Acceptability of a digital pulmonary rehabilitation app as an adjunct or alternative to usual care for people with chronic lung diseases: A qualitative study of patients’ views and experiences

Abstract

Background: Centre-PR may not be accessible for people living distant from PR centres. Remote digital PR may have equivalent benefits to centre-PR; however, previous trials were potentially biased towards digitally literate patients, and largely excluded participants with a preference for centre-PR. There is limited data on the real-world implementation of, and acceptability for, Digital-PR alone or as an adjunct to other models of PR. Objectives: To gather patients’ views about the acceptability of Active+me REMOTE, a digital pulmonary rehabilitation app (Digital-PR). Methods: A qualitative exploratory study using semi-structured interviews with a subset (n = 15) of patients in a mixed method, feasibility study of a hybrid pulmonary rehabilitation, blending Digital-PR with other models of PR. Transcribed data were coded descriptively using Braun and Clarkes’ methodology, data interpretation was facilitated through a Miro virtual whiteboard. Results: There was appreciation for the concept of Digital-PR, indicated by positive responses in the domains of “friends and family recommendation,” “intention to continue using the app,” and “privacy concerns.” Benefits were reported by two participants who had declined centre-based PR. The app was rated low regarding user-friendliness. Challenges in understanding/using the app and a perception of challenges for others were reported and were associated with poor digital literacy and tech savviness. High digital skills did not predict a favourable assessment of the app as user-friendly. Discussion: Whilst there was a general appreciation for the concept of digital PR as an adjunct or alternative to traditional centre-based PR, the app did not appear to be user-friendly, nor acceptable to people with low digital literacy. The findings have implications for the wider routine implementation of Digital-PR.