Co-developing a qualitative study with expert patients to explore experiences of supported asthma self-management in the IMP²ART trial (ID 519)
University College London
Abstract
Introduction: The IMPlementing IMProved Asthma self-management as RouTine (IMP²ART) trial is testing the effectiveness of
a theoretically-informed strategy to improve implementation of supported self-management in general practice. To
understand the overall impact of IMP²ART it is important to capture patient experiences of supported self-management, so
we worked with our Patient and Public Involvement (PPI) colleagues to explore how a study should be conducted.
Aim: To co-develop research themes with PPI colleagues to inform the design of a qualitative patient interview study to be
conducted within the IMP²ART trial.
Methods: Colleagues were purposively recruited from the Asthma UK Centre for Applied Research PPI Group and contributed on-line semi-structured discussions. Discussions were recorded so that suggested themes could be identified
and potential questions prepared for topic guides in the proposed qualitative study.
Results: Eight PPI colleagues contributed. They expressed interest and support for the proposed qualitative study.
Healthcare usage did not consistently reflect perceptions of asthma control. Self-management encompassed lifestyle
changes broader than medication adherence, and patients make trade-offs to avoid unscheduled care to manage asthma in
the context of their lives. Professional support for self-management is not viewed as essential for all patients and guidance
is not routinely welcomed, though action plans are generally considered useful. The relationship with healthcare
professionals is ideally a partnership to which patients bring expertise of their own asthma and professionals contribute
resources and specialist knowledge.
Discussion: Discussions with PPI colleagues suggested four themes on supported self-management that could be explored
in future qualitative interviews: (1) diverse perceptions of well-controlled asthma; (2) mixed ideas of expertise and
responsibility; (3) tick-box reviews could be a barrier to self-management; and (4) action plans are universally useful.
Collaborating with PPI colleagues on study plans and research themes enhanced relevance of research and informed an
initial analysis framework.
Funding: Funder: NIHR PGfAR [RP-PG-1016-20008]. The views expressed are those of the authors and not necessarily those of the NIHR or the DHSC.
Conflicts of interest: None
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