Louise Sewell

Wearable technologies, such as smartwatches, are increasingly used by people with Chronic Obstructive Pulmonary Disease (COPD) for health monitoring and self-management. However, there is limited evidence-informed guidance available to help patients and healthcare practitioners use these tools effectively in everyday life. Objectives: This study aimed to co-create a digital resource for people with COPD and healthcare practitioners to support the use of smartwatches for self-management. Methods: A participatory co-creation methodology was used, based on the Three Co’s Framework (co-define, co-design, co-refine). Participants included people with COPD, carers, family, or friends of people with COPD; healthcare practitioners; and researchers who attended workshops and individual think-aloud interviews to develop a website and video resource. The resource was refined based on real-time feedback. Data were analysed using rapid qualitative analysis. Results: Twenty-one participants engaged and identified key informational needs, including understanding smartwatch features, interpreting health data, and setting personalised goals. The co-created website and video resource were positively received. Participants valued the inclusion of real-life experiences and practical guidance tailored to both patients and healthcare practitioners. Conclusions: This study presents the first co-created resource for COPD and healthcare practitioners on using smartwatches. The co-creation process was successfully delivered online and face-to-face, demonstrating a robust, inclusive approach to managing multiple stakeholders. The resource offers practical value for patients and practitioners and contributes to the growing field of remote interventions for chronic respiratory conditions. Future research is needed to evaluate its effectiveness.

PurposeUnderstanding the experiences of people with Chronic Obstructive Pulmonary Disease (COPD) using activity monitors in daily life could support the utilisation of technology within healthcare to increase physical activity and support self-management. This qualitative study aimed to explore the experiences of people with COPD using activity monitors at home in everyday life.MethodsSemi-structured face-to-face or telephone interviews were conducted with seven people with COPD between August 2018 and June 2020. Participants had all used an activity monitor within the last year (Fitbit, Garmin, or Apple Watch). Interviews were analysed in-depth using Interpretative Phenomenological Analysis (IPA).ResultsFour themes, developed using IPA, highlight participants' engagement with activity monitors and integrating them into their lives: (1) Motivational features to monitor activity, (2) Importance of setting achievable goals, (3) Developing knowledge and awareness, and (4) Integration into everyday life for self-management.ConclusionActivity monitors were perceived to be beneficial and useful to people with COPD, not just for monitoring their activity, but also helping to self-manage their condition. Activity monitors may be a useful tool within rehabilitation and healthcare services for COPD. Activity monitors were beneficial for people with Chronic Obstructive Pulmonary Disease (COPD) to monitor their physical activity and support self-management of their COPD.People with COPD could see and make sense of their activity levels, set activity goals and increase their motivation from the objectively monitored activity.Activity monitors can help to support individual goal setting and facilitate ownership, but support is needed to set achievable and realistic goals.Healthcare practitioners need to be aware of the potential negative effects of using activity monitors on mental or physical health and wellbeing and support people with COPD to manage pressure and expectations of meeting their goals.

Physical activity monitoring technology (e.g. smartphone apps or wearables) can objectively record physical activity levels, potentially support interventions to increase activity levels, and support the self-management of Chronic Obstructive Pulmonary Disease (COPD). Insight into patients’ experiences of monitoring physical activity is needed to inform future healthcare practice and policy utilizing this technology to support long-term positive health behavior change. This scoping review aimed to explore the experiences of using technology for monitoring physical activity among people with COPD. The Joanna Briggs Institute scoping review methodological framework was used. Relevant scientific databases (CINAHL Complete, MEDLINE, PsycINFO, SPORTDiscus, Cochrane Library and Scopus) were searched from 1st January 2016 to 16th March 2021. Thematic synthesis was used to analyze the data. Twelve studies exploring the experiences of people with COPD using technology for monitoring physical activity were included in the synthesis. Seven themes were developed and summarize experiences: 1) Monitoring and keeping track of their activity and health, 2) Supporting motivation to be active, 3) Acceptability of the device, 4) Experiencing technical issues with the device, 5) Setting appropriate and achievable goals for their health condition, 6) Integrating the device into their life and daily routine, and 7) Perceived physical and psychological benefits of using the device. Further high-quality research is needed to understand the experiences of people with COPD using technology to monitor physical activity in everyday life and better self-manage their health condition. Supporting people with COPD to monitor their physical activity could enable them to better self-manage their health condition.

Introduction: Pulmonary rehabilitation (PR) is a multidisciplinary program of care for patients with chronic respiratory disease. The educational component is an integral component and represents a large proportion of a program. However, it can be difficult to secure regular multidisciplinary input to PR programs.Objectives: This service evaluation assessed whether DVD presentations are acceptable to patients and effective as an education medium.Method: Two PR groups were compared; one group received education by DVD and the other by spoken talk. Both groups evaluated the content and delivery of each session and their knowledge was measured using the Bristol COPD Knowledge Questionnaire (BCKQ).Results: One hundred and twenty‐three patients with Chronic Obstructive Pulmonary Disease (COPD) took part; 58 evaluated the DVD, 75 the talk sessions. There were no differences between the two groups at baseline with respect to age, gender distribution, or FEV₁. Both groups were satisfied with the content (99.46% DVD, 100% talk group) and delivery (100% both DVD and talk groups) of their education sessions. At baseline, there were no between group differences in the mean BCKQ. After PR, significant changes in BCKQ scores were seen within the groups (6.52 points (1.48‐11.37) DVD group and 8.96 points (6.50‐11.19) talk group), again with no differences between the groups.Conclusion: A DVD‐based education package is both acceptable to PR patients and effective at improving patients’ knowledge of COPD. Using filmed educational talks with PR would have a number of benefits to both the patients and the service and may be a way of increasing the capacity of PR services.

Objective: Monitoring of physical activity and sedentary behaviours by mobile phone applications (apps) and wearable technology (wearables) may improve these health behaviours. This systematic review aims to synthesise the qualitative literature on the barriers and facilitators of using apps and wearables for monitoring physical activity and/or sedentary behaviour in adults. Methods: This review protocol is registered in PROSPERO (CRD42017070194). Scientific databases including CINAHL Complete, MEDLINE, PsycINFO, SPORTDiscus, Cochrane Library and Scopus will be searched for relevant studies published from 1 January 2012 to the date the searches are conducted. Studies will be included if they incorporated adults who used an app or wearable for monitoring physical activity and/or sedentary behaviour; explored the barriers and/or facilitators of using an app and/or wearable; and were published in English. Following duplicate screening of titles and abstracts, full texts of potentially eligible papers will be screened to identify studies using qualitative approaches to explore barriers and facilitators of using apps and/or wearables for monitoring physical activity and/or sedentary behaviour. Discrepancies will be resolved through consensus or by consulting a third screener. Relevant excerpts (quotes and text) from the included papers will be extracted and analysed thematically. The Critical Appraisal Skills Programme Qualitative Research Checklist will be used to appraise included studies. Conclusion: The results of this work will be useful for those intending to monitor physical activity and/or sedentary behaviour using these technologies.

Care bundles may be an effective tool to standardise care for patients admitted with an exacerbation of chronic obstructive pulmonary disease (COPD). However, it is unclear how care bundles can be implemented without the need for additional resources. We redeployed a respiratory early discharge service (REDS) to deliver a COPD discharge bundle. We audited the effect of this service redesign on length of stay (LOS) and uptake of referrals to smoking cessation and pulmonary rehabilitation services. Of 1,742 patients with COPD, 1,170 received the discharge care bundle. Mean LOS for patients who received the discharge care bundle was 6.17 days versus 7.08 days for patients who did not. Smoking cessation and pulmonary rehabilitation referrals increased during the project year. A COPD discharge care bundle can be implemented on a large scale by redeploying a REDS without an increase on hospital LOS.