Developing a patient-centred template for asthma reviews: an IMP2ART implementation strategy
Templates for use in consultations typically aim to improve adherence to key functions, but risk overriding the patient agenda. As part of the IMPlementing IMProved Asthma self-management as Routine (IMP2ART) programme, we aimed to develop a review template designed to enhance patient-centred care, and promote supported self-management in primary care asthma reviews.
Building on current guidelines, recommendations of an Asthma UK and Royal College of Physicians workshop, professional experience, patient-centred care 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 items to be included and excluded and advised on feasibility.
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 if asthma is poorly controlled; links to access a range of external information sources for patients; and a closing question to confirm that the patient’s agenda has been addressed. The template highlights patient-centeredness, encourages action plan provision, and supports patients to self-manage their asthma.
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.