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

Conference:

SAPC ASM 2019 - Exeter

Talk Code:

6E.4c

Presenter:

Steph JC Taylor

Co-authors:

Kirstie McClatchey, Aimee Sheldon, Liz Steed, Steph JC Taylor, Hilary Pinnock, Charlotte Ridgeway, Oliver Taylor, Francis Appiagyei, David Price.

Author institutions:

Queen Mary University of London, Asthma UK Centre for Applied Research, The University of Edinburgh, Optimum Patient Care.

Problem

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.

Approach

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.

Findings

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.

Consequences

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.

Submitted by:

Steph Taylor

Funding acknowledgement:

IMP2ART is independent research funded by NIHR PGfAR (RP-PG-1016-20008). The views expressed are those of the authors, not necessarily those of the NHS, NIHR or Department of Health and Social Care.