Adherence to Personal Health Devices: A Case Study in Diabetes Management

Personal health devices can enable continuous monitoring of health parameters. However, the benefit of these devices is often directly related to the frequency of use. Therefore, adherence to personal health devices is critical. This paper takes a data mining approach to study continuous glucose monitor use in diabetes management. We evaluate two independent datasets from a total of 44 subjects for 60 - 270 days. Our results show that: 1) missed target goals (i.e. suboptimal outcomes) is a factor that is associated with wearing behavior of personal health devices, and 2) longer duration of non-adherence, identified through missing data or data gaps, is significantly associated with poorer outcomes. More specifically, we found that up to 33% of data gaps occurred when users were in abnormal blood glucose categories. The longest data gaps occurred in the most severe (i.e. very low / very high) glucose categories. Additionally, subjects with poorly-controlled diabetes had longer average data gap duration than subjects with well-controlled diabetes. This work contributes to the literature on the design of context-aware systems that can leverage data-driven approaches to understand factors that influence non-wearing behavior. The results can also support targeted interventions to improve health outcomes.