Participants
breathlessness, spirometry-confirmed, COPD
COPD, SECONDARY
Between 2017 and 2020, participants were screened and recruited from primary and secondary care across 17 geographically dispersed NHS organisations (NHS Trusts) in England. Eligible participants had a spirometry-confirmed diagnosis of COPD with moderate to very severe airflow limitation and were eligible for referral to their local pulmonary rehabilitation service [Following baseline data collection participants were randomised to intervention or usual care (control) using a centralised, online service and stratified by NHS Trust. Within each NHS Trust minimisation balanced allocations according to baseline HADS subscale scores, breathlessness determined by the modified Medical Research Council breathlessness scale (mMRC) and smoking status [