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

Abstract

<b>Introduction:</b> Templates are frequently used in asthma reviews as reminders and to improve documentation, however, they can affect patient-centred care and opportunities to discuss self-management. <b>Aims and objectives:</b> The IMPlementing IMProved Asthma self-management as RouTine (IMP²ART) programme aimed to develop a patient-centred asthma review template that encourages self-management. <b>Methods:</b> Aligned to the Medical Research Council (MRC) complex intervention framework, the multidisciplinary team developed a review template in three phases: 1) Developmental phase (qualitative exploration with clinicians, a systematic review, and prototype template development) 2) Feasibility pilot phase (qualitative feedback from clinicians (n=7)) 3) Pilot phase (delivering the template with the IMP²ART programme, incorporating patient and professional resources, and inviting feedback from clinicians (n=6)). <b>Results:</b> Template development was guided by the qualitative work that identified templates can be poorly integrated with IT-systems. The systematic review identified a need to be patient-centred and incorporate open-text options and self-management questions/education. The prototype template was developed for different IT-systems; with an opening question to establish agendas; refined content; links to patient information; a closing prompt to confirm action plan provision. The feasibility pilot phase identified refinements needed, including focusing the opening question to asthma. The pilot ensured the template integrated with IMP²ART. <b>Conclusions:</b> A multi-stage development process contributed to the development of the review template. IMP²ART is now being tested in a UK-wide cluster-RCT.