Understanding Patient Adherence Through Sensor Data: An Integrated Approach to Chronic Disease Management

Treatment adherence in chronic diseases is addressed here as a measurable construct that can be formally defined and computed from heterogeneous IoT data streams. The central contribution of this work lies in establishing a mathematical formulation of adherence that integrates both explicit treatment-related activities and behavioural indicators derived from sensor observations. The methodology specifies how raw data from wearables, BLE beacons, and ambient devices can be transformed into clinically meaningful activities through fuzzy logic, enabling the representation of uncertainty, temporal variability, and partial evidence. This framework also accommodates activity labels generated by machine learning models, providing a mechanism to adapt their outputs—originally expressed as probabilistic or categorical predictions—into fuzzy memberships suitable for adherence computation. By unifying sensor-driven activity extraction and model-based activity recognition under a common fuzzy representation, the proposed formulation delivers a coherent pathway for calculating adherence across multiple dimensions and contexts, thereby supporting robust and interpretable evaluation of patient behaviour. By integrating these elements, the methodology provides a comprehensive and interpretable profile of adherence, moving from isolated measures to a unified characterisation of patient behaviour. The framework enables healthcare professionals and patients to better monitor progress, anticipate risks, and support long-term disease management.