Experiences of home-based pulmonary rehabilitation with mHealth and centre-based in people with chronic obstructive pulmonary disease

Abstract

Background: Mobile health (mHealth) provides innovative solutions to improve access to pulmonary rehabilitation. This study aimed to examine the experiences of people with chronic obstructive pulmonary disease (COPD) who undertook either an 8-week home-based PR with a mHealth application (app) (m-PRTM) or centre-based PR (CB-PR).

Methods: Convenience then purposive sampling was used to recruit participants enrolled in a randomised controlled trial (RCT) after completion or withdrawal from either m-PRTM or CB-PR. Participants undertook individual, semi-structured interviews. Interview transcripts were inductively coded and thematically analysed using a critical realist approach.

Results: Thirteen m-PRTM and 12 CB-PR participants were interviewed (mean age (SD) 75 (8) years, 52% male). Four themes were conceptualised: internal motivators influence uptake and adherence, external motivators influence uptake and adherence, program structure impacts practicality and experience, and living with and managing COPD and other health issues. Motivators for both programs included improved fitness levels, feeling accountable to the program and reinforcement from staff and peers. The m-PRTM in-app functionalities such as the daily task list were additionally motivational. m-PRTM participants arranged the program around their schedule while centred-based participants arranged their schedule around the program. Multi-morbidity and illness were barriers to adherence in both programs. The social network, environment, and resources available to participants impacted their enjoyment.

Conclusion: This study adds important information for service providers considering implementation of mHealth PR programs.

Patient or Public Contribution: Consumers co-designed and user-tested the m-PRTM app. The qualitative data presented in this manuscript was obtained through interviews with consumers.