Wearable Wellness: How the Oura Ring May Enhance Patient Care in Pharmacy Practice

Introduction

The Oura Ring is a sophisticated wearable ring device that has redefined how individuals monitor their health and wellness. Unlike conventional wearables such as smartwatches, the Oura Ring claims to be discreet, elegant, and packed with cutting-edge technology. By focusing on sleep, health metrics, and activity, it can provide a holistic approach to health tracking. 

Before we dive in, it's important to understand that the Oura ring is not a medical device and is not intended to diagnose, treat, cure, monitor, or prevent medical conditions or illnesses. Additionally, Oura Health has no affiliation with RxTeach.

History & Partnerships¹

The Oura Ring was developed by Oura Health, a Finnish health technology company, and has evolved significantly since its inception:

• 2013: Oura Health was founded in Oulu, Finland, with the vision of creating a compact, intuitive health-tracking device.
• 2015: The first-generation Oura Ring launched via Kickstarter, emphasizing sleep and recovery metrics. Its unique design and focus on wellness garnered immediate attention.
• 2018: The second-generation Oura Ring featured a sleeker design, improved battery life, and added temperature tracking, making it more versatile and appealing.
• 2021: The third-generation Oura Ring introduced groundbreaking features, including continuous heart rate monitoring, blood oxygen sensing (SpO2), and menstrual cycle tracking. The company’s collaborations with research institutions and healthcare organizations further cemented its reputation as a leader in wearable technology.
• 2022: Oura partnered with Gucci to launch a ring with 18-karat yellow gold details. 
• 2023: Oura partnered with Equinox to launch a rest & recovery kit, including the third-generation ring. 
• 2024: The fourth-generation Oura Ring included many software and hardware updates to make it more accurate, useful, and easier to wear without any bumps on the inside of the ring. Oura also signed a deal to supply rings to U.S. military personnel, including data analytics services for use by the Pentagon’s health department. Oura also partnered with Dexcom to give users data about their blood sugar levels along with how sleep, exercise, and heart rate can affect their bodies. 

Features^2,3

The Oura Ring combines sensors with intuitive software to offer a wide array of health metrics:

1. Sleep Tracking:
   • Measures total sleep time, sleep stages (light, deep, and REM), and sleep efficiency.
   • Provides insights into sleep quality through a Sleep Score, highlighting areas for improvement.
2. Readiness Score:
   • Combines sleep, heart rate variability (HRV), body temperature, and previous activity levels to determine the body’s readiness for daily tasks.
3. Activity Tracking:
   • Tracks steps, calories burned, and physical activity.
   • Provides personalized recommendations to balance activity and recovery.
4. Temperature Monitoring:
   • Monitors body temperature continuously, aiding in early detection of illness and menstrual cycle phase prediction.
5. Heart Rate Monitoring:
   • Tracks resting heart rate, heart rate variability, and nighttime heart rate trends.
   • Measures blood oxygen levels (SpO2) to detect potential respiratory issues.
6. Period Prediction:
   • Uses temperature data to predict menstrual cycles and ovulation windows, making it a valuable tool for women’s health.

Oura also partners with Headspace, Strava, and Natural Cycles to integrate stress management, workout, and fertility protocols, respectively, within the application. 

Accuracy and Scientific Basis

A PubMed literature review in December 2024, revealed one systematic review and meta-analysis of “Real-World Accuracy of Wearable Activity Trackers for Detecting Medical Conditions.”⁴ The review highlighted 3/28 studies including the Oura ring across various conditions, such as COVID-19, atrial fibrillation, fall risk, and viral symptoms. Subgroup analysis for device type showed that the Oura ring had a sensitivity and specificity of 80.47% and 72.6%, respectively, for detecting COVID-19. Pooled analysis across all devices showed high sensitivity/high specificity for atrial fibrillation and moderate sensitivity/low specificity for predicting fall risk. As a result, the review recommended that these devices, as a whole, support the use for detection of COVID-19 and atrial fibrillation, but not to predict falls.

Two other randomized controlled trials featuring the Oura ring were conducted. The first used the Oura ring to measure sleep effects from an investigational neuromodulation therapy (repetitive transcranial magnetic stimulation [rTMS]) in patients with complex regional pain syndrome (CRPS).⁵ The second study also used the Oura ring to measure sleep effects from creatine supplementation following resistance training in naturally menstruating females.⁶ Although both studies involved small sample sizes (N=31 & 21, respectively), the Oura ring may offer promise as a clinical trial and real-world evidence tool to gather health-metric data. 

Functions in Healthcare and Pharmacy⁷

The Oura Ring’s data and insights may provide value in healthcare and pharmacy, especially in the context of collecting real-world evidence and data generation:

1. Sleep and Mental Health:
   • Helps pharmacists identify sleep disturbances and recommend treatments, including medications and behavioral changes.
   • Data can support interventions for conditions like insomnia, anxiety, and depression.
2. Chronic Disease Management:
   • Metrics such as readiness scores and HRV help monitor conditions like cardiovascular disease and diabetes.
   • Temperature trends can signal flare-ups or complications.
3. Women’s Health:
   • Partnered with Natural Cycles, the first FDA-cleared birth control app. 
   • Provides detailed menstrual cycle tracking, assisting pharmacists in counseling patients on contraceptives or hormonal therapies.
4. Remote Monitoring:
   • Integrates with healthcare systems, allowing pharmacists and providers to remotely monitor patients’ vitals and adjust treatments accordingly.
5. COVID-19 and Illness Detection:
   • During the pandemic, Oura Rings were used to detect early signs of infection through temperature deviations, proving their utility in public health.

Limitations and Considerations⁸

While the Oura Ring offers many benefits, it’s not without limitations:

• FDA: It lacks FDA clearance and approval, limiting its clinical adoption. Although it has partnered with Natural Cycles, the first FDA-cleared birth control app, it is not recommended to replace health management from a healthcare professional. 
• Cost: Its price point may deter some users despite its advanced features. The fourth-generation Oura Ring costs $349 for a silver finish and up to $499 for a gold finish. Additionally, full membership to utilize all features cost $5.99/month or $69.99/year. 
• Data Interpretation: Users often need guidance to fully understand the metrics and their implications.

Future Perspectives

The future of the Oura Ring is promising, with potential advancements including:

• AI-driven insights for more personalized health recommendations.
• Expansion into FDA-cleared applications, enabling broader clinical use.
• Frequent clinical trial and real-world evidence use to collect essential health metrics.
• Enhanced sensors to track additional biomarkers, such as hydration or stress hormones.

Conclusion

The Oura Ring is a trailblazer in wearable health technology, offering unique insights into sleep, readiness, and overall wellness. Its scientific foundation, potential in clinical-trial and real-world evidence use, and expanding applications could make it a valuable tool in healthcare and pharmacy. As wearable technology evolves, the Oura Ring’s role in promoting proactive, personalized health management will continue to grow, solidifying its impact on modern healthcare.

FDA Approved Wearables (2023)⁹

References

1. Oura Ring: the most accurate sleep and activity tracker. Oura Ring. https://ouraring.com/why-oura. 
2. Svensson T, Kaushalya Madhawa, Hoang Nt, Chung U, Akiko Kishi Svensson. Validity and reliability of the Oura Ring Generation 3 (Gen3) with Oura sleep staging algorithm 2.0 (OSSA 2.0) when compared to multi-night ambulatory polysomnography: A validation study of 96 participants and 421,045 epochs. Sleep Medicine. 2024;115. doi:https://doi.org/10.1016/j.sleep.2024.01.020. 
3. Oura Ring: Science-Based Research for Human Health. Oura Ring. Published 2024. https://ouraring.com/science-and-research. 
4. Singh B, Chastin S, Miatke A, et al. Real-World Accuracy of Wearable Activity Trackers for Detecting Medical Conditions: Systematic Review and Meta-Analysis. JMIR Mhealth Uhealth. 2024;12:e56972. Published 2024 Aug 30. doi:10.2196/56972.
5. Vanhanen J, Kujala J, Liljeström M, Kalso E, Virkkala J, Harno H. rTMS targeted to the secondary somatosensory cortex influences sleep in CRPS patients, as measured with the OURA ring. Brain Behav. 2023;13(11):e3252. doi:10.1002/brb3.3252. 
6. Aguiar Bonfim Cruz AJ, Brooks SJ, Kleinkopf K, et al. Creatine Improves Total Sleep Duration Following Resistance Training Days versus Non-Resistance Training Days among Naturally Menstruating Females. Nutrients. 2024;16(16):2772. Published 2024 Aug 20. doi:10.3390/nu16162772. 
7. Team O. Oura Integrates With FDA-Cleared Birth Control App, Natural Cycles°. The Pulse Blog. Published August 2, 2022. Accessed December 29, 2024. https://ouraring.com/blog/oura-partners-with-fda-cleared-birth-control-app-natural-cycles/?srsltid=AfmBOoqlyqnoMbqaHFK4BC6xQvpLUt1YJ1ougGmDZA8akWMkoy3fFX8c.
8. Oura Ring Membership. Oura Ring. Published 2024. Accessed December 29, 2024. https://ouraring.com/membership?srsltid=AfmBOop1DMhFVoy3OQUgJew_NEvG468TwhfdUn5PpBzmwh0t2klKmBbV. 
9. Li K, Morales-Garza M, Cardoso C, et al. Early Changes in Acute Myocardial Infarction in Pigs: Achieving Early Detection with Wearable Devices. Diagnostics (Basel). 2023;13(6):1006. Published 2023 Mar 7. doi:10.3390/diagnostics13061006.