Remote asthma reviews: Developing practical resources for the IMP2ART trial to meet the challenges of remote asthma reviews in a COVID-19 pandemic.
Problem
COVID-19 changed how we deliver care. Remote consultations (e.g. telephone, videocalls, and on-line) became the norm, and are likely to be an option in primary care beyond the pandemic. The IMP2ART cluster-randomised controlled trial aims to embed supported self-management for asthma in routine practice, and resources required updating to reflect the pandemic context.
Approach
Web-based guidance, in both documentary and video format, was identified from NHS sources, GMC, BMA, MDU and Royal Colleges, using a combination of the search terms ‘remote consultations’, ‘health care professional’, ‘general practitioners’ and ‘nursing’. Themes from these sources were discussed with the IMP2ART Professional Advisory Group (PAG) and Patient and Public Involvement (PPI) group to explore their perceptions of the benefits/challenges of carrying out remote asthma reviews in primary care. Discussions were recorded with consent, and key points documented.
Findings
Identified themes included practical advice using technology; ethical/legal issues; communication strategies; planning and patient selection, but typically focussing on acute consultations. In-depth discussion with PAG and PPI groups, provided insight into the perceived challenges and benefits of remote reviews for asthma. The PPI group felt remote consultations were effective if participants were well-prepared, but were cautious about potential disruption to continuity of care, ‘digital inequity’ and they highlighted the need to respect patient preference for mode of consultation. The PAG were generally confident about technological issues, but identified future training needs for practice staff to carry out remote asthma reviews. Suggestions for remote delivery of asthma-specific tasks (e.g. checking inhaler technique, completing action plans) were discussed.
Consequences
With advice from the two groups, we were able to adapt current guidance to the specific context of an asthma review and developed ‘how to’ resources, including infographics and podcasts, which will be available to the intervention arm of the trial.