748 - Safety and adverse event monitoring in wearable health tracker interventions for cancer rehabilitation: a review

Friday, February 23, 2024

5:00 PM – 6:30 PM EDT

Presenting Author(s)

NB

Nicole R. Bennington-McKay, BA

Medical Student
University of Washington School of Medicine
Seattle, Washington, United States

Corresponding Author(s)

HH

Hanna Hunter, MD

Assistant Professor
University of Washington School of Medicine, Department of Rehabilitation Medicine
Seattle, Washington, United States

Objectives: There is growing interest in mHealth (mobile health) interventions to promote exercise in the oncology patient population, many with medical complexity and barriers to attending in-person exercise programs. The purpose of our study was to 1) evaluate heterogeneity in safety and adverse event monitoring in exercise studies utilizing wearables in cancer rehabilitation and 2) compare the functional outcome measures evaluated among different oncology patient populations.

Design: A review was conducted in PubMed, Cochrane, and Embase. Studies were included if they utilized a pedometer or wearable health tracker-based intervention in an oncology patient population. Search terms included “neoplasm” and “pedometer” or “step count” or “wearable activity monitor.”

Results: 36 eligible studies involving 3031 participants with breast, colorectal, urologic, hematologic, brain, and liver cancers were identified. Studies were assessed for their type of exercise intervention, safety specific inclusion and exclusion criteria, healthcare professional involvement, and adverse event monitoring. 13 studies utilized pedometers, 19 utilized commercial fitness trackers, and 4 utilized both, in aerobic and walking-based exercise interventions. 10 studies also utilized a self-created website or app. Many excluded patients with metastatic disease, poor functional status or health comorbidities. Few studies defined criteria for adverse events, and studies that did were more likely to report adverse events. 3 studies reported serious adverse events, such as cardiac arrest or death. Primary outcomes varied from fatigue, increase in step count, quality of life, and physical performance measures.

Conclusions: There is a lack of uniformity in safety and adverse event monitoring in studies of wearable health trackers and mHealth in cancer rehabilitation. While adverse events are rare, protocols should be established for adverse event monitoring and reporting. Through personalized programming, exercise experts, such as physiatrists, can bridge the gap to medically complex patient populations that need rehabilitation but are commonly excluded from these mHealth exercise interventions.