The rise of wearable technology is transforming how clinicians track chronic respiratory diseases like asthma and COPD (chronic obstructive pulmonary disease). Traditionally, managing these conditions has relied heavily on intermittent clinic visits and subjective symptom reports. But what if we could continuously monitor how patients breathe, move, and feel — right from their homes?

Enter wearables: smart devices that collect real-time physiological and behavioral data. These devices typically work in tandem with smartphone apps that prompt patients to complete patient-reported outcome (PRO) measures — allowing for integrated, real-time tracking of a full range of patient-relevant outcomes. When combined, these tools offer a powerful new lens for respiratory health.

Why PROs matter in respiratory disease

PROs are essential for understanding the true impact of respiratory disease on daily life. PRO measures like the Asthma Control Test (ACT), COPD Assessment Test (CAT), and modified Medical Research Council (mMRC) Dyspnea Scale help patients communicate their symptoms and limitations. Yet, these snapshots — typically completed during in-clinic visits — often miss the nuances of fluctuating symptoms and the effects of lifestyle or environment.

This is where wearables shine: they offer objective, continuous, real-world data that can complement traditional PROs — typically administered in-clinic on paper or electronically — by adding daily context and physiological insight to self-reported symptoms. By enabling patients to complete PRO measures remotely, often via smartphone apps, paired with real-time wearable data, we gain a fuller, more continuous picture of their health and functioning.

What wearables can measure

Modern wearables can track a range of data relevant to respiratory care, including:

• Physical activity (steps, walking time, exertion)
• Heart rate and heart rate variability
• Respiratory rate and breathing patterns
• Sleep quality and disruptions
• Environmental exposures (via linked apps or sensors)

While wearables provide continuous physiological data, PROs are typically captured via separate smartphone apps or digital platforms, where patients log symptoms, functioning, or side effects on a scheduled or event-triggered basis.

When patients report increased fatigue or shortness of breath, wearables can confirm whether activity levels dropped, sleep was disrupted, or physiologic stress markers changed — giving clinicians a fuller picture of disease impact and progression.

Applications in COPD and asthma

One of the most promising areas for wearables in respiratory care is pulmonary rehabilitation (PR). PR is a cornerstone therapy for COPD and increasingly recommended for severe asthma. However, adherence and engagement outside clinical settings can be challenging.

Wearables like Fitbit or Garmin devices are being used in PR programs to:

• Monitor daily activity levels
• Set and track exercise goals
• Deliver motivational feedback
• Correlate physical activity trends with PROs such as dyspnea and fatigue

Recent studies suggest that integrating wearables into PR not only boosts patient motivation but also correlates with improved self-reported symptoms and quality of life.

Another area of growth is early detection of exacerbations. New wearable patches and multi-sensor systems can detect subtle changes in respiratory rate, coughing, or oxygen saturation — sometimes days before a patient would seek help. When combined with self-reported symptoms like increased breathlessness or wheezing, these alerts could trigger early intervention and reduce hospitalizations.

Case in point: A digital lifeline for COPD patients

In one pilot program, COPD patients were equipped with a wearable sensor that tracked activity, respiratory patterns, and heart rate. They also submitted weekly symptom reports via an app. When wearable data indicated decreased activity and rising respiratory rate, and the patient-reported worsening breathlessness, clinicians were alerted and could intervene early — often adjusting treatment or scheduling a check-in before an exacerbation worsened.

This “digital safety net” approach is gaining traction as a way to personalize care and improve outcomes, especially in vulnerable or remote populations.

Challenges to widespread use

Despite their promise, wearables in respiratory care face several hurdles:

• Data integration: Many devices still don’t seamlessly connect with electronic health records (EHRs).
• Clinical validation: While feasibility is proven, more large-scale trials are needed to show that wearable-enhanced PRO monitoring improves long-term outcomes.
• Implementation: Providers may require training in how to teach their patients to utilize wearables and the associated smartphone apps that collect PRO data, meaning that time spent on these activities should be considered billable.
• Equity and access: Not all patients have smartphones, internet access, or feel comfortable using digital devices — particularly older adults, those in underserved or rural communities, and individuals facing technological or connectivity barriers.
• Privacy and regulation: Health data from consumer-grade devices must be handled securely, and many wearables are not yet classified as medical devices.

The road ahead

With increasing support from healthcare systems, regulators, and tech companies, the future looks bright for wearable-assisted respiratory care. Remote patient monitoring is now reimbursable in countries like the U.S., and smart integration with PRO tools is making these technologies more usable and impactful.

As clinicians and researchers continue to validate these tools, we can expect wearables — and the PRO data they pair with — to become a routine part of respiratory disease management. Smartphone apps are now central to this ecosystem, not just for data capture but for delivering care.

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