🏅 Scientific Research Poster Winner
Delivery of supported self-management in remote asthma reviews: a systematic rapid realist review (ID 274)
University of Edinburgh
Funding: EK is supported by the Chief Scientist Office [AUKCAR/19/01] within the Asthma UK Centre for Applied Research [AUK-AC-2012-01 and AUK-AC-2018-01]. Additionally, embedded within the National Institute for Health Research (NIHR) IMP2ART (IMProving IMPlementation of Asthma self-management as RouTine) programme of work (RP-PG-1016-20008).
Abstract
Aim: The COVID-19 pandemic forced health care systems globally to adapt quickly to remote modes of health care delivery, including for routine asthma reviews. A core component of asthma care is supporting self-management, a guideline-recommended intervention that reduces the risk of acute attacks, and improves asthma control and quality of life. Following standard methodology for rapid realist reviews, we aimed to explore context and mechanism for the outcomes of clinical effectiveness, acceptability and safety of supported self-management delivery within remote asthma consultations.Method: We systematically searched four electronic databases and, with expert advice and guidance from an External Reference Group (ERG), selected 18 papers that explored self-management delivery during routine asthma reviews (specifically including telephone/video consultations). Data were extracted using Context-Mechanism-Outcome (C-M-O) configurations and synthesised into overarching themes using the PRISMS taxonomy of supported self-management as a framework to structure the findings. The ERG reviewed the data and provided expert direction.
Results: The review findings identified how support for self-management delivered remotely was acceptable (often more highly accepted than in-person consultations), and was an equally safe and effective alternative to face-to-face reviews. In addition, remote delivery of supported self-management was associated with; increased patient convenience, improved access to and attendance at remote reviews. Remote reviews provided the core content of an asthma review, remote completion of asthma action plans and offered continuity of care.
Conclusion: Remote delivery of supported self-management for asthma was generally found to be clinically effective, acceptable and safe with the added advantage of increasing accessibility. Our findings support the option of remote delivery of routine asthma care and provide possible guidance for healthcare professionals conducting routine asthma reviews remotely, to successfully embed supported self-management techniques into individual consultations.
Conflicts of interest: None
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