Continuous in-the-field measurement of heart rate: Correlates of drug use, craving, stress, and mood in polydrug users.
BACKGROUND
Ambulatory physiological monitoring could clarify antecedents and consequences of drug use and could contribute to a sensor-triggered mobile intervention that automatically detects behaviorally risky situations. Our goal was to show that such monitoring is feasible and can produce meaningful data.


METHODS
We assessed heart rate (HR) with AutoSense, a suite of biosensors that wirelessly transmits data to a smartphone, for up to 4 weeks in 40 polydrug users in opioid-agonist maintenance as they went about their daily lives. Participants also self-reported drug use, mood, and activities on electronic diaries. We compared HR with self-report using multilevel modeling (SAS Proc Mixed).


RESULTS
Compliance with AutoSense was good; the data yield from the wireless electrocardiographs was 85.7%. HR was higher when participants reported cocaine use than when they reported heroin use (F(2,9)=250.3, p<.0001) and was also higher as a function of the dose of cocaine reported (F(1,8)=207.7, p<.0001). HR was higher when participants reported craving heroin (F(1,16)=230.9, p<.0001) or cocaine (F(1,14)=157.2, p<.0001) than when they reported of not craving. HR was lower (p<.05) in randomly prompted entries in which participants reported feeling relaxed, feeling happy, or watching TV, and was higher when they reported feeling stressed, being hassled, or walking.


CONCLUSIONS
High-yield, high-quality heart-rate data can be obtained from drug users in their natural environment as they go about their daily lives, and the resultant data robustly reflect episodes of cocaine and heroin use and other mental and behavioral events of interest.
Clinical Pharmacology and Therapeutics Research Branch, Intramural Research Program, National Institute on Drug Abuse, Baltimore, MD, United States.
Ashley P
AP
Kennedy
Clinical Pharmacology and Therapeutics Research Branch, Intramural Research Program, National Institute on Drug Abuse, Baltimore, MD, United States.
David H
DH
Epstein
Clinical Pharmacology and Therapeutics Research Branch, Intramural Research Program, National Institute on Drug Abuse, Baltimore, MD, United States.
Michelle L
ML
Jobes
Johns Hopkins Bayview Medical Center, Baltimore, MD, United States.
Daniel
D
Agage
Johns Hopkins Bayview Medical Center, Baltimore, MD, United States.
Matthew
M
Tyburski
Clinical Pharmacology and Therapeutics Research Branch, Intramural Research Program, National Institute on Drug Abuse, Baltimore, MD, United States.
Karran A
KA
Phillips
Department of Computer Science, University of Memphis, Memphis, TN, United States.
Amin Ahsan
AA
Ali
Department of Computer Science, University of Memphis, Memphis, TN, United States.
Rummana
R
Bari
Department of Computer Science, University of Memphis, Memphis, TN, United States.
Syed Monowar
SM
Hossain
Department of Computer Science, Troy University, Troy, AL, United States.
Karen
K
Hovsepian
Department of Computer Science, University of Memphis, Memphis, TN, United States.
Md Mahbubur
MM
Rahman
Department of Electrical & Computer Engineering, The Ohio State University, Columbus, OH, United States.
Emre
E
Ertin
Department of Computer Science, University of Memphis, Memphis, TN, United States.
Santosh
S
Kumar
Clinical Pharmacology and Therapeutics Research Branch, Intramural Research Program, National Institute on Drug Abuse, Baltimore, MD, United States. Electronic address: kpreston@intra.nida.nih.gov.
Kenzie L
KL
Preston
D000293:Adolescent; D000328:Adult; D000339:Affect / Q000502:physiology*; D000368:Aged; D018660:Blood Pressure Monitoring, Ambulatory / Q000295:instrumentation*; D003042:Cocaine / Q000494:pharmacology; D066249:Craving / Q000502:physiology*; D055030:Drug Users / Q000523:psychology*; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D003932:Heroin / Q000494:pharmacology; D006801:Humans; D008297:Male; D008875:Middle Aged
D003932:Heroin; D003042:Cocaine
Ambulatory physiological monitoring; Cocaine; Craving; Heart rate; Heroin