Tackling ‘White Coat Syndrome’: how the Wearable Clinic is helping patients with chronic kidney disease

Did you know almost 3 million people in the UK have been diagnosed with chronic kidney disease (CKD)? Today is World Kidney Day and we’re highlighting how the Wearable Clinic research project at the University of Manchester, funded by EPSRC, is helping patients with CKD to monitor their own blood pressure.

It’s common for people with CKD to have high blood pressure: approximately two thirds of patients are affected. High blood pressure is often called a ‘silent disease’ because there are typically no symptoms – you can’t always ‘feel it’. But if it’s left untreated, it can lead to heart failure, stroke and further damage to the kidneys.

Therefore, it’s vital for people with CKD to manage their blood pressure and have regular, accurate measurements to detect any problems at any early stage, and prevent them from getting worse.

These measurements often aren’t as accurate as they could be. Blood pressure changes throughout the day, so having one measurement doesn’t necessarily reveal the full story about a patient’s blood pressure. Also, people often feel nervous about visiting medical settings, meaning that readings are often higher in clinic than when taken elsewhere: the so-called ‘white coat’ effect.

How can we get a clearer picture? One solution is to ask a patient to wear a monitor for 24 hours that takes measurements as they go about their everyday life.

This is where the Wearable Clinic comes in. We are designing intelligent applications for wearable technology that measure and use blood pressure readings taken outside the clinic as part of care for people with chronic kidney disease. These readings are automatically sent to the patient’s care team and integrated into their care plan.

Using state-of-the-art techniques, we detect when conditions are suitable for taking accurate readings and minimise disruption to patients.

Before any measurements are taken, the care team adjusts the application settings for the patient, deciding how often blood pressure readings should be taken. Once the settings have been agreed, the application creates a plan for obtaining the readings and shares it with the patient on their own mobile device.

In the background, the application combines inputs from different sensors to identify suitable times to take a reading – for example, the application will be able to sense if the patient is exercising, and will avoid prompting for a reading. When the conditions are right, the application will activate and notify the patient that it is time to take a reading. If there are any problems, the application may give further instructions or postpone taking the reading before trying again.

Once a valid reading has been taken, it is sent and stored in the patient’s electronic record, along with past readings. This can be seen by both the patient and their care team, keeping everybody in the loop without requiring the patient to come to the clinic.

After that, the readings continue on a 24-hour cycle, building up a bank of data. And like that, the Wearable Clinic is getting a clearer, more accurate picture of CKD patients’ blood pressure levels.

Interested in knowing more about the Wearable Clinic? Find out how wearables could revolutionise healthcare in general, or read more about the Wearable Clinic’s big vision for incorporating wearables into the NHS.