Development of a patient-centred electronic review template to support self-management in primary care

Background Electronic templates are frequently used in long-term condition reviews (e.g. asthma) to act as reminders and improve documentation, however, they can restrict patient-centred care and opportunities for patients to discuss concerns and self-management.

Aim The IMPlementing IMProved Asthma self-management as RouTine (IMP²ART) programme aimed to develop a patient-centred asthma review template that encourages supported self-management.

Design & setting This was a mixed-methods study, which integrated qualitative and systematic review data, primary care Professional Advisory Group feedback, and qualitative data from clinician interviews.

Method Aligned with the Medical Research Council complex intervention framework, a template was developed in three phases: 1) Development phase: qualitative exploration with clinicians and patients, a systematic review, and prototype template development; 2) Feasibility pilot phase: feedback from clinicians (n=7); 3) Pre-piloting phase: delivering the template within the IMP²ART implementation strategy (incorporating the template with patient and professional resources) and eliciting clinician feedback (n=6).

Results Template development was guided by the preliminary qualitative work and the systematic review. A prototype template was developed with an opening question to establish patient agendas, and a closing prompt to confirm agendas have been addressed and an asthma action plan provided. The feasibility pilot identified refinements needed, including focusing the opening question to asthma. Pre-piloting ensured integration with the IMP²ART strategy.

Conclusion Following the multi-stage development process, the implementation strategy including the asthma review template is now being tested in a cluster randomised controlled trial.