Clinical outcome measures

Physical frailtyShort Physical Performance Battery (SPPB) [27]Incorporates 4-m gait speed, five sit-to-stands, and static balance tests. It takes approximately 10–15 mins to complete, requires a floor mark for the gait-speed test, chair for sit-to-stand, and a timer, and results in a score from 0–12 (≤7 indicating frailty, 8–9 pre-frailty, and 10–12 robustness).
Health-related quality of lifeChronic Respiratory Questionnaire (CRQ-SR) [28]This scale contains 20 items measuring the impact of chronic respiratory disease across four domains: dyspnoea, mastery, fatigue, and emotional function. Each item is scored from 1–7, and the mean score across each domain is calculated. Higher scores indicate better health status.
Activities of daily livingManchester Respiratory Activities of Daily Living questionnaire [29].This measure includes 21 self-report items across four domains: mobility, kitchen activities, domestic tasks, and leisure activities. Most items are scored 0–1 based on responses of doing tasks “not at all”, “with help”, “alone with difficulty” or “alone easily” and total scores range from 0 to 21, where 21 indicates no impairment in daily activities.
Health statusEuro-Qol 5D-5LThis measure contains five descriptive items (mobility, self-care, usual activities, pain, and anxiety/depression) with a five-point scale from “no problems” to “unable/extreme problems”, and a visual analogue scale asking participants to rate their health from 0 (worst health imaginable) to 100 (best health imaginable). Descriptive item scores are converted into a single index value for health status, where a high value represents higher health status. Scores would also contribute to health economic analyses in a future effectiveness study.
Anxiety and depressionHospital Anxiety and Depression Questionnaire (HADS) [30]This is a 14-item questionnaire with two subscales: anxiety (seven items) and depression (seven items). Items are scored on a scale of 0 to 3. Items are summed creating a maximum score of 21 on each subscale, where higher scores indicate higher levels of symptoms of anxiety or depression.
LonelinessDe Jong Gierveld Loneliness Scale (6-item) [31]This shortened version includes three items measuring social loneliness, and three items measuring emotional loneliness, scored as 0 or 1. When summed, a higher score indicates higher levels of loneliness.
Service useClient Service Receipt Inventory (CSRI) [32]This measure asks participants about their contacts with hospital and community health care services, any investigations or diagnostic tests, help from informal carers, and equipment used, over the past 3 months. This measure would also contribute to health economic analysis in a future effectiveness study.