Developing a patient-centred template for asthma reviews: an IMP2ART implementation strategy

Abstract

Introduction: Computer templates are used in consultation to review long-term conditions such as asthma. Templates aim to improve adherence to key functions, but risk overriding the patient agenda. The IMPlementing IMProved Asthma self-management as RouTine (IMP2ART) programme, aimed to develop an asthma review template to enhance patient-centred care, and promote supported self-management in primary care. Methods: Building on current guidelines, recommendations of an Asthma UK and Royal College of Physicians workshop, patient-centred literature, and behaviour change theory, the multidisciplinary team (clinicians, health psychologists, technical experts) developed a prototype template. A professional advisory group of asthma-interested GPs and nurses (n=17), provided insights into item inclusions and advised on feasibility within primary care. Results: Key features of the prototype template include: an opening question to establish the patient’s agenda such that patients concerns and goals can be addressed; a reduction in extensive data collection e.g. by using different tabs for spirometry; considerations for poorly controlled asthma; links to access a range of external information sources for patients; and a closing question to confirm the patient’s agenda has been addressed. The template highlights patient-centredness, encourages action plan provision, and supports patients to self-manage their asthma. Conclusions: Our prototype template is designed to promote patient-centred care and overcome the risk of reducing asthma reviews to ‘tick-box’ exercises. We will now seek feedback on the utility of the template from professionals and patients. Funding: NIHR PGfAR (RP-PG-1016-20008).