Accepted for/Published in: JMIR Human Factors
Date Submitted: Nov 20, 2025
Date Accepted: Aug 24, 2026
Understanding delivery and engagement with a digital self-management intervention for COPD: A qualitative study across two clinical settings
ABSTRACT
Background:
Adherence to COPD self management plans can improve health outcomes, yet access to pulmonary rehabilitation remains limited. Digital self management interventions such as myCOPD offer a potential means to extend support across care pathways. However, little is known about how such tools are delivered in routine practice or how delivery influences patient engagement across different clinical settings.
Objective:
This study aimed to explore perceived barriers and facilitators to the delivery and engagement of myCOPD by examining the perspectives of both patients and healthcare professionals (HCPs) across two NHS settings.
Methods:
This qualitative study was conducted between November 2023 and April 2024 across two clinical settings: community pulmonary rehabilitation and a hospital discharge pathway following acute exacerbation of COPD. Semi structured interviews were conducted with patients using myCOPD and HCPs involved in its delivery. Interview topics included health background, digital technology use, and experiences of engaging with the intervention. A convenience sampling approach, with elements of purposive sampling, was used to ensure representation across settings. Clinical data were obtained from health records with consent, and usage data were provided by my mhealth Ltd with consent. Interviews were analysed using reflexive abductive thematic analysis.
Results:
Thirty interviews were completed (16 patients, 14 HCPs). Participants described how multimorbidity, perceived digital ability, and socioeconomic context shaped their engagement with myCOPD. Delivery approaches differed between settings: community teams described proactive, iterative support, whereas hospital teams described more passive, onboarding focused delivery shaped by workflow constraints. These delivery styles influenced two engagement patterns—single aspect engagement (targeted use of specific features) and multifaceted engagement (routine, integrated use). Participants also identified perceived barriers (e.g., usability concerns, limited integration with in person care) and perceived benefits (e.g., improved inhaler technique, increased confidence, lifestyle adjustments).
Conclusions:
Delivery context and local workflows appear to shape how patients engage with myCOPD, suggesting that implementation strategies may need to be tailored to setting specific capacities and roles. Considering patient characteristics (particularly multimorbidity and perceived digital ability) may support more equitable engagement. Further work is needed to understand how frontline teams can best integrate digital self management tools into routine COPD care. Clinical Trial: N/a
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