable devices mainly in providing data for health care professionals rather than providing feedback for themselves, although this was also important. Barriers to use included poor hand function, average technology confidence, and potential costs. It was felt that wearable device design that considered the user would ensure better compliance and adoption. Conclusions Wearable devices that allow remote monitoring and assessment could improve health care access for patients living remotely or are unable to travel. COVID-19 has increased the use of remotely delivered health care; therefore, future integration of technology with health care will be crucial. Wearable device designers should be aware of the variability in Parkinson disease symptoms and the unique needs of users. Special consideration should be given to Parkinson disease–related health barriers and the users’ confidence with technology. In this context, a user-centered design approach that includes people with Parkinson disease in the design of technology will likely be rewarded with improved user engagement and the adoption of and compliance with wearable devices, potentially leading to more accurate disease management, including self-management.

Feasibility and usability of a digital health technology system to monitor mobility and assess medication adherence in mild-to-moderate Parkinson's disease

“…We received mixed feedback about the devices, particularly the smartwatch was considered “ too big ” and “ bulky ” by some participants but too small to use with a tremor by others. These findings follow previous research that suggests that wearable devices should be adjusted to individuals' needs and motor symptoms ( 49 ). Participants should therefore be offered a range of models between which they are free to choose based on personal preference.…”

“…Overall, participants in this study considered the DHTS usable, however the usability score given by participants was negatively correlated with age, indicating that younger adults felt more at ease using the DHTS. This may be a consequence of the lack of experience with DHT associated with advanced age ( 48 ), or a lack of confidence associated with handling new technology observed in older adults with PD ( 49 ). This suggests that participants may have benefitted from more practice time.…”

“…The greater acceptance of using our DHTS may result from our devices being small, and easily hidden by clothing. Additionally, although many participants in our study were willing to utilise the DHTS, previous studies have highlighted that they do not want this as a replacement for clinical consultations with participants often prioritising communication with their clinician (47,49).…”

Feasibility and patient acceptability of a commercially available wearable and a smart phone application in identification of motor states in parkinson’s disease

“…Continuous monitoring of both motor and non-motor symptoms in patients with PD would offer an opportunity to improve therapeutic regimens in both standard care and especially in clinical trials where accuracy in valuation of treatment effects is critical [9]. Both patients and health care professionals see promises in wearable monitoring technologies in supplementing and improving the care of PD [8,10]. Several solutions for continuous monitoring of PD have been presented [11,12].…”

“…Many of the technologies require use of several sensors attached to the body [11][12][13]. However, patients with PD prefer small, easy-to-use devices that would not interfere with their daily routine [8,10]. Several studies have evaluated the feasibility and accuracy of data collected using a smartwatch and smartphone [14][15][16] A substantive literature on detection of Parkinson symptoms from wearable data exists [17,18].…”