IMPlementing IMProved Asthma self-management as RouTine (IMP2ART) in primary care: internal pilot for a cluster randomised controlled trial

McClatchey, Kirstie; Sheringham, Jessica; Barat, Atena; Delaney, Brigitte; Searle, B; Marsh, Viv; Hammersley, Vicky; Taylor, Stephanie; Pinnock, Hilary

doi:10.1183/13993003.congress-2022.394

Cited by 3 publications

(8 citation statements)

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“…As advised by Yin for explanatory case studies [ 22 ], our analytic strategy for both case study data and the additional interviews will be in part guided by the theoretical propositions we have already set out, and in part inductive, guided by the data [ 12 ]. These propositions have informed the data analysis tools we have developed to organise and redescribe the data for each case.…”

Section: Methodsmentioning

confidence: 99%

“…We will use integrated analysis to produce a narrative synthesis across all the data sources that critically assess the evidence for the initial programme theory [ 12 ]. If possible, we will look to understand the mechanisms and moderators that enable the use of the IMP 2 ART implementation strategies to increase supported self-management of asthma in general practice.…”

Section: Methodsmentioning

confidence: 99%

“…

Fig. 1 IMP2ART’s logic mode [ 12 ]. Facilitation through trained specialist asthma nurses acts as a catalyst for the use of MP2ART strategies in practices, which in turn aims to optimise professionals’ capacity, motivation and opportunity to deliver supported self-management to patients with asthma.…”

Section: Introductionmentioning

confidence: 99%

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Understanding the processes underpinning IMPlementing IMProved Asthma self-management as RouTine (IMP2ART) in primary care: study protocol for a process evaluation within a cluster randomised controlled implementation trial

Sheringham,

Steed,

McClatchey

et al. 2024

Trials

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Background Providing supported self-management for people with asthma can reduce the burden on patients, health services and wider society. Implementation, however, remains poor in routine clinical practice. IMPlementing IMProved Asthma self-management as RouTine (IMP2ART) is a UK-wide cluster randomised implementation trial that aims to test the impact of a whole-systems implementation strategy, embedding supported asthma self-management in primary care compared with usual care. To maximise opportunities for sustainable implementation beyond the trial, it is necessary to understand how and why the IMP2ART trial achieved its clinical and implementation outcomes. Methods A mixed-methods process evaluation nested within the IMP2ART trial will be undertaken to understand how supported self-management was implemented (or not) by primary care practices, to aid interpretation of trial findings and to inform scaling up and sustainability. Data and analysis strategies have been informed by mid-range and programme-level theory. Quantitative data will be collected across all practices to describe practice context, IMP2ART delivery (including fidelity and adaption) and practice response. Case studies undertaken in three to six sites, supplemented by additional interviews with practice staff and stakeholders, will be undertaken to gain an in-depth understanding of the interaction of practice context, delivery, and response. Synthesis, informed by theory, will combine analyses of both qualitative and quantitative data. Finally, implications for the scale up of asthma self-management implementation strategies to other practices in the UK will be explored through workshops with stakeholders. Discussion This mixed-methods, theoretically informed, process evaluation seeks to provide insights into the delivery and response to a whole-systems approach to the implementation of supported self-management in asthma care in primary care. It is underway at a time of significant change in primary care in the UK. The methods have, therefore, been developed to be adaptable to this changing context and to capture the impact of these changes on the delivery and response to research and implementation processes.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Understanding the processes underpinning IMPlementing IMProved Asthma self-management as RouTine (IMP2ART) in primary care: study protocol for a process evaluation within a cluster randomised controlled implementation trial

Sheringham,

Steed,

McClatchey

et al. 2024

Trials

View full text Add to dashboard Cite

show abstract

“…Implementing Improved Asthma Self-Management as Routine in primary care (IMP²ART) is a three-level implementation strategy including providing patient resources, developing professional skills, influencing organisational priorities and routines [36]. The pilot phase reported by McClatchey et al (Edinburgh), having randomised 12 GP practices (implementation arm or usual control arm) showed that IMP²ART was acceptable and feasible [37].…”

Section: Supported Self-management In Asthmamentioning

confidence: 99%

“…The pilot phase reported by M c C latchey et al . [ 37 ] (Edinburgh, UK), having randomised 12 GP practices (implementation arm or usual control arm), showed that IMP 2 ART was acceptable and feasible.…”

Section: Group 103: General Practice and Primary Carementioning

confidence: 99%

ERS International Congress 2022: highlights from the Respiratory Clinical Care and Physiology Assembly

et al. 2023

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It is a challenge to keep abreast of all the clinical and scientific advances in the field of respiratory medicine. This article contains an overview of laboratory-based science, clinical trials and qualitative research that were presented during the 2022 European Respiratory Society International Congress within the sessions from the five groups of the Assembly 1 – Respiratory clinical care and physiology. Selected presentations are summarised from a wide range of topics: clinical problems, rehabilitation and chronic care, general practice and primary care, electronic/mobile health (e-health/m-health), clinical respiratory physiology, exercise and functional imaging.

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IMPlementing IMProved Asthma self-management as RouTine (IMP2ART) in primary care: study protocol for a cluster randomised controlled implementation trial

McClatchey

Hammersley

Steed

et al. 2023

Trials

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Background Asthma is a common long-term condition and major public health problem. Supported self-management for asthma that includes a written personalised asthma action plan, supported by regular professional review, reduces unscheduled consultations and improves asthma outcomes and quality of life. However, despite unequivocal inter/national guideline recommendations, supported self-management is poorly implemented in practice. The IMPlementing IMProved Asthma self-management as RouTine (IMP2ART) implementation strategy has been developed to address this challenge. The aim of this implementation trial is to determine whether facilitated delivery of the IMP2ART strategy increases the provision of asthma action plans and reduces unscheduled care in the context of routine UK primary care. Methods IMP2ART is a parallel group, cluster randomised controlled hybrid II implementation trial. One hundred forty-four general practices will be randomly assigned to either the IMP2ART implementation strategy or control group. Following a facilitation workshop, implementation group practices will receive organisational resources to help them prioritise supported self-management (including audit and feedback; an IMP2ART asthma review template), training for professionals and resources to support patients to self-manage their asthma. The control group will continue with usual asthma care. The primary clinical outcome is the between-group difference in unscheduled care in the second year after randomisation (i.e. between 12 and 24 months post-randomisation) assessed from routine data. Additionally, a primary implementation outcome of asthma action plan ownership at 12 months will be assessed by questionnaire to a random sub-group of people with asthma. Secondary outcomes include the number of asthma reviews conducted, prescribing outcomes (reliever medication and oral steroids), asthma symptom control, patients’ confidence in self-management and professional support and resource use. A health economic analysis will assess cost-effectiveness, and a mixed methods process evaluation will explore implementation, fidelity and adaptation. Discussion The evidence for supported asthma self-management is overwhelming. This study will add to the literature regarding strategies that can effectively implement supported self-management in primary care to reduce unscheduled consultations and improve asthma outcomes and quality of life. Trial registration ISRCTN15448074. Registered on 2 December 2019.

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IMPlementing IMProved Asthma self-management as RouTine (IMP2ART) in primary care: internal pilot for a cluster randomised controlled trial

Cited by 3 publications

References 0 publications

Understanding the processes underpinning IMPlementing IMProved Asthma self-management as RouTine (IMP2ART) in primary care: study protocol for a process evaluation within a cluster randomised controlled implementation trial

Understanding the processes underpinning IMPlementing IMProved Asthma self-management as RouTine (IMP2ART) in primary care: study protocol for a process evaluation within a cluster randomised controlled implementation trial

ERS International Congress 2022: highlights from the Respiratory Clinical Care and Physiology Assembly

IMPlementing IMProved Asthma self-management as RouTine (IMP2ART) in primary care: study protocol for a cluster randomised controlled implementation trial

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