IMPlementing IMProved Asthma self-management as Routine Treatment: the IMP2ART programme
Supported self-management, which helps people adjust their treatment in response to changes in symptoms, improves day-to-day control and reduces the risk of asthma attacks. However, for many reasons, supported self-management is not widely implemented; fewer than a quarter of people replying to a recent Asthma UK web-survey owned an action plan. Our recent systematic review concluded that successful implementation of supported self-management requires attention to patient resources, professional motivation and training, and organisational prioritisation and support
Building on the findings of preliminary IMP2ART studies, and working with six general practices, Asthma UK, PRCS-UK and Education for Health we will develop the components of an implementation strategy. For example:• Patient resources to support self-management (e.g. a range of action plans; flexible access to professional advice; digital options)• Professional education to motivate and train practice teams (e.g. online, team-based modules to raise awareness and provide specific skills) • Organisational strategies to facilitate adoption (e.g. audit/feedback; review templates; electronic action plans)Facilitated by respiratory nurse specialists, practices will be encouraged to adopt and adapt strategies to suit their practice routines.
We will recruit GPs, asthma nurses, and admin staff from four practices to pre-pilot the implementation strategy, and provide qualitative feedback on feasibility. We will report progress on the pre-pilot.
THE IMP2ART UK-WIDE TRIALFollowing a pilot (n=12 practices) we will undertake a national cluster-RCT (n=144 practices) which will evaluate the impact and cost-effectiveness of the IMP2ART implementation strategy on unscheduled care (assessed from routine data) and ownership of action plans. A mixed-methods process evaluation will explore potential for scaling-up and sustainability.