Usual Care vs Home-based Intervention in PAD

According to the HONOR study published in JAMA, patients with peripheral artery disease (PAD) didn’t improve their walking performance through a home-based exercise program with a wearable activity monitor and coaching, relative to those receiving usual care.

Two hundred patients enrolled in the study were assigned to receive either usual care or home-based exercise intervention. Patients in the usual care group were contacted every three months to collect information on their walking and exercise activity while the home-based intervention patients underwent four weekly sessions with a coach during the first month and reported their outcomes, goals, and challenges for the remaining nine months.

Although a lot of people rely on wearable devices to improve their health, data collected in this study didn’t show any increase in the frequency or amount of exercise when using one.  Moreover, the PROMIS pain intervention score worsened in the interference group patients.

That coaching and monitoring might improve home-based exercise and walking distance is a good hypothesis, and with activity monitors becoming nearly ubiquitous there’s a lot of excitement around using them in health care. But it’s important to test such hypotheses. The design of this study used PROMIS measures of mobility, pain, and satisfaction with activities. DADOS has recently integrated computer-adaptive testing (CAT) based PROMIS tools, offering you up to 50 questionnaires for domains such as pain intervention, fatigue, anxiety, and mobility.