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Full title: Real-world evidence feasibility trial, in both community and hospital-based settings, for a technology-enabled hybrid service delivery model for Pulmonary Rehabilitation: assessing patient uptake and adherence, and impact on patient outcomes and service capacity.

The HybridPR trial is a feasibility study of a larger trial to compare the effectiveness of a technology-enabled pulmonary rehabilitation service and a standard pulmonary rehabilitation service.

An older woman exercising with dumbbells in her kitchen

Pulmonary rehabilitation (PR) for patients with respiratory disease improves exercise capacity, quality-of-life and provides vital education for condition management. A standard PR programme involves two, in-person, exercise classes per week over a period of eight weeks after which the patient is discharged to self-care.

New technology exists to allow the delivery of a hybrid PR programme which commences with in-person classes and then supports a move to a remotely delivered service. While retaining some in-person contact, technology could increase access and automate delivery of education and exercise by overcoming shortages of skilled staff.

Trial setting, design, and methods

This is a single-site trial conducted at Harefield Hospital, Royal Brompton and Harefield NHS Trust (part of Guy’s and St Thomas’ Trust).

The study adopts a real-world design (with quantitative and qualitative components), and will include a comparison of a HybridPR intervention group with a propensity matched control group who have previously received standard PR.

The hybrid approach to PR will mean that patients will have the option to use technology (Active+me REMOTE App) to either i) support in-person PR classes or for monitoring only; or ii) to replace some of the in-person PR classes; or iii) to replace all in-person PR classes.

The trial has recruited participants who have COPD and other chronic respiratory diseases, have a grade of 2-5 on the MRC Dyspnoea Scale, and are referred for PR.

Trial objectives

The primary objective is to assess the feasibility of conducting a larger definitive trial. As part of the study, secondary objectives will also be assessed.

Chief Investigator: Prof Graham Ball (Medical Technology Research Centre, ARU)
ARCTU involvement: Trial management; statistical services
Trial sponsor and funding: ARU (sponsor); Small Business Research Initiative (SBRI) (funder)
Project reference number: ClincialTrials.gov: NCT05881590