Is a Hybrid Pulmonary Rehabilitation Programme Feasible and Effective in Individuals With COPD After an Exacerbation-Related Hospitalisation: A Mixed Methods Study.

Only 21 participants were analysed, and all had chosen to enrol and complete the programme. The quantitative results are before-and-after changes in the same participants, so they cannot show that the programme caused the improvements. The sample was small, which the authors say may limit the robustness of the quantitative analyses. The study was embedded in a larger ongoing prospective study whose complete dataset is expected by March 2026. Six participants were too frail to perform the 6MST at baseline, and five remained unable at the end. Five participants had video-call difficulties, and barriers to telerehabilitation included devices, internet connection and digital literacy. The study was monocentric in northern France, and interviews were translated from French. Participants were not asked about prior pulmonary rehabilitation experience. Data from the larger ongoing study indicate 36% of eligible patients declined participation because of barriers such as visual or hearing disability, lack of internet access or fear of telerehabilitation.

The delivery of the home-based PR programme was financially supported by the National Health Insurance Fund, and the funder had no role in design, conduct or reporting. O.L.R. and J.-M.G. reported personal fees and non-financial support unrelated to this work from pharmaceutical companies; O.L.R. is a principal investigator in studies for Vertex and CSL Behring. The other authors declared no conflicts.

Do not attribute the improvements to the hybrid format alone. Participants received face-to-face sessions, remote sessions, education, self-management, exercise equipment, care-manager support and often carer involvement, so the contribution of any single component cannot be separated.