JMIR FORMATIVE RESEARCH

Debeij et al

Original Paper

The Potential Use and Value of a Wearable Monitoring Bracelet
for Patients With Chronic Obstructive Pulmonary Disease:
Qualitative Study Investigating the Patient and Health Care
Professional Perspectives
Suzanne M Debeij1,2, MSc; Jiska J Aardoom1,3, PhD; Miriam L Haaksma1,2, PhD; Wieteke A M Stoop4, MSc; Eléonore
F van Dam van Isselt1,2, PhD; Marise J Kasteleyn1,3, PhD
1

Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands

2

University Network for the Care Sector South Holland, Leiden University Medical Center, Leiden, Netherlands

3

National eHealth Living Lab, Leiden, Netherlands

4

Department of Cardiac and Pulmonary Rehabilitation, Revant, Breda, Netherlands

Corresponding Author:
Suzanne M Debeij, MSc
Department of Public Health and Primary Care
Leiden University Medical Center
Hippocratespad 21
Leiden, 2300 RC
Netherlands
Phone: 31 651306514
Email: s.m.debeij@lumc.nl

Abstract
Background: The occurrence of exacerbations has major effects on the health of people with chronic obstructive pulmonary
disease (COPD). Monitoring devices that measure (vital) parameters hold promise for timely identification and treatment of
exacerbations. Stakeholders’ perspectives on the use of monitoring devices are of importance for the successful development andimplementation of a device.
Objective: This study aimed to explore the potential use and value of a wearable monitoring bracelet (MB) for patients with
COPD at high risk for exacerbation. The perspectives of health care professionals as well as patients were examined, both
immediately after hospitalization and over a longer period. Furthermore, potential facilitators and barriers to the use andimplementation of an MB were explored.
Methods: Data for this qualitative study were collected from January to April 2023. A total of 11 participants (eg, n=6 healthcare professionals [HCPs], 2 patients, and 3 additional patients) participated. In total, 2 semistructured focus groups were conducted
via video calls; 1 with HCPs of various professional backgrounds and 1 with patients. In addition, 3 semistructured individualinterviews were held with patients. The interviews and focus groups addressed attitudes, wishes, needs, as well as factors that
could either support or impede the potential MB use. Data from interviews and focus groups were coded and analyzed according
to the principles of the framework method.
Results: HCPs and patients both predominantly emphasized the importance of an MB in terms of promptly identifying
exacerbations by detecting deviations from normal (vital) parameters, and subsequently alerting users. According to HCPs, thisis how an MB should support the self-management of patients. Most participants did not anticipate major differences in value
and use of an MB between the short-term and the long-term periods after hospitalization. Facilitators of the potential use andimplementation of an MB that participants highlighted were ease of use and some form of support for patients in using an MB
and interpreting the data. HCPs as well as patients expressed concerns about potential costs as a barrier to use and implementation.
Another barrier that HCPs mentioned, was the prerequisite of digital literacy for patients to be able to interpret and react to thedata from an MB.
Conclusions: HCPs and patients both recognize that an MB could be beneficial and valuable to patients with COPD at highrisk for exacerbation, in the short as well as the long term. In particular, they perceived value in supporting self-management ofhttps://formative.jmir.org/2024/1/e57108

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Debeij et alpatients with COPD. Stakeholders would be able to use the obtained insights in support of the effective implementation of MBs
in COPD patient care, which can potentially improve health care and the overall well-being of patients with COPD.
(JMIR Form Res 2024;8:e57108) doi: 10.2196/57108
KEYWORDS
eHealth; Chronic Obstructive Pulmonary Disease; COPD; wearable; exacerbation; self-management; monitoring bracelet; remotemonitoring; mobile phone

Introduction
Chronic obstructive pulmonary disease (COPD) is a chronic
progressive inflammatory lung disease characterized bypersistent respiratory symptoms and airflow limitation. It affects
millions of people worldwide and places a substantial economic
and health burden on societies and patients [1-3]. A major
challenge associated with COPD is the occurrence andrecurrence of exacerbations, which involve acute and maintained
worsening of symptoms [4]. Exacerbations not only acceleratedisease progression, but also lead to reduced health-related
quality of life, increased health care use, poor health status, andeven mortality [5-7]. It is estimated that one-third of patientswith COPD who have been hospitalized due to an acuteexacerbation are readmitted within 1 year [8,9]. Consequently,
preventing exacerbations is an important part of COPD care.
Essential to preventing exacerbations and improving healthoutcomes is optimizing self-management of patients with COPD
[10-12]. Self-management is an iterative process during which
patients use strategies to actively cope with their chronic disease
within the context of their daily life [13]. Goals to optimize
self-management can, for example, be directed at improving
exacerbation and energy management.
In recent years, advances in telemedicine and remote patientmonitoring have shown great potential to support
self-management and enable timely identification and treatmentof COPD exacerbations [14-20]. Wearables such as monitoringbracelets can, for example, measure various (vital) parameters
to detect early COPD symptom deterioration and so allow for
more timely interventions. This can reduce severity of
exacerbations, and therefore, prevent hospital admissions.
Besides early detection of deterioration, wearables can provide
both patients and professionals with insight into patients’recovery patterns. This may increase patients’ awareness about
their health status during stable periods, before an exacerbation,and throughout the recovery period following an exacerbation.
This, in turn, empowers them to engage in self-management.
While the use of a monitoring bracelet (MB) in COPD careseems promising, its integration into health care is a complex
and challenging process. The monitoring device should fit thephysical, social, and cultural environment [21]. Therefore, we
focused on the Dutch health care setting to ensure the fit of the
MB in that context. To realize this, stakeholders’ perspectives
on the use of monitoring devices are of crucial importance forthe successful development and implementation of such devices.
Poor digital health literacy of users, security and a design that
do not fit users’ needs are some of the barriers to effective
implementation [22,23]. However, relatively little is known
about the perspectives of health care professionals on the use
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RenderXof wearables to support COPD management [24]. Yet, theirinsights on the use and value of wearables are of crucial
importance to enable successful integration into clinical practice.
Regarding the patient perspective, a recent systematic review
did not find a clear role of wearables in improving healthoutcomes in chronic disease. That is, both positive and neutral
outcomes were found when investigating the impact ofwearables on health care outcomes [24]. More research is needed
to examine the ways in which different functionalities ofwearables can aid in the management of specific types of chronic
diseases. This study, therefore, aimed to explore the potential
use and value of an MB for patients with COPD in the Dutch
health care setting at high risk for an exacerbation. Perspectivesof health care professionals (HCPs) and patients regarding theuse and value of an MB in the period immediately following
hospitalization and later were examined. In addition, potential
facilitators and barriers to the use and implementation of awearable were explored.

Methods
Study Design
This qualitative study comprised 2 semistructured focus groups,
1 with health care professionals (HCPs) and the other consistingof patients with COPD. Because of technical issues during the
focus groups for patients, 3 individual interviews with patientswere conducted to supplement the data. The period of datacollection ran from January 31, 2023, to April 21, 2023. The
reporting of this study follows the guidelines of the Consolidate
Criteria for Reporting Qualitative Studies (COREQ; Multimedia
Appendix 1) [25].

Ethical Considerations
The study was declared not to fall under the scope of the Dutch
Medical Research Involving Human Subjects Act (WMO) bya non-WMO review board of the Leiden University Medical
Center and was granted a certificate of no objection (reference
number 22-3020). The study was carried out in accordance with
the General Data Protection Regulation (GDPR). All participants
provided informed consent before their participation.
Participants had the ability to opt out. Patients received a €25(US $27.74) gift voucher for their participation. HCPs receiveda €100 (US $110.95) gift voucher. All participant data waspseudonymized to ensure confidentiality.

Participants
Both patients with COPD and HCPs were recruited from the
Revant rehabilitation center and the Franciscus Gasthuis andVlietland hospital in the Netherlands. To be eligible toparticipate, patients needed to (1) be aged 18 years or older, (2)JMIR Form Res 2024 | vol. 8 | e57108 | p. 2
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have a diagnosis of COPD, (3) have been admitted to thehospital for an acute exacerbation of COPD in the past 2 years,
and (4) be able to understand, read and speak the Dutch
language. The eligibility criteria for HCPs were that they musthave been treating patients with COPD in one of theparticipating institutions. HCPs could have occupations suchas pulmonary nurse, physical therapist, or pulmonologist.

Study Procedures
Potential HCPs were purposively sampled, approached, andinformed of the study by representatives from the participating
institutions with an information letter. Potential patients with
COPD were approached and informed of the study by their
HCP. Participants were informed that Corsano Health (Corsano
Health B.V.) develops medical bracelets for remote patientmonitoring. Some examples of the 20 parameters that thebracelet can measure were provided. However, participants did
not have the opportunity to see or try the bracelet. Before thestudy, participants received an invitation to join a focus group
via Microsoft Teams. If patients with COPD were not able toparticipate in the focus group, they were scheduled for anindividual interview by phone.

Focus Groups and Interviews
A total of 4 female researchers participated (authors JA, SD,
and MK, and researcher EO) in the data collection. Participants
had not met the researchers before and did not have knowledgeof the interviewer. All researchers had experience in qualitative
research and made notes. No other people were present during
focus groups and interviews. The focus groups and individualinterviews both followed a predetermined semistructured
interview guide (Multimedia Appendix 2). At the start of theinterview, descriptive characteristics were collected. The mainpart of the interviews and focus groups contained questions
regarding the participants’ attitudes, wishes, and needs for an
MB, as well as potential facilitators and barriers related to theuse and implementation of an MB. The questions covered therecovery period directly after an exacerbation as well as
long-term use in the prevention of exacerbations. To gather
participants’ perspectives on all these topics, they were presented
with an example of an existing MB (ie, the Corsano Cardiowatch[Corsano Health B.V.]) and its corresponding functionalities
were explained. The Corsano Cardiowatch is a medicallycertified health MB that is able to continuously measure
health-related parameters such as heart rate, heart ratevariability, breathing rates, skin temperature, physical activity(eg, steps and cadence), and sleep. These parameters aremeasured by an accelerometer and photoplethysmogram sensor.
The bracelet offers flexible data collection intervals, and data
are subsequently privately stored in a health cloud. These data
can be safely and continuously transferred to the patient’s healthcare professional through a digital platform. Hence, the watch
is an unobtrusive tool to continuously monitor a patient’s (vital)
parameters. An example of a question asked is “What are yourgeneral needs and ideas about the monitoring bracelet?”Data Analyses
Descriptive analyses were conducted to summarize thesociodemographic characteristics of patients and HCPs. The
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Debeij et alinterview was audio recorded and the recording was stored ina restricted secure data folder of the Leiden University Medical
Centre. Interviews were transcribed and not returned toparticipants. Due to technical issues, one recording failed andso notes made during this interview were used in the data
analysis. The transcribed interviews were coded and analyzed
according to the principles of the framework method [26]. Data
were coded using Atlas.ti software (version 22, ATLAS.ti
Scientific Software Development GmBH). Coding was
performed by 2 researchers (SD and JA or MK). The second
coder repeated the process on samples from the interviews toverify codes. A code tree was created, and codes were discussed
until consensus was reached. The analysis was used to categorize
recurrent and common themes and to identify key elements in
the interviews. Participants did not provide feedback on thefindings.

Results
Overview
A total of 5 patients with COPD and 6 HCPs participated in thisstudy. The HCPs worked in a hospital or in a rehabilitation
center as a pulmonologist (n=2), nurse (n=2), nurse practitioner(n=1), or physical therapist (n=1). Patients were aged between
60 and 80 years and had COPD GOLD (Global Initiative for
Chronic Obstructive Lung Disease) stage 3 or 4. The interviews
took approximately 30 minutes and the focus groups took 1
hour. Results are presented as (1) MB in support ofself-management, (2) expected use of an MB during the courseof illness, and (3) facilitators and barriers. The exact number ofindividuals that were invited for participation and declined is
unknown.

MB in Support of Self-Management
The first aspect that most patients described as valuable in an
MB is its ability to help with the (very) early recognition of an
exacerbation. Some participants specifically stated that it should
register and interpret trends in (vital) parameters, andsubsequently notify them in case of deviations from normal
values.
…I expect the bracelet to warn me that there is something wrong
with me before I notice it myself. [male, patient]
Valuable (vital) parameters that an MB should be able tomeasure, according to participants, are oxygen saturation,
respiration (frequency), heart rate, and physical activity, because
these measures are informative about a person’s health status.
For physical activity, different variables were mentioned suchas: step count, type of performed activities (such as standing or
walking), and pace of movement. One HCP felt that step countis not an accurate parameter for early detection of exacerbations
and emphasized the greater importance of vital parameters. Also
mentioned by 1 HCP was the importance of additional
information about a patient’s perspective by offering the optionof self-monitoring in an MB.
Another potential benefit frequently mentioned by both patientsand HCPs was receiving alerts when data deviate from normal.
Both groups acknowledged the importance of HCPs having
access to their patients’ monitoring data. However, there was
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no consensus on who should receive these alerts first. Somepatients thought that the HCP should be alerted first andsubsequently reach out to the patients, while other participants
thought it was the patients’ responsibility to reach out if
something is wrong.
…When the time comes, you can call for help yourself. The
watch doesn't have to do that, I can do it myself. The mostimportant thing is that the watch lets me know me whensomething is wrong. [female, patient]
Most HCPs further mentioned that an MB should support
patients in having ownership over their health. An MB can foster
this ownership and give patients more autonomy by providing
body awareness, finding rest, and providing awareness of andinsight into normal values and trends. The HCPs further reported
possible benefits for patients in terms of being able to ask formore specific help with their COPD when parameters deviate
from normal, building confidence, reducing anxiety, feelingheard, and supporting the transition from the rehabilitation
center to their home. HCPs could for example discuss unusual
data with patients and explore the reasons behind suchdeviations.
…I can imagine people will be motivated as they gain insight
into their movement patterns and whether these stay within theset norms. That they become more confident and are able toask for more specific help when they see deviations. [HCP]

Benefits and Drawbacks of a Monitoring Bracelet
Benefits mentioned by patients were being able to act quickly,
a sense of reassurance, heightened body awareness, improved
insight into the disease and normal values and patterns, andfinally, improved insight for informal caregivers into how thepatient is doing. Possible drawbacks were also mentioned. Most
HCPs felt that some patients might just focus on the data andnot think critically, become obsessed with the data, or feel that
their privacy was being invaded. They also described that theMB system should be integrated with the electronic patient
dossier, because using multiple systems at the same time islaborious. Some patients also described the potential drawbackof becoming obsessed with data, invasion of their privacy, andreluctance due to having to use yet another application. Several
patients did not see any drawbacks in using an MB.

The Expected Use of Monitoring Bracelet During the
Course of Illness
Most participants did not anticipate any potential difference
between the short-term and the long-term use of an MB. Several
participants said that an MB should be worn through all phases,that is, periods of well-being, exacerbation, and recovery, toobtain a comprehensive view of a patient’s condition. It is
important to remember that during recovery, parameters may
still deviate from normal. One thing highlighted by HCPs thatmight be of added value in the long-term is a parameter tomeasure physical activity. HCPs did not consider step count tobe suitable for detecting exacerbations in the short-term, but adecrease in the trend of steps taken could be a sign ofdeteriorating health in the long-term. Patients did not
differentiate between the importance of parameters in thelong-term or the short-term.
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HCPs further stated that patients could try the MB in the healthcare setting, to see if it suits their abilities and needs. An MB
could support the transition from a care setting to the homesetting, by giving insight into changes in parameters.
…It might help us to better guide patients' transition from 10
weeks of comprehensive care to a “go do it yourself at home”
approach. What difficulties do patients encounter? We often
hear back: “it just didn't work out” or “I failed again” andthen [with an MB] we can point out more specifically “I noticethat...” [HCP]

Facilitators and Barriers
A major facilitator for the use of an MB is providing support
to patients on how to use the device. Some HCPs thought thatpatients will not be able to use an MB correctly without suchsupport.
…I think this bracelet would be useless without instruction.
Then [with instructions] you will know if you’re going into theright direction or maybe in a wrong direction. [HCP]The support could be in the form of a manual, video instructions,or even a whole support system with coaching from HCPs or
support groups with other patients. This system could include
coaching appointments with HCPs for regular feedback onparameters. Patients elaborated on the crucial role of support
with statements about a decrease in motivation if they did notknow how to use an MB. One patient mentioned that it would
be useful if informal caregivers could also receive information
about an MB.
HCPs also indicated that it was their responsibility to assess
whether an MB could be of value to a person, and to provide
guidance and coaching accordingly. Several HCPs said thatpatients in rehabilitation could learn how to use, practice, andinterpret the system. Patients need to gain experience with an
MB to know what values are normal within their own physique.
…I think it is our role to coach the patient. So giving good
instructions, adequate cut-off scores, like this is when you needto get in touch and if you're within this range you are okay.
[HCP]
In addition, an MB should be easy to use, should not
malfunction, should provide signals that are tailored to a patient,and it should have an attractive design. Patients also describedthat it should have additional features compared with a regularsmartwatch. Instructions on how to use and interpret theobtained data are an important precondition for MB use. Anotherimportant precondition for the use of an MB is ensuring theaccuracy of the data and the reliable detection of abnormal
values and trends. Additional preconditions mentioned byparticipants included standard procedures and protocols, anadequate battery life of the MB, ensuring privacy, affordable
cost, and the bracelet being waterproof.
Despite a generally positive attitude, HCPs also see somebarriers to the use of an MB in health care. For example, theymentioned the time required to monitor the data, which could
lead to an increased demand for staff and therefore increased
costs. They further mentioned that patients with COPD are often
older and of lower socioeconomic status, which are risk factors
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for lower digital literacy. Patients described some of the samebarriers, such as the potential costs, while also identifying somebarriers on a more practical level, such as having to wear thedevice all the time. Furthermore, 1 patient mentioned she wasafraid she would be overlooked if an MB malfunctioned.
…They [doctors] are all so incredibly busy. I’m afraid I will beoverlooked if I wear the watch, and something is wrong withthe watch. We're already being overlooked now. [female,patient]

Discussion
Principal Findings
The results of this study show that Dutch patients and Dutch
HCPs both have an overall positive and comparable view of theuse and value of an MB in the care of patients with COPD. The
most frequently mentioned value of an MB for patients with
COPD, according to both HCPs and patients, is its support in
self-management of COPD. In addition, HCPs indicated thatan MB should support patients’ ownership of their health.
Furthermore, the support that patients would need to use an MB
as well as the support that an MB could provide, were discussed.
The potential benefits most frequently highlighted by HCPs andpatients related to early detection and alerting in case of
exacerbation. There was no consensus on whether the alerts
should be received by the HCP or patient first. Participants did
not anticipate major differences regarding the expected use of
an MB during the course of illness. The most frequently
mentioned facilitators for using an MB were adequate support(eg, from HCP or peers) and instructions on how to use itcorrectly, ease of use, and an appealing design. Potential barriers
were the need for time and staff to guide patients, costs (eg, forpurchase or guidance), and having to use multiple apps at thesame time.
The need for support described by both HCPs and patients inthis study in using and interpreting data from an MB is in linewith the literature focused on patients. Target groups that havemore problems with understanding and accessing eHealth inparticular, are known to need more support in using it [27].
Previous literature shows that a platform supporting
self-management of people with COPD was used more whenparticipants received more personal support in how to use it[28]. HCPs in this study highlighted the importance of acomprehensive support system. This is in contrast with earlier
literature where HCPs primarily emphasized the necessity oftechnological support alone [29]. Although a patient’s
motivation influences the use of eHealth, support increases theeffectiveness of and adherence to eHealth interventions [30].
Support from others should be managed carefully, as factors
such as the bond between patient and the person giving support
and perceived legitimacy of the person giving support can
influence the use of an eHealth intervention [27,30].
Participants also described the support that an MB could provide
at various time points in COPD, including stable phases andduring recovery from an exacerbation. Support during thesephases can be provided in various domains, which Gardener etal [31] grouped into 4 overarching categories: physical,
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psychological, social, and spiritual. Participants describedsupport in the physical domain in terms of self-management.
This form of support fits into the “managing symptoms andmedications” domain of support for managing life with COPD
[29,31]. The support that an MB can provide in managing one’s
COPD, was also highlighted by participants in the study of Wu
et al [32], who conducted a qualitative study on the needs ofpatients with COPD in applications that support theirself-management. Other studies that implemented eHealthinterventions and tools to support self-management of long-term
conditions suggest that eHealth is safe and best used alongsideusual care [33]. eHealth is most promising in blended caresettings [28,34]. As factors such as personality, lifestyle,progression of a chronic disease, and environmental
characteristics influence self-management, they should be taken
into consideration when developing eHealth to support
self-management.
In addition, the ability to accurately detect early signs of an
exacerbation by measuring deviations in (vital) parameters was
highlighted as the most important characteristic an MB shouldhave both shortly after an exacerbation as over a longer period.
This is not surprising, as exacerbations have a detrimental effecton health and having an exacerbation is a major risk factor for
another exacerbation [35]. Other predictors of exacerbations
include comorbidities, disease severity, symptom burden, andenvironmental factors [36,37]. Predictors such as these cannot
be measured by an MB. Nevertheless, other predictors of an
exacerbation, such as decreased physical activity, pulse rate,oxygen saturation, and respiratory rate, can be measured by an
MB [36-39]. If an exacerbation is recognized and treated intime, the length and severity of the exacerbation can be reduced,
which can support patients’ short- and long-term recovery [40].
An MB should be easy to use, according to the participants.
This is in line with recent literature which suggests that simple
eHealth interventions are more likely to be feasible and effective[34]. The desire of the elderly target group for an uncomplicatedand familiar design of eHealth has been described earlier [41].
Therefore, an MB should be adapted to the skills, wishes, andneeds of the target population [42]. The target population for
an MB in COPD management does not only consist of patients,
but also of HCPs. However, there is a lack of understanding
regarding the perspective of the HCPs on the use of MBs in
COPD care [24]. This study suggests that Dutch HCPs hold apositive view that complements the patient perspective. The
inclusion of this additional perspective is of upmost importance,since cocreation with the target population can provide insight
into the skills, wishes, and needs and thus facilitate an MBs use[41]. In addition, known barriers for target groups should beconsidered, such as cognitive barriers, physical disabilities, andlack of motivation [23,41]. To ensure an optimal fit for the target
population in a national context, not only the patient but also
other stakeholders should be involved in the development
process [43,44].
As such, the use of nonobtrusive wearable devices appears tobe beneficial and well accepted by patients and HCPs to be
integrated into existing care, with little difference between
long-term and short-term care. An MB could be combined withother eHealth solutions, such as smartphone apps and air quality
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monitoring devices to increase the impact. To effectively
implement an MB supporting the management of COPD, HCPs,
patients, developers, and other stakeholders in the Dutch context
should be informed and involved in the process. In both
long-term and short-term care, an MB could help improveoverall well-being, health outcomes, and quality of life ofpatients with COPD.

Limitations
Participants indicated they were not familiar with thepossibilities of an MB, which suggests that they may not beaware of all the facilitators and barriers relating to the use andimplementation of an MB. For example, because they were notable to see or try the MB, they could not experience theunobtrusive, small, lightweight design, and long battery life.
Another limitation of this study is the small sample size. As aresult, we are not sure if data saturation is sufficient to provide
a representative perspective of the population. Nonetheless,given the explorative nature of this study, the sample size wassufficient to provide a first insight into the potential value of an
MB. Furthermore, it may have been too difficult for patientswith low digital literacy to participate in interviews via video

Debeij et al
calls, which may have led to selection bias and reduced
generalizability.

Conclusions
This qualitative study showed that both HCPs and patientsrecognize that an MB could be beneficial and valuable forpatients with COPD at high risk of exacerbation, both in the
short-term and long-term. In particular, they highlighted theperceived value of an MB in supporting the self-managementof patients with COPD. Both HCPs and patients wanted to use
an MB for the early detection of exacerbations and did not see
major differences in its use in short-term or long-term care.
Furthermore, the identified facilitators and barriers to the use
and implementation of an MB in COPD care, emphasize theneed for ongoing research and careful consideration of
stakeholders’ perspectives. This may ultimately support thesuccessful implementation and adoption of wearable technology
in this area of care. The integration of an MB into clinicalpractice through blended care has the potential to increase
overall well-being and health outcomes of patients with COPD
by supporting their self-management.

Acknowledgments
First, we would like to thank Eline Oldenburg for her contributions to this study in terms of the development of study materials,
as well as her support in conducting and transcribing part of the interviews. We would also like to thank Anne-Lotte Redel and
Lotte Bult for their support in recruiting health care professionals at hospital Franciscus Gasthuis and Vlietland, and to Wieteke
Stoop for her support at Revant rehabilitation center. Finally, we would like to thank Corsano Health B.V. for commissioning
and funding this study. Last, no AI is used in designing, conducting, or analyzing this study. ChatGPT is used to improve sentences.

Data Availability
The data are not readily available because participants did not give consent to share data with other parties.

Conflicts of Interest
All authors declare that they have no conflicts of interest. Corsano Health B.V. was not involved in the execution, analysis, orreporting of the study.

Multimedia Appendix 1
COREQ (Consolidate Criteria for Reporting Qualitative Studies) checklist.
[PDF File (Adobe PDF File), 1116 KB-Multimedia Appendix 1]

Multimedia Appendix 2Interview protocols.
[PDF File (Adobe PDF File), 229 KB-Multimedia Appendix 2]

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Abbreviations
COPD: chronic obstructive pulmonary disease
COREQ: Consolidate Criteria for Reporting Qualitative Studies
GDPR: General Data Protection Regulation
GOLD: Global Initiative for Chronic Obstructive Lung Disease
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HCP: health care professional
MB: monitoring bracelet
WMO: Dutch Medical Research Involving Human Subjects Act

Edited by A Mavragani; submitted 12.02.24; peer-reviewed by I Yang; comments to author 01.05.24; revised version received 06.06.24;
accepted 26.06.24; published 13.09.24
Please cite as:
Debeij SM, Aardoom JJ, Haaksma ML, Stoop WAM, van Dam van Isselt EF, Kasteleyn MJ
The Potential Use and Value of a Wearable Monitoring Bracelet for Patients With Chronic Obstructive Pulmonary Disease: Qualitative
Study Investigating the Patient and Health Care Professional Perspectives
JMIR Form Res 2024;8:e57108
URL: https://formative.jmir.org/2024/1/e57108
doi: 10.2196/57108
PMID:©Suzanne M Debeij, Jiska J Aardoom, Miriam L Haaksma, Wieteke A M Stoop, Eléonore F van Dam van Isselt, Marise J
Kasteleyn. Originally published in JMIR Formative Research (https://formative.jmir.org), 13.09.2024. This is an open-accessarticle distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/),
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR
Formative Research, is properly cited. The complete bibliographic information, a link to the original publication on
https://formative.jmir.org, as well as this copyright and license information must be included.

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