Study finds Fitbits can be used to monitor symptoms in transplant patients

UNC Lineberger researchers say the findings of a new study published in the journal Quality of Life Research indicate that activity trackers could be a useful tool for tracking symptoms and physical function. These trackers may be especially useful for patients who are not able to self-report symptoms using questionnaires because of language barriers, literacy, cognitive or health status.

Study finds Fitbits can be used to monitor symptoms in transplant patients click to enlarge UNC Lineberger members Antonia Bennett, PhD and William Wood, MD

Activity trackers like the Fitbit are designed to track people’s health by counting daily steps and measuring sleep. But can they be used to gauge patients’ symptoms and overall functional status after a serious medical procedure?

Researchers from UNC Lineberger explored that question in a new study. They used Fitbits to track the physical activity of 32 patients who had undergone bone marrow transplant, finding that decreases in average daily steps were associated with increases in pain, fatigue, nausea and other symptoms, as well as a reduction in self-reported physical activities.

The researchers say the findings, which were published recently in the journal Quality of Life Research, indicate that activity trackers could be a useful tool for tracking symptoms and physical function systematically, especially for patients who may not be able to self-report their symptoms using questionnaires because of language barriers, literacy, cognitive or health status.

“We found that changes in daily steps are highly correlated with pain and fatigue,” said Antonia Bennett, PhD, a UNC Lineberger member and research assistant professor in the UNC Gillings School of Global Public Health. “These wearables provide a way to monitor how patients are doing, and they provide continuous data with very little patient burden.”

In the study, the research team evaluated daily steps, as measured by Fitbit Flex activity trackers, and symptoms, in patients undergoing bone marrow transplant. Patients receive this procedure as a treatment for leukemia, lymphoma, myeloma and other diseases. Transplant is also linked to significant short-term side effects, usually due to the chemotherapy and radiation they receive.  

In the study, the sample of adult transplant recipients wore the activity trackers and completed assessments about their symptoms and quality of life for four weeks during transplant hospitalization and four weeks after discharge.

The research protocol that provided the data for this study was led by William Wood, MD, a UNC Lineberger member and assistant professor in the UNC School of Medicine. “Physical function can be measured in many different ways -- from performance testing to patient-report to passively observed daily activity,” Wood said. “Studies like this demonstrate that wearable devices can measure an aspect of physical function that is directly related to symptomatic toxicities following treatment.”

Wood also noted: “As clinicians, we often want to know – overall, how well are our patients doing with treatment? Are they better, worse, or about the same? Data from wearable devices may allow us to answer these questions with much more precision than we’ve had in the past.”

“With these research results and future studies, we are aiming to transform these new activity trackers into patient-centered clinical assessment tools,” Bennett said.  

The full report of these findings, titled “Evaluation of pedometry as a patient-centered outcome in patients undergoing hematopoietic cell transplant (HCT): a comparison of pedometry and patient reports of symptoms, health, and quality of life,” was published online Nov. 17 by the journal Quality of Life Research.

In addition to Bennett, other authors include: Bryce B. Reeve of UNC Lineberger and the Gillings School of Global Public Health; Ethan M. Basch of UNC Lineberger and the UNC School of Medicine; Sandra A. Mitchell, of the Division of Cancer Control and Population Sciences at the Outcomes Research Branch of the National Cancer Institute; Mathew Meeneghan of UNC Lineberger and the UNC School of Medicine; Claudio L. Battaglini of UNC Lineberger and the UNC Department of Exercise and Sport Science; Abbie E. Smith-Ryan of the UNC Department of Exercise and Sport Science; Brett Phillips of UNC Lineberger; Thomas C. Shea of UNC Lineberger and the UNC School of Medicine, and William A. Wood of UNC Lineberger and the UNC School of Medicine.            

This study was supported by the University of North Carolina Cancer Research Fund.