Opinion The Importance of ‘In the Now’ Prospective Symptom Tracking in Chronic and Post-Viral Conditions: A Commentary 2025 Hayes et al

[Andy]

Beyond Symptoms: How mHealth and Wearables Are Revolutionising Chronic Illness Monitoring

In an age of data-driven medicine and remote care, real-time symptom tracking is increasingly crucial, especially for people with chronic conditions. Symptom tracking is the practice of regularly monitoring physical and/or mental symptoms1, 2, from handwritten diaries to advanced mobile health (mHealth) applications and wearable devices1, 2, supporting patient autonomy, clinical decisions, and health equity.

At its core, symptom tracking allows individuals to log details about the type, severity, frequency, and context of symptoms over time. Though simple, it is transformative for chronic illnesses like rheumatoid arthritis, lupus, Myalgic Encephalomyelitis/Chronic Fatigue Syndrome, and now long-COVID, where symptom vary in type, severity, and frequency3-6. Understanding these patterns can help clinicians and patients identify triggers, evaluate treatment efficacy, and make informed behavioural or medical choices. The COVID-19 pandemic has increased urgency for such tracking. While post-viral fatigue syndromes have long been known7, over two million UK residents reported long-COVID by early 20238. With post-exertional malaise being a sporadic and variable hallmark of both long-COVID and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome9, 10, symptom tracking is essential for effective management.

Open access

 

[Hoopoe]

I'm not convinced that wearables are useful or managing the illness in daily life.

A relation between a trigger and symptoms that is important can be discovered through mere observation. Taking notes can make it easier to discover less obvious effects and costs no money.

Adding a wearable device will maybe make it easier to discover relations with smaller effects, which are ultimately of low importance.

Wearables add a bit of complexity to one's life and consume attention. Not much but I find simplicity is also important. The fewer things I have to keep track of, the more relaxed I can be. I'm not sure if the gain from a wearable device exceeds the various associated costs (money, personal attention, etc).

Back when I tried a wearable device, there seemed to be an association between some of the things it tracked and my symptoms but learning to listen to the body was just as effective. The difficulty in managing symptoms lies in doing what is good for the body, like going to bed early despite wanting to do other things, not in figuring out that going to bed early means a bit less fatigue the next day. I also didn't see any relation between a high heart rate triggering PEM. It seemed to more that an elevated heart rate at rest was a warning sign, not something that was causing the problem.

 

[Sean]

This whole approach looks more and more like just using technology for its own sake, to give he appearance of understanding and doing something.

What the hell happened to people just learning to live with limitations at their own pace, without a whole lot of pointless performative formalisation getting in the way?

 

[Trish]

We have multiple threads in this subforum for discussing whether we found wearables useful. Monitoring and pacing
Some of us find them useful, some don't. I think researching their use is valid and potentially useful, particularly for new patients still getting the hang of listening to body signals, and for clinical follow up to see how their patients are doing longer term.