Response
We sincerely appreciate the thoughtful comments and interest expressed by Sun et al. regarding our qualitative study. Their engagement highlights the importance of exploring patient experiences in pulmonary rehabilitation (PR) research. Our qualitative study complements findings from our randomised controlled equivalence trial (RCT) [1] that included 90 participants. Our RCT demonstrated that a mHealth PR programme resulted in equivalent improvements in exercise capacity and superior improvements in health status when compared with centre‐based PR (CB‐PR) in people with chronic obstructive pulmonary disease (COPD). The aim of our qualitative study was to explore the participant experience of the mHealth programme and how it compares and differs from CB‐PR. Due to the often low uptake and completion rates of CB‐PR [2, 3, 4], we suggest PR providers consider the participant's experience of different service models alongside the evidence for effectiveness when prescribing PR.
We clearly acknowledge in our manuscript that the transferability of our findings may be limited to individuals who share characteristics outlined in our RCT inclusion criteria. We specifically state that the results may not be generalisable to populations from different cultural backgrounds or to those with limited digital literacy. We also note in our limitations that we did not assess nutritional intake and baseline involvement in exercise. However, we note the majority of the cohort were ex‐smokers with moderate to severe COPD and multiple comorbidities, reflecting the typical patient population referred to PR programmes in Australia. Additionally, the sample of participants invited to interview was representative of the cohort from the RCT, including by age (average of 75 [SD 7] years) and with greater than 85% of the cohort retired. The sample size was appropriate for a qualitative study design, which aimed to complete an in‐depth, inductive exploration of the participant experience and was determined based on data saturation. Our focus was on achieving thematic depth across a range of participant contexts, rather than generalisability. We note in our manuscript the strategies used to ensure the qualitative trustworthiness of our results.
In regard to a long‐term follow‐up plan, an 8‐week exercise programme was examined as this is in line with national and international guidelines [3, 5] and is the commonly prescribed length of programme in Australia. Long‐term sustainability of results was beyond the scope of these two studies, and we agree that further research is required to evaluate the maintenance of outcomes of mHealth PR programmes.
Author Contributions
All authors read and approved the letter of response.
Conflicts of Interest
The authors declare no conflicts of interest.
Data Availability Statement
The data that support the findings of this study are available from the corresponding author upon reasonable request.
References
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Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Data Availability Statement
The data that support the findings of this study are available from the corresponding author upon reasonable request.