Digital technologies to deliver pulmonary rehabilitation programmes for adults with COPD: early value assessment

Some people with more advanced COPD may have difficulty with mobility or completing some of the exercise capacity measures. In the National Respiratory Audit Programme (NRAP), these are reported as '0' or 'failure'.

People who interact more with healthcare services, for example, those currently having face-to-face pulmonary rehabilitation, may report higher rates of exacerbation because of greater awareness and opportunity for diagnosis. But they may have relatively shortened hospital stays with better outcomes. Selection criteria and follow up (up to 12 months) should carefully address the potential for surveillance bias.

COPD is most common in people over 50 years old, with men at higher risk of developing COPD than women. There is also a higher prevalence of respiratory diseases in people with lower socioeconomic status. This is because of the effect of living in deprived areas and higher rates of smoking. The company should consider including people from these subgroups to ensure generalisability of findings.

The company should provide training for staff to support use of the technology.

Evidence generation should be overseen by a steering group including researchers, commissioners, practitioners, and people with lived experience.

The evidence generation process is most likely to succeed with dedicated research staff to reduce the burden on NHS staff, and by using suitable real-world data to collect information when possible.

Careful planning of the approach to information governance is vital. The company should ensure that appropriate structures and policies are in place to ensure that the data is handled in a confidential and secure manner and to appropriate ethical and quality standards.

Using the EQ‑5D requires a licence, with an associated cost.