IMPlementing IMProved Asthma self-management as RouTine (IMP2ART) in primary care: internal pilot for a cluster randomised controlled trial

Clinical Research Results Abstract Introduction: IMPlementing IMProved Asthma self-management as RouTine (IMP2ART) is a multidisciplinary and theoretically-informed strategy to improve implementation of supported self-management and asthma outcomes in routine practice. The strategy includes 1) patient resources to support self-management 2) professional asthma self-management education for practice staff 3) organisational strategies. This pilot, internal to a cluster randomised controlled trial, aimed to test trial processes and recruitment feasibility, and to understand practices’ likely engagement with the IMP2ART strategy.Methods: A mixed-method pilot was conducted in 12 general practices (May-September 2021). Practices were randomised to the IMP2ART implementation arm (n=6), or usual care control (n=6). Recruitment and set-up processes were monitored, with quantitative data analysed on key aspects of IMP2ART delivery (IMP2ART asthma review template uploads, audit/feedback reports sent, IMP2ART workshops held) and practice response (website views, education module completion). 10 qualitative interviews were conducted with implementation arm staff (general practitioners; nurses; practice managers) and IMP2ART facilitators (who delivered the strategy). Interviews were audio-recorded and analysed using framework analysis.Results: We recruited 12 practices to the study. One control practice withdrew (change in practice approach to data governance). We delivered the IMP2ART strategy largely as planned; the IMP2ART asthma review template was successfully uploaded, the annual asthma audit report was sent, and practice workshops were held in all implementation practices (attendance ranged from 7-31 clinical and administrative staff). There were, however, minor delivery delays for some monthly audit/feedback reports. Practice response analysis indicated ≈450 unique page views on the resource website, and 100% of practices completed the team education module. Interview data were largely positive, with examples of how practices were using IMP2ART.Discussion: The IMP2ART trial processes were successful and required only minor changes. Practices engaged with the implementation strategy and its resources, suggesting the IMP2ART strategy is acceptable and feasible. 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