How effective are home health monitors?

Gone are the days when people used to go to a clinic or hospital to get their body vitals checked. Times have surely changed, and technology has evolved, making the task somewhat of a one-click affair.

Even smartwatches and phones tracking the number of steps is old tech. These personal medical devices have since evolved to track heart rhythm, blood pressure, and sleep, among other things. Not only that, but most homes now have home blood pressure monitors and glucometers. There are also combined ECG and digital stethoscopes, Bluetooth scales and even gut health monitors.

Also read: 65 percent of doctor moms experience the pressures of burnout, study reveals

These provide convenience. However, accuracy is often questioned.

According to Harvard Health, the accuracy of consumer devices depends on what needs to be measured. In a study where the accuracy of heart rate monitors and energy expenditure were assessed using phones and health apps, the accuracy was found to be higher in the case of heart rate but less in the case of energy expenditure.

So, are these health monitors effective? Let’s find out.

Blood pressure monitors

“The present use of home BP (blood pressure) devices is twofold,” says Dr Amit Sharma, an interventional cardiologist at Holy Spirit Hospital, Mumbai. “Quite often, the readings taken at a doc’s clinic are inaccurately high over the stress of meeting the doctor and starting medications. There is a term for it called white coat hypertension. In such a case, the patient is asked to monitor her blood pressure at home regularly so that we can identify hypertensive patients accurately. We also rely at least in part on home measurements to guide treatment so that medications are appropriately optimised,” the doctor explains.

However, the expected error is around 10% as compared to manual blood pressure devices, the expert explains. The doctor advises opting for a device from a good and accredited company and “avoid” wrist-based BP monitors.

How to monitor blood pressure at home

* Avoid caffeinated and alcoholic beverages, and smoking at least 30 minutes before the test

*Sit quietly with your back supported and feet on the floor for five minutes prior to the test

*When taking the measurement, support your arm so your elbow is at the level of your heart

*Always wear the blood pressure cuff over bare skin

*Measure your BP as per the instructions mentioned

*Keep a record of your blood pressure readings as well as the time at which they were made

Glucose monitors or glucometers

Also read: Mosquito coils are more harmful to your lungs than cigarettes; here’s how

Regularly monitoring one’s blood sugar levels can be daunting for any diabetic. However, glucometers are especially important for the diabetics who are on insulin and hence prevent hypoglycemia and hyperglycemia, says Dr Anupam Biswas, consultant—endocrinology, Fortis Hospital, Noida. “In fact, patients who take multiple daily insulin injections should be encouraged to monitor glucose levels prior to meals, exercise, at bedtime, and when they suspect low blood glucose levels,” he explains.

The commonly used glucometer comprises a hand-held device with a digital screen. It comes with test strips that react to glucose. Often, a spring-loaded needle is used to create a puncture in the skin to extract blood, usually from the side of a fingertip.

For those who do not want to go the needle way, there is a continuous glucose monitor (CGM). These work on sensors, which measure the glucose levels in the fluid between cells. The information can be sent to a smartphone or tablet and can even be downloaded using some devices.

According to Dr Biswas, the glucometers, commonly used to monitor the glucose level, may not display the same level of accuracy as venous plasma glucose. “However, they can provide a fair trend regarding a person’s blood glucose levels,” he adds.

The devices that are accurate provide results within +/- 15% of the lab 95% of the time or +/- 20% of the lab 99% of the time, according to the US FDA (Food & Drug Administration).

As per the expert, if a glucometer shows blood glucose count above or below normal, go for a retest. “A reading that seems discordant with clinical reality should be tested in a lab. But in case it shows high or low blood glucose levels, and it is corroborated by the patient’s symptoms, consult the treating doctor at the earliest,” he says.

On their accuracy, Dr Biswas opines that although many devices function well under various scenarios, doctors and patients should be aware of factors that can impair meter accuracy.

ECG monitors and digital stethoscopes

Not only at-home blood pressure monitors and glucometers, but there are at-home ECG monitors available too. “There are several of these available in India currently, based on cost, ease of use, battery life, and accuracy,” says Dr Sharma. These work on sensors, and some are so compact as to fit in one’s pocket.

Speaking on accuracy, Dr Sharma says, “A personal ECG monitor cannot be as accurate as a clinical or hospital-grade ECG machine. These are meant to enhance the information a doctor can use to manage a particular condition. However, there are no replacements for regular medical care.”

Digital stethoscopes, on the other hand, are indeed very accurate, more than the usual stethoscopes, the doctor says. “A digital stethoscope is able to convert an acoustic sound to electronic signals, which can be further amplified for optimal listening by the doctor. This makes sure no heart murmurs or abnormal sounds are missed. A prominent benefit of this device is the clear audio and sound quality,” he explains.

Smart scales

While measuring weight is what a scale is meant to do, there are now smart ones available in the market that measure weight along with other metrics like body-mass-index, muscle mass, etc.

These devices are becoming increasingly popular among health enthusiasts, says Dr Tarun Sahni, senior consultant—internal medicine, Indraprastha Apollo Hospitals, New Delhi.

On accuracy, he says, the reliability of these varies depending on the brand and model. “Although high-end models are generally more accurate than the cheaper ones, no device can offer 100% accuracy when it comes to measuring body composition. Factors like body position, time of the day, and level of hydration can impact accuracy readings,” he explains.

However, the device can be useful for tracking changes in body composition over time. These are also convenient and accessible, the expert says. “Having said that, it is crucial to consult a doctor for a complete health check-up to ensure good health and smart scales cannot be relied upon as the sole indicator of one’s overall health,” Dr Sahni adds.

While buying one, several factors should be factored in like cost, accuracy, metrics, connectivity, companion apps, health goals, etc, the expert opines.

Coming back to fitness trackers, although these are handy and accessible, their accuracy varies depending on the technology used and what is being measured.

As per a 2020 study in the International Journal of Environmental Research and Public Health, which involved 11 different trackers such as wearables and some functioning through mobile apps, accuracy differed with trackers when it came to step counting. While brisk walking elicited more accurate results, it was less accurate when it came to daily activities and intermittent walking that involved arm movement. Similarly, studies suggest while trackers are good overall in tracking heart rate, the accuracy varies depending on the device.

A growing market

A new study by consulting firm Juniper Research found that the total number of patients using remote patient monitoring (RPM) solutions will reach 115.5 million globally by 2027, equating to 1.4% of the total population. This is an increase from only 75 million in 2023. According to the study, this growth of 67% is driven by greater pressure on healthcare systems, including clinical staff shortages and limited space within hospitals, driving the need for alternative healthcare solutions.

According to another report by Market.us, the market for wearable medical devices was estimated to be worth $30.1 billion in 2022, and it is anticipated to grow to $165.5 million by 2032, showing a CAGR of almost 19.1% from 2023 to 2032.

Similarly, the global home blood pressure monitoring devices market size is expected to grow by $565.93 million from 2021 to 2026, according to Technavio. Moreover, the growth momentum of the market will accelerate at a CAGR of 5.4% during the forecast period.