Feasibility of Asthma Registry Implementation in Primary Care Among Doctors in Klang District, Malaysia

Aim: To develop and implement an asthma registry to support systematic, efficient, and standardised documentation of routine asthma data in primary care clinics. Outline of context: Primary care clinics in Klang offer asthma care, but audits are conducted one-off annually, limiting continuous monitoring and evaluation of asthma care against evidence-based recommendations. Brief description of the change: We developed a clinical quality registry for implementation at two public primary care clinics that used an electronic medical record (EMR) system for their clinic operations. The registry template (in Microsoft Excel) lists 25 data elements covering patient demography, asthma control, treatment, self-management, education, and continuity of care. The data are stored at Universiti Malaya. Strategy for change and why would it work: We interviewed all doctors who had used the registry for at least one month to assess feasibility. Interviewees found it easy to learn and use with minimal technical issues. Training and the presence of an on-site investigator during the early adoption phase were helpful, though the system was generally manageable even without assistance. The registry was perceived as potentially improving patients' asthma outcomes because the data elements helped update users' knowledge and adherence to evidence-based asthma care, ensured thorough assessment during reviews, and enabled regular audits. Although the registry was seen as efficient for dedicated asthma clinics, its use during regular outpatient services was challenging and deemed impractical due to patients' multiple comorbidities. Although concurrent real-time data entry by multiple team members was possible, it was deemed less convenient. Impact and lesson learned: In six months, 9/43 (21.9%) doctors from the two clinics used the registry during 264 patient consultations. Interviewees were optimistic about sustaining and integrating the registry within the existing infrastructure on a larger scale. However, while feasible, incorporating it with the clinic EMR system could increase its adoption.