How people with long-term health conditions use digital health technologies
Data from low-cost wearables and other monitoring devices can be used to track the health and health behaviours of people with long-term health conditions (including diabetes and cardiovascular disease). Using such devices to help guide patients in self-management, and alerting clinicians to changes in their patient's health or health behaviour is a promising approach to better health and health care.
Work in my group, based at the Nuffield Department for Primary Care Health Sciences (NDPCHS) in collaboration with the Department of Engineering Science, aims to explore how digital technologies are used by people with a long-term health conditions. We are particularly interested in developing research that can identify the ways in which data from such devices is clinically relevant, how people use them, and how health care might change as a result of their use. Current studies include monitoring recovery after hospital admission for a range of conditions and supporting better use of medicines. There are opportunities to work with an interdisciplinary team bringing together clinical academics, engineers, industry, social scientists and patient representatives to produce world-leading research into digital health.
The student will have the opportunity to develop skills in quantitative, qualitative or mixed methods research, including planning a protocol for a study, collecting and analysing data, and preparing reports for publication. This will require critical appraisal of relevant literature from the field, analysis of data previously collected, as well as collecting and analysing original data.
Supervision in the Nuffield Department of Primary Care Health Sciences is a collaborative process between the student and supervisor. Both need to agree on an interesting project. DPhil projects with me are likely to include an evaluation of the theoretical underpinning and evidence for a new treatment (usually in the form of a systematic review); establishing the best ways to measure its impact; and carrying out a study, for example a small-scale randomised trial, to evaluate its feasibility and impact. The project might also include analysis of data collected in previous studies. In most cases, supervision will take the form of a formal supervision meeting once a month (with more frequent meetings early on in the project) at which progress with the research is discussed and plans made for the next month’s research. In practice, however, additional informal meetings occur more often - once or twice a month - and the NDPCHS has an active group of graduate students and postgraduate researchers able to offer advice. Working as a doctoral student in the clinical trials unit provides access to informal advice from staff with skills and experience using a wide range of research methodologies.
1. Farmer, A. et al. Self-Management Support Using a Digital Health System Compared With Usual Care for Chronic Obstructive Pulmonary Disease: Randomized Controlled Trial. J Med Internet Res 19, e144–15 (2017).
2. Bobrow, K. Farmer A et al. Mobile Phone Text Messages to Support Treatment Adherence in Adults With High Blood Pressure (SMS-Text Adherence Support [StAR]): A Single-Blind, Randomized Trial. Circulation 133, 592–600 (2016).
3. Farmer, A. J. et al. Adherence to Oral Glucose-Lowering Therapies and Associations With 1-Year HbA1c: A Retrospective Cohort Analysis in a Large Primary Care Database. 39, 258–263 (2016).
4. Farmer, A. & Tarassenko, L. Use of wearable monitoring devices to change health behavior. JAMA : the journal of the American Medical Association 313, 1864–1865 (2015).