{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T23:30:15Z","timestamp":1778110215679,"version":"3.51.4"},"reference-count":48,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T00:00:00Z","timestamp":1767657600000},"content-version":"unspecified","delay-in-days":5,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"crossref","award":["NIHR201539"],"award-info":[{"award-number":["NIHR201539"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Resp Res"],"accepted":{"date-parts":[[2025,12,8]]},"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pulmonary rehabilitation (PR) is a highly effective intervention for people with chronic respiratory disease; however, it is not known how best to sustain its benefits. Clinical trials are needed to establish if participation in singing for lung health (SLH) groups following PR will improve health-related quality of life, healthcare utilisation and exercise capacity compared with usual care. A feasibility study would help to guide development of these trials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In a multicentre, mixed-methods randomised controlled feasibility trial, PR participants at four sites were prescreened at baseline assessment. An SLH taster session was included routinely as part of the PR programmes. Eligible PR completers were invited to take part in the trial and randomised to usual care or a 12-week SLH course. Feasibility outcomes included recruitment rate, intervention compliance (at least 8\/12 sessions) and health economic analysis. Interviews with participants and study personnel were undertaken and thematic analysis of the results was completed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Between October 2022 and November 2023, 1311 patients were assessed to start PR, 838 completed. Of those completing, 243 were ineligible to take part (predominantly due to vaccination status and excluded diagnoses for PR referral), and 531 declined. 64 people (33 female, mean (SD) age 69 (12), 41 ethnically white, 33 with chronic obstructive pulmonary disease, 16 with asthma, 9 with interstitial lung disease, 6 with bronchiectasis) were recruited, with 30 (93.8%) SLH and 29 (90.6%) controls completing the study. 20 (62.5%) of the SLH group completed at least 8\/12 SLH sessions. There was enthusiasm for a definitive trial from participants, clinicians and singing group leaders\u2019 perspectives, based on positive experiences of trial involvement. Improvements to recruitment strategy, intervention structure, outcome measures and staffing were suggested.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A definitive randomised controlled trial of SLH post-PR appears feasible, with acceptable uptake and completion rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"isrctn\" xlink:href=\"ISRCTN11056049\">ISRCTN11056049<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjresp-2025-003236","type":"journal-article","created":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T15:40:17Z","timestamp":1767714017000},"page":"e003236","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Singing for lung health following completion of pulmonary rehabilitation: feasibility of a randomised controlled trial"],"prefix":"10.1136","volume":"13","clinical-trial-number":[{"clinical-trial-number":"isrctn11056049","registry":"10.18810\/isrctn"},{"clinical-trial-number":"isrctn11056049","registry":"10.18810\/isrctn"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0576-8823","authenticated-orcid":false,"given":"Adam","family":"Lewis","sequence":"first","affiliation":[{"name":"School of Health Sciences, University of Southampton, Southampton, UK"},{"name":"College of Health, Medicine and Life Sciences, Department of Health Sciences, Brunel University London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Brunel University London, London, UK"},{"name":"Guy's and St Thomas\u2019 NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8027-1879","authenticated-orcid":false,"given":"Parris","family":"Williams","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute, Imperial College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Steinmann","sequence":"additional","affiliation":[{"name":"Guy's and St Thomas\u2019 NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen A","family":"Ingram","sequence":"additional","affiliation":[{"name":"Royal Brompton and Harefield Hospitals, Guy's and St Thomas\u2019 NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noah","family":"Longley","sequence":"additional","affiliation":[{"name":"Royal Brompton and Harefield Hospitals, Guy's and St Thomas\u2019 NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Puja","family":"Trivedi","sequence":"additional","affiliation":[{"name":"Royal Brompton and Harefield Hospitals, Guy's and St Thomas\u2019 NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stuart","family":"Clarke","sequence":"additional","affiliation":[{"name":"Royal Brompton and Harefield Hospitals, Guy's and St Thomas\u2019 NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helen","family":"Lammin","sequence":"additional","affiliation":[{"name":"Royal Brompton and Harefield Hospitals, Guy's and St Thomas\u2019 NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Edwards","sequence":"additional","affiliation":[{"name":"Royal Brompton and Harefield Hospitals, Guy's and St Thomas\u2019 NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Koulopoulou","sequence":"additional","affiliation":[{"name":"King\u2019s College Hospital NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arun","family":"Sureshkumar","sequence":"additional","affiliation":[{"name":"King\u2019s College Hospital NHS Foundation Trust, London, UK"},{"name":"Barts Health NHS Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Moore","sequence":"additional","affiliation":[{"name":"Barts Health NHS Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul E","family":"Pfeffer","sequence":"additional","affiliation":[{"name":"Barts Health NHS Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leanne","family":"Reardon","sequence":"additional","affiliation":[{"name":"South London Clinical Research Network, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kim","family":"Sorley","sequence":"additional","affiliation":[{"name":"South London Clinical Research Network, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jarvis","family":"Kenman","sequence":"additional","affiliation":[{"name":"Barts Health NHS Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brendan","family":"DeLuca","sequence":"additional","affiliation":[{"name":"Imperial College Healthcare NHS Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle","family":"Maguire","sequence":"additional","affiliation":[{"name":"Imperial College Healthcare NHS Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura-Jane","family":"Smith","sequence":"additional","affiliation":[{"name":"King\u2019s College Hospital NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Elkin","sequence":"additional","affiliation":[{"name":"Imperial College Healthcare NHS Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam","family":"Lound","sequence":"additional","affiliation":[{"name":"Imperial College Healthcare NHS Trust, London, UK"},{"name":"HCS Belfast Health and Social Care Trust, Belfast, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Moth","sequence":"additional","affiliation":[{"name":"Imperial College Healthcare NHS Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Penelope","family":"Rickman","sequence":"additional","affiliation":[{"name":"Guy's and St Thomas\u2019 NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharon","family":"Alexander","sequence":"additional","affiliation":[{"name":"Guy's and St Thomas\u2019 NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natasha","family":"Lohan","sequence":"additional","affiliation":[{"name":"College of Health, Medicine and Life Sciences, Department of Health Sciences, Brunel University London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily","family":"Garsin","sequence":"additional","affiliation":[{"name":"College of Health, Medicine and Life Sciences, Department of Health Sciences, Brunel University London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Young","sequence":"additional","affiliation":[{"name":"College of Health, Medicine and Life Sciences, Department of Health Sciences, Brunel University London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda","family":"Harris","sequence":"additional","affiliation":[{"name":"College of Health, Medicine and Life Sciences, Department of Health Sciences, Brunel University London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosie","family":"Watters","sequence":"additional","affiliation":[{"name":"Royal Brompton and Harefield Hospitals, Guy's and St Thomas\u2019 NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cleo","family":"Lane","sequence":"additional","affiliation":[{"name":"College of Health, Medicine and Life Sciences, Department of Health Sciences, Brunel University London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9067-599X","authenticated-orcid":false,"given":"Claire M","family":"Nolan","sequence":"additional","affiliation":[{"name":"College of Health, Medicine and Life Sciences, Department of Health Sciences, Brunel University London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6464-1526","authenticated-orcid":false,"given":"Joy","family":"Conway","sequence":"additional","affiliation":[{"name":"College of Health, Medicine and Life Sciences, Department of Health Sciences, Brunel University London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William D-C","family":"Man","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute, Imperial College London, London, UK"},{"name":"Royal Brompton and Harefield Hospitals, Guy's and St Thomas\u2019 NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Winston","family":"Banya","sequence":"additional","affiliation":[{"name":"Royal Brompton and Harefield Hospitals, Guy's and St Thomas\u2019 NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nana","family":"Anokye","sequence":"additional","affiliation":[{"name":"College of Health, Medicine and Life Sciences, Department of Health Sciences, Brunel University London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9614-3580","authenticated-orcid":false,"given":"Keir Elmslie James","family":"Philip","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute, Imperial College London, London, UK"},{"name":"Imperial College Healthcare NHS Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Phoene","family":"Cave","sequence":"additional","affiliation":[{"name":"The Musical Breath Ltd, Eastbourne, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3235-0454","authenticated-orcid":false,"given":"Nicholas S","family":"Hopkinson","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute, Imperial College London, London, UK"},{"name":"Royal Brompton and Harefield Hospitals, Guy's and St Thomas\u2019 NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,1,6]]},"reference":[{"key":"2026010607401354000_13.1.e003236.1","unstructured":"Public Health England . Respiratory disease: applying all our health. Crown Copywright; 2015."},{"key":"2026010607401354000_13.1.e003236.2","unstructured":"Trueman D , Woodcock F , Hancock E . Estimating the economic burden of respiratory illness in the UK. London British Lung Foundation; 2016."},{"key":"2026010607401354000_13.1.e003236.3","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.02277-2016"},{"key":"2026010607401354000_13.1.e003236.4","doi-asserted-by":"crossref","first-page":"1709","DOI":"10.1513\/AnnalsATS.202304-288OC","article-title":"National Prevalence of Social Isolation and Loneliness in Adults with Chronic Obstructive Pulmonary Disease","volume":"20","author":"Suen","year":"2023","journal-title":"Annals ATS"},{"key":"2026010607401354000_13.1.e003236.5","doi-asserted-by":"crossref","DOI":"10.1002\/14651858.CD003793.pub3","article-title":"Pulmonary rehabilitation for chronic obstructive pulmonary disease","volume":"2015","author":"McCarthy","year":"2015","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"2026010607401354000_13.1.e003236.6","doi-asserted-by":"publisher","DOI":"10.1136\/thorax-2023-220439"},{"key":"2026010607401354000_13.1.e003236.7","unstructured":"National Institute for Health and Care Excellence . Chronic obstructive pulmonary disease in over 16s: diagnosis and management. NICE guideline [NG115]. 2019. Available: https:\/\/doi.org\/https:\/\/www.nice.org.uk\/guidance\/ng115"},{"key":"2026010607401354000_13.1.e003236.8","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200204-318OC"},{"key":"2026010607401354000_13.1.e003236.9","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1164\/rccm.201603-0602OC","article-title":"Benefits of Long-Term Pulmonary Rehabilitation Maintenance Program in Patients with Severe Chronic Obstructive Pulmonary Disease. Three-Year Follow-up","volume":"195","author":"G\u00fcell","year":"2017","journal-title":"Am J Respir Crit Care Med"},{"key":"2026010607401354000_13.1.e003236.10","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.11609"},{"key":"2026010607401354000_13.1.e003236.11","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S150650"},{"key":"2026010607401354000_13.1.e003236.12","doi-asserted-by":"crossref","DOI":"10.3389\/fresc.2021.743588","article-title":"Evaluation of the Implementation of a Home-Based Exercise Training Program for People With COPD: A Mixed-Methods Study","volume":"2","author":"Cerini","year":"2021","journal-title":"Front Rehabil Sci"},{"key":"2026010607401354000_13.1.e003236.13","doi-asserted-by":"crossref","first-page":"1227","DOI":"10.1016\/j.chest.2022.09.006","article-title":"Maintenance Pulmonary Rehabilitation","volume":"162","author":"Ramakrishnan","year":"2022","journal-title":"Chest"},{"key":"2026010607401354000_13.1.e003236.14","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-020-70483-3","article-title":"Social isolation, loneliness and physical performance in older-adults: fixed effects analyses of a cohort study","volume":"10","author":"Philip","year":"2020","journal-title":"Sci Rep"},{"key":"2026010607401354000_13.1.e003236.15","doi-asserted-by":"crossref","DOI":"10.1136\/bmjresp-2017-000216","article-title":"Singing for Lung Health: a qualitative assessment of a British Lung Foundation programme for group leaders","volume":"4","author":"Lewis","year":"2017","journal-title":"BMJ Open Resp Res"},{"key":"2026010607401354000_13.1.e003236.16","doi-asserted-by":"crossref","DOI":"10.1136\/bmjresp-2021-000996","article-title":"The physiology of singing and implications for \u2018Singing for Lung Health\u2019 as a therapy for individuals with chronic obstructive pulmonary disease","volume":"8","author":"Lewis","year":"2021","journal-title":"BMJ Open Resp Res"},{"key":"2026010607401354000_13.1.e003236.17","doi-asserted-by":"crossref","first-page":"2086","DOI":"10.3390\/biomedicines10092086","article-title":"Singing for People with Advance Chronic Respiratory Diseases: A Qualitative Meta-Synthesis","volume":"10","author":"Ly","year":"2022","journal-title":"Biomedicines"},{"key":"2026010607401354000_13.1.e003236.18","doi-asserted-by":"crossref","first-page":"16080","DOI":"10.1038\/npjpcrm.2016.80","article-title":"Singing for Lung Health\u2014a systematic review of the literature and consensus statement","volume":"26","author":"Lewis","year":"2016","journal-title":"Npj Prim Care Resp Med"},{"key":"2026010607401354000_13.1.e003236.19","doi-asserted-by":"publisher","DOI":"10.3109\/09638280903464471"},{"key":"2026010607401354000_13.1.e003236.20","doi-asserted-by":"crossref","DOI":"10.3389\/fresc.2024.1447765","article-title":"Long-term self-reported attendance in exercise training or lung choir and status of quality of life following initial pulmonary rehabilitation for COPD","volume":"5","author":"Kaasgaard","year":"2024","journal-title":"Front Rehabil Sci"},{"key":"2026010607401354000_13.1.e003236.21","article-title":"CONSORT 2010 statement: extension to randomised pilot and feasibility trials","volume":"355","author":"Eldridge","year":"2010","journal-title":"BMJ"},{"key":"2026010607401354000_13.1.e003236.22","doi-asserted-by":"publisher","DOI":"10.3310\/hta14220"},{"key":"2026010607401354000_13.1.e003236.23","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00183014"},{"key":"2026010607401354000_13.1.e003236.24","unstructured":"Chapman JL . Singing and teaching singing: a holistic approach to classical voice. San Diego: Plural Publishing Inc, 2011."},{"key":"2026010607401354000_13.1.e003236.25","doi-asserted-by":"crossref","DOI":"10.1136\/bmjresp-2024-002365","article-title":"Singing for lung health in COPD: a multicentre randomised controlled trial of online delivery","volume":"11","author":"Philip","year":"2024","journal-title":"BMJ Open Resp Res"},{"key":"2026010607401354000_13.1.e003236.26","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2466-12-69","article-title":"Singing classes for chronic obstructive pulmonary disease: a randomized controlled trial","volume":"12","author":"Lord","year":"2012","journal-title":"BMC Pulm Med"},{"key":"2026010607401354000_13.1.e003236.27","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2466-10-41","article-title":"Singing teaching as a therapy for chronic respiratory disease--a randomised controlled trial and qualitative evaluation","volume":"10","author":"Lord","year":"2010","journal-title":"BMC Pulm Med"},{"key":"2026010607401354000_13.1.e003236.28","unstructured":"Hooper R . Justifying sample size for a feasibility study. National Institute for Health Research; 2019."},{"key":"2026010607401354000_13.1.e003236.29","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2288-13-104","article-title":"An audit of sample sizes for pilot and feasibility trials being undertaken in the United Kingdom registered in the United Kingdom Clinical Research Network database","volume":"13","author":"Billingham","year":"2013","journal-title":"BMC Med Res Methodol"},{"key":"2026010607401354000_13.1.e003236.30","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00134312"},{"key":"2026010607401354000_13.1.e003236.31","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1080\/14780887.2020.1769238","article-title":"One size fits all? What counts as quality practice in (reflexive) thematic analysis?","volume":"18","author":"Braun","year":"2021","journal-title":"Qual Res Psychol"},{"key":"2026010607401354000_13.1.e003236.32","unstructured":"Braun V , Clarke V . Thematic analysis. Washington, D.C: American Psychological Association, 2012."},{"key":"2026010607401354000_13.1.e003236.33","doi-asserted-by":"crossref","DOI":"10.1186\/s40814-015-0026-y","article-title":"Maximising the impact of qualitative research in feasibility studies for randomised controlled trials: guidance for researchers","volume":"1","author":"O\u2019Cathain","year":"2015","journal-title":"Pilot Feasibility Stud"},{"key":"2026010607401354000_13.1.e003236.34","doi-asserted-by":"crossref","DOI":"10.1183\/13993003.01142-2021","article-title":"Use of Singing for Lung Health as an alternative training modality within pulmonary rehabilitation for COPD: a randomised controlled trial","volume":"59","author":"Kaasgaard","year":"2022","journal-title":"Eur Respir J"},{"key":"2026010607401354000_13.1.e003236.35","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2019-214246"},{"key":"2026010607401354000_13.1.e003236.36","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00073609"},{"key":"2026010607401354000_13.1.e003236.37","doi-asserted-by":"crossref","unstructured":"Eldridge SM , Chan CL , Campbell MJ , et al . CONSORT 2010 statement: extension to randomised pilot and feasibility trials. Pilot Feasibility Stud 2016;2. doi:10.1186\/s40814-016-0105-8","DOI":"10.1186\/s40814-016-0105-8"},{"key":"2026010607401354000_13.1.e003236.38","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/S2213-2600(24)00376-X","article-title":"Top ten research priorities for breathlessness research: UK James Lind Alliance priority setting partnership","volume":"13","author":"Evans","year":"2025","journal-title":"Lancet Respir Med"},{"key":"2026010607401354000_13.1.e003236.39","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2022-064276","article-title":"Reporting of data on participant ethnicity and socioeconomic status in high-impact medical journals: a targeted literature review","volume":"12","author":"Buttery","year":"2022","journal-title":"BMJ Open"},{"key":"2026010607401354000_13.1.e003236.40","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2016-208514"},{"key":"2026010607401354000_13.1.e003236.41","doi-asserted-by":"crossref","first-page":"5479","DOI":"10.1080\/09638288.2024.2304095","article-title":"The experiences of people with chronic obstructive pulmonary disease (COPD) using activity monitors in everyday life: an interpretative phenomenological study","volume":"46","author":"Wilde","year":"2024","journal-title":"Disabil Rehabil"},{"key":"2026010607401354000_13.1.e003236.42","doi-asserted-by":"crossref","first-page":"2057","DOI":"10.1111\/crj.12773","article-title":"Acceptability and validity of a home exercise diary used in home-based pulmonary rehabilitation: A secondary analysis of a randomised controlled trial","volume":"12","author":"Lahham","year":"2018","journal-title":"Clin Respir J"},{"key":"2026010607401354000_13.1.e003236.43","unstructured":"National Institute for Health and Care Excellence . Digital technologies to support self-management of COPD: early value assessment. 2025. Available: https:\/\/www.nice.org.uk\/guidance\/hte19\/chapter\/1-Recommendations [Accessed 19 Sep 2025]."},{"key":"2026010607401354000_13.1.e003236.44","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2021.05.011"},{"key":"2026010607401354000_13.1.e003236.45","article-title":"Responsiveness of the short physical performance battery (SPPB) in severely dyspnoeic patients with COPD","volume":"46","author":"Carrington","year":"2015","journal-title":"European Respiratory Journal"},{"key":"2026010607401354000_13.1.e003236.46","doi-asserted-by":"publisher","DOI":"10.1016\/S0033-3182(93)71928-3"},{"key":"2026010607401354000_13.1.e003236.47","doi-asserted-by":"publisher","DOI":"10.1177\/002214650905000103"},{"key":"2026010607401354000_13.1.e003236.48","doi-asserted-by":"crossref","first-page":"3821","DOI":"10.1017\/S0033291724002083","article-title":"Measuring loneliness: a head-to-head psychometric comparison of the 3- and 20-item UCLA Loneliness Scales","volume":"54","author":"Gosling","year":"2024","journal-title":"Psychol Med"}],"container-title":["BMJ Open Respiratory Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjresp-2025-003236","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T15:40:25Z","timestamp":1767714025000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopenrespres.bmj.com\/lookup\/doi\/10.1136\/bmjresp-2025-003236"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":48,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,6]]},"published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1136\/bmjresp-2025-003236"],"URL":"https:\/\/doi.org\/10.1136\/bmjresp-2025-003236","relation":{},"ISSN":["2052-4439"],"issn-type":[{"value":"2052-4439","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]}}}