Development of a patient-centred asthma review template to improve self-management in UK primary care

Clinical Research Results Abstract Introduction: Asthma results in 6.3 million primary care consultations in the United Kingdom (UK) each year, and supported asthma self-management (including regular clinical review, patient education, and asthma action plan provision) can improve asthma control and quality of life. Templates are frequently used in reviews to act as reminders and improve documentation, however, can affect patient-centred care and opportunities for patients to discuss concerns and self-management. The IMPlementing IMProved Asthma self-management as RouTine (IMP2ART) programme aimed to develop a patient-centred asthma review template that encourages supported self-management.Methods: Aligned with the Medical Research Council (MRC) complex intervention framework, the multidisciplinary team developed a review template in three phases: 1) Developmental phase, which included qualitative exploration with clinicians, a systematic review, and prototype template development 2) Feasibility pilot phase, with qualitative feedback from clinicians (n=7) 3) Pilot phase, delivering the template within the IMP2ART programme (incorporating the template, along with patient resources and professional education), and inviting feedback from clinicians (n=6).Results: Template development was guided by the preliminary qualitative work which identified that templates can be poorly integrated with IT-systems. The systematic review identified a need to incorporate open-text/flexible options, more self-management questions and education, and to focus on patient-centredness. The prototype template was then developed for different clinical IT-systems; with an opening question to establish patient agendas; refined content (with optional fields); links to patient-information; a closing prompt to confirm agendas are addressed and an action plan provided. The feasibility pilot phase identified refinements needed, including changing the opening question to be asthma focused. The pilot ensured the template integrated with the IMP2ART programme.Discussion: A multi-stage development process, aligned with the MRC framework, contributed to the development of the asthma review template. The IMP2ART programme is now being tested in a UK-wide cluster randomised controlled trial [ref: RP-PG-1016-20008]. Research Idea Abstract Service Development & Evaluation Abstract Declaration of Interest Declaration of Interest: Funding: NIHR PGfAR (RP-PG-1016-20008).The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. References and Clinical Trial Registry Information