Abstract

Background and 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 general practice. The strategy includes 1) patient resources to educate and support self-management 2) professional asthma self-management education training for practice staff, and 3) organisational strategies (audit/feedback, review template), with support from a trained facilitator. The trial will measure overall clinical and implementation effectiveness, through unscheduled care and asthma action plan ownership, but we expect implementation experiences will vary between practices. We are seeking to learn through a process evaluation how contrasting practice contexts and use of implementation strategies influence the effectiveness of the implementation strategy.IMP2ART.
Method: In-depth qualitative case studies will be undertaken in up to four practices taking part in the implementation arm of the trial, who will be invited post randomisation. We will seek diversity in the case study characteristics in terms of practice size, geography, and models of asthma care delivery to capture variation in . implementation experiences.
A range of dData collection methods will be used to acquire a comprehensive understanding of the practice experience and will include: repeat interviews with key staff, in-person observations, recordings of asthma clinics reviews, and analysis of key practice documents. Data collection will be longitudinal, with the same a single embedded researcher, to capture how the practice changes over the two years in which they participate in the trial. We will start collecting data from the “IMP2ART workshop”, (the first time the IMP2ART facilitator meets the practice at the “IMP2ART workshop”).
Discussion: Since the COVID-19 pandemic, UK general practice in the UK has been subject to major changes and is likely to evolve still further over the course of the next few years. These case studies seek to capture the processes by which practices implement supported asthma self-management for asthma, their response to IMP2ART’s implementation strategy, and the changing context in which they work.