Abstract

Aim: IMPlementing IMProved Asthma self-management as RouTine (IMP2ART) is a multidisciplinary and theoretically-informed strategy to improve implementation of supported self-management and asthma outcomes in routine practice. The strategy includes 1) patient resources to support self-management 2) professional asthma self-management education for practice staff 3) organisational strategies. This pilot, internal to a cluster randomised controlled trial, aimed to test trial processes and recruitment feasibility, and to understand practices’ likely engagement with the IMP2ART strategy.
Method: A mixed-method pilot was conducted in 12 general practices (January-September 2021). Practices were randomised to the IMP2ART implementation arm (n=6), or usual care control (n=6). Recruitment and set-up processes were monitored, with quantitative data analysed on key aspects of IMP2ART delivery (IMP2ART asthma review template uploads, audit/feedback reports sent, IMP2ART workshops held) and practice response (website views, education module completion). 10 qualitative interviews were conducted with implementation arm staff (general practitioners; nurses; practice managers) and IMP2ART facilitators (who delivered the strategy). Interviews were audio-recorded and analysed using framework analysis.
Results: We recruited 12 practices to the study. One control practice withdrew (change in practice approach to data governance). We delivered the IMP2ART strategy largely as planned; the IMP2ART asthma review template was successfully uploaded, the annual asthma audit report was sent, and practice workshops were held in all implementation practices (attendance ranged from 7-31 clinical and administrative staff). There were, however, minor delivery delays for some monthly audit/feedback reports. Practice response analysis indicated ≈450 unique page views on the resource website, and 100% of practices completed the team education module. Interview data were largely positive, with examples of how practices were using IMP2ART.
Conclusion: The IMP2ART trial processes were successful and required only minor changes. Practices engaged with the implementation strategy and its resources, suggesting the IMP2ART strategy is acceptable and feasible.