Abstract

Introduction
An estimated 1.4 million people (2%) in the UK are living with Chronic Obstructive Pulmonary Disease (COPD),with 2 million cases remaining undiagnosed [1].COPD is the fourth leading cause of death in Scotland [2].COPD significantly impacts public health, emphasising the importance of effective prevention, early detection,and management to lower mortality rates. COPD incidence and risk of adverse outcomes are linked with socioeconomic deprivation, lower educational attainment and childhood disadvantage [3,4], therefore the collaboration with service users from underserved communities is crucial when developing solutions.
We wanted to identify some key challenges with public contributors, enabling us to co-design person-centered digital solutions.

Methods
We formed a group of 30 COPD patients,carers,and families from underserved communities with no prior experience in research, innovation or the use of health data, who agreed to help us co-design digital projects. We conducted 5 simple discussion-based workshops, aimed at fostering mutual trust and understanding to gain insights and identify key elements for the co-design phase.

Key questions explored were in initial workshops were:
1. What aspects of your COPD care work well, and which do not?
2. How do you manage your COPD on your own?

We wanted to
- Identify care gaps
- Gather feedback
- Utilise their experiences to design a digital pathway ensuring inclusion for individuals from underserved communities.
- Create an environment where participants are encouraged to share their feedback openly, ensuring maximum input from
contributors.

Results
Key challenges reported:
• Long wait times and delays being diagnosed.
• Lack of support, feeling "abandoned" during early stages, when management is key to slowing progression.
• Issues around accessing COPD specialists.
• Difficulty understanding medical terminology and disease progression
• Encountering contradictory information from healthcare providers, highlighting a strong need for accurate and consistent
guidance.
• Challenges in access to PR (waiting lists),vaccine adherence,access to Community Respiratory Teams
• How social factors such as housing,support systems,loneliness,and finances impact self-management.

Conclusion
Developing digital solutions that prioritise the lived experiences of individuals with COPD will more effectively support COPD communities. This work will continue to inform future design of our new digital pathways.