The Influence of Wearables on Health Care Outcomes in Chronic Disease: Systematic Review
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Abstract
Background: Chronic diseases contribute to high rates of disability and mortality. Patient engagement in chronic disease self-management is an essential component of chronic disease models of health care. Wearables provide patient-centered health data in real time, which can help inform self-management decision-making. Despite the perceived benefits of wearables in improving chronic disease self-management, their influence on health care outcomes remains poorly understood. Objective: This review aimed to examine the influence of wearables on health care outcomes in individuals with chronic diseases through a systematic review of the literature. Methods: A narrative systematic review was conducted by searching 6 databases for randomized and observational studies published between January 1, 2016, and July 1, 2021, that included the use of a wearable intervention in a chronic disease group to assess its impact on a predefined outcome measure. These outcomes were defined as any influence on the patient or clinician experience, cost-effectiveness, or health care outcomes as a result of the wearable intervention. Data from the included studies were extracted based on 6 key themes, which formed the basis for a narrative qualitative synthesis. All outcomes were mapped against each component of the Quadruple Aim of health care. The guidelines of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement were followed in this study. Results: A total of 30 articles were included; studies reported 2446 participants (mean age: range 10.1-74.4 years), and the influence of 14 types of wearables on 18 chronic diseases was presented. The most studied chronic diseases were type 2 diabetes (4/30, 13%), Parkinson disease (3/30, 10%), and chronic lower back pain (3/30, 10%). The results were mixed when assessing the impact on a predefined primary outcome, with 50% (15/30) of studies finding a positive influence on the studied outcome and 50% (15/30) demonstrating a nil effect. There was a positive effect of 3D virtual reality systems on chronic pain in 7% (2/30) of studies that evaluated 2 distinct chronic pain syndromes. Mixed results were observed in influencing exercise capacity; weight; and biomarkers of disease, such as hemoglobin A1c, in diabetes. In total, 155 outcomes were studied. Most (139/155, 89.7%) addressed the health care outcomes component. This included pain (11/155, 7.5%), quality of life (7/155, 4.8%), and physical function (5/155, 3.4%). Approximately 7.7% (12/155) of outcome measures represented the patient experience component, with 1.3% (2/155) addressing the clinician experience and cost. Conclusions: Given their popularity and capability, wearables may play an integral role in chronic disease management. However, further research is required to generate a strong evidence base for safe and effective implementation. Trial Registration: PROSPERO International Prospective Register of Systematic Reviews CRD42021244562; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=244562
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Recent reviews have highlighted the effectiveness of fitness trackers in increasing physical activity levels and improving health outcomes related to chronic disease management.
“Recent reviews have highlighted their effectiveness in increasing physical activity levels and improving health outcomes related to chronic disease management [17,18].”
From Economic evaluation of wearable fitness trackers versus metformin for preventing type 2 diabetes in the UK population (2025) · cites this paper as [18]
The Results section, “Theoretical Aspects of Wearables in Improving Health Care Outcomes” (page not provided), reports positive primary outcomes in 15 of 30 studies. But only 5 of 30 studies found a positive impact on physical activity, and the review says there was no strong relationship between wearables and improved physical activity. The claim therefore overstates the review’s findings on increasing activity. (LLM, conf=0.88)
Experimental — accuracy not yet measuredDigital wearable devices may enhance patients' awareness of their own behaviors and support their engagement in physical activity and behavioral adjustment by objectively capturing exercise-related indicators.
“By objectively capturing exercise-related indicators, they may enhance patients' awareness of their own behaviors and support their engagement in physical activity and behavioral adjustment (5, 6).”
Previous reviews have generally examined the effects of wearable technologies on broad healthcare outcomes in chronic diseases, the clinical application of smartwatch technologies in diabetes, home-based digital diabetes management, or the effects of wearable technologies on physical activity and metabolic outcomes.
“Previous reviews have generally examined the effects of wearable technologies on broad healthcare outcomes in chronic diseases, the clinical application of smartwatch technologies in diabetes, home-based digital diabetes management, or the effects of wearable technologies on physical activity and metabolic outcomes (5, 6, 24, 31).”
The majority of studies that assess how wearable devices affect health outcomes are small.
“However, most studies evaluating the impact of wearable devices on health outcomes are small and further studies and standardized evaluation are required.118,119”
From The Impact of Physical Activity in Patients With Type 2 Diabetes (2025) · cites this paper as [118]
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- Authors
- Mattison, G., Canfell, O., Forrester, D., Dobbins, C., Smith, D., Töyräs, J., & Sullivan, C.
- Affiliations
- The University of Queensland (AU)
- Metro North Hospital and Health Service (AU)
- Corresponding author
- Mattison, Graeme
- ORCID
- Venue
- Journal of Medical Internet Research
- Publisher
- JMIR Publications Inc.
- Published
- 2022-07-01
- Volume
- 24
- Issue
- 7
- Pages
- e36690
- ISSN
- 1438-8871 (ISSN-L)
- PMC
- PMC9288104
- OpenAlex
- W4280553349
- Cited by
- 171
- References
- 74
- Citations by year
- 2026: 45 · 2025: 60 · 2024: 45 · 2023: 20 · 2022: 1
- FWCI
- 6.09
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Journal of Medical Internet Research (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- University of Queensland
- Topics
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Physical Sciences › Computer Science › Computer Vision and Pattern Recognition › Context-Aware Activity Recognition Systems
- Physical Sciences › Computer Science › Human-Computer Interaction › Innovative Human-Technology Interaction
- Keywords
- wearable devices, chronic disease self-management, health care outcomes, Quadruple Aim, type 2 diabetes, Parkinson's disease, chronic low back pain, chronic pain, virtual reality, exercise capacity, HbA1c, patient engagement, cost-effectiveness, patient-centered care, remote monitoring, quality of life, patient satisfaction, health care utilization, disease biomarkers
- MeSH terms
- Wearable Electronic Devices, Adolescent, Adult, Aged, Child, Chronic Disease, Delivery of Health Care, Diabetes Mellitus, Type 2, Humans, Middle Aged, Quality of Life, Young Adult, Chronic Pain
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