Using Experience-Based Co-design to Develop mHealth App for Digital Pulmonary Rehabilitation Management of Patients with Chronic Obstructive Pulmonary Disease (COPD)

Chronic obstructive pulmonary disease (COPD) is a progressive life-threatening lung disease that causes breathlessness, chronic cough, and overall decrease in patients' quality of life. Pulmonary rehabilitation (PR) slows COPD progression and reduces the overall economic burden of the disease. However, only a small portion of patients participate in conventional face-to-face PR due to a lack of resources, or motivation. Digital PR interventions may reduce these barriers, but only a few digital PR interventions available are rigorously designed and tested. The purposes of this study were to (1) develop a high-fidelity prototype app for digital PR using an experience-based co-design (EBCD) approach, and (2) conduct a usability testing of the PR prototype app. We engaged 15 COPD patients and 11 healthcare providers in the EBCD process. Following the development, 7 patients participated in the usability testing and a semi-structured interview to provide their feedback on the prototype app. The EBCD approach resulted in a prototype of a digital PR intervention - COPDTrack, with features suggested from patients and providers. These features include: digital PR exercise courses, real-time health monitoring, digital 6-min walk test, visualization of progress, patient reported outcomes, and the ability to communicate with healthcare providers. The usability testing results indicated that most participants completed tasks successfully and were able to navigate smoothly throughout the app. Our study demonstrates the feasibility of integrating EBCD into the HCD process to facilitate the design and development of the digital PR intervention for COPD patients.