Acceptability of a mobile spirometry model for COPD case-finding in primary care: A qualitative exploration of patient and general practice perspectives

Chronic obstructive pulmonary disease (COPD) is among the top ten causes of death in Singapore, yet spirometry - the gold standard for diagnosis - remains significantly underutilized in primary care. We introduced a mobile health (mHealth) technology-based model for COPD case-finding in Singapore primary care, including a questionnaire for COPD risk stratification and referral to mobile spirometry using a digital platform. We conducted a qualitative study using semi-structured, individual in-depth interviews with 20 patients at risk of COPD and 10 general practitioners (GPs) who referred patients to enrol in this new model. Interviews were audio-recorded, transcribed verbatim and thematically analysed using deductive and inductive strategies, informed by the Technology Acceptance Model (TAM) framework. We found that GPs and patients generally perceived the new model as useful and acceptable, particularly for its ability to improve accessibility, increase awareness of COPD, and facilitate early detection. However, barriers related to the interpretation of spirometry results, workflow integration, the physical demands of the test, and psychological readiness among patients may influence its broader implementation. These results suggest that the new model for COPD case-finding has the potential to strengthen early detection of COPD and improve preventive respiratory care in Singapore primary care. However, barriers need to be addressed through system integration, training, and patient education to support future implementation.