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

TY - JOUR

T1 - IMPlementing IMProved Asthma self-management as RouTine (IMP2ART) in UK primary care

T2 - An internal pilot for a cluster randomised controlled trial

AU - McClatchey, Kirstie

AU - Bertram, Daisy

AU - Barat, Atena

AU - Delaney, Brigitte

AU - Hammersley, Vicky

AU - Korell, Barbara

AU - Marsh, Viv

AU - Preston, Megan

AU - Sheringham, Jessica

AU - Steed, Liz

AU - Julious, Steven

AU - Price, David

AU - Taylor, Stephanie J. C.

AU - Pinnock, Hilary

N1 - Copyright: © 2026 McClatchey et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

PY - 2026/3/20

Y1 - 2026/3/20

N2 - Introduction Supported self-management that includes a personalised asthma action plan and 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 UK primary care. The IMPlementing IMProved Asthma self-management as RouTine (IMP2ART) implementation strategy (including facilitated provision of patient, professional, and organisational resources) has been developed to address this challenge and is being evaluated in a UK-wide cluster randomised controlled trial (cRCT). The internal pilot aimed to assess the trial recruitment processes, delivery of and general practice engagement with the implementation strategy to inform the progression criteria. Methods Using mixed methods, we recruited 12 general practices and monitored trial processes and IMP2ART delivery through team logs and automated data (e.g., use of patient online resources; uptake of practice education modules). Qualitative interviews with general practice staff and IMP2ART facilitators explored feasibility and acceptability of the implementation strategy. Results We randomised 12 general practices to the IMP2ART implementation strategy arm (n = 6) or usual asthma care (control, n = 6). One control practice withdrew post-randomisation following concerns about data sharing. Most components were delivered successfully to the implementation group practices so that we met our progression criteria. In all six practices, the facilitated workshop was arranged within 12 weeks of randomisation and the team education module was completed (median 11 accesses/practice), the in-depth module was completed by ‘the healthcare professional responsible for asthma reviews’ (range 3-7 professionals/practice), and the asthma review template was successfully downloaded to the practice system. All six implementation practices received the baseline and first monthly audit and feedback report although there were delays in this process due to national-level governance changes. Practices’ perceptions of IMP2ART were encouraging. In general, they participated in the patient, professional and organisational implementation strategies and reported positive experiences of the trial. Conclusions The study provides evidence that the IMP2ART trial is feasible, and the implementation strategy is acceptable with only minor adjustments to trial processes. The IMP2ART strategy is now being tested in a UK-wide cRCT [ref: ISRCTN15448074], evaluating implementation (action plan ownership) and health outcomes (unscheduled care).

AB - Introduction Supported self-management that includes a personalised asthma action plan and 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 UK primary care. The IMPlementing IMProved Asthma self-management as RouTine (IMP2ART) implementation strategy (including facilitated provision of patient, professional, and organisational resources) has been developed to address this challenge and is being evaluated in a UK-wide cluster randomised controlled trial (cRCT). The internal pilot aimed to assess the trial recruitment processes, delivery of and general practice engagement with the implementation strategy to inform the progression criteria. Methods Using mixed methods, we recruited 12 general practices and monitored trial processes and IMP2ART delivery through team logs and automated data (e.g., use of patient online resources; uptake of practice education modules). Qualitative interviews with general practice staff and IMP2ART facilitators explored feasibility and acceptability of the implementation strategy. Results We randomised 12 general practices to the IMP2ART implementation strategy arm (n = 6) or usual asthma care (control, n = 6). One control practice withdrew post-randomisation following concerns about data sharing. Most components were delivered successfully to the implementation group practices so that we met our progression criteria. In all six practices, the facilitated workshop was arranged within 12 weeks of randomisation and the team education module was completed (median 11 accesses/practice), the in-depth module was completed by ‘the healthcare professional responsible for asthma reviews’ (range 3-7 professionals/practice), and the asthma review template was successfully downloaded to the practice system. All six implementation practices received the baseline and first monthly audit and feedback report although there were delays in this process due to national-level governance changes. Practices’ perceptions of IMP2ART were encouraging. In general, they participated in the patient, professional and organisational implementation strategies and reported positive experiences of the trial. Conclusions The study provides evidence that the IMP2ART trial is feasible, and the implementation strategy is acceptable with only minor adjustments to trial processes. The IMP2ART strategy is now being tested in a UK-wide cRCT [ref: ISRCTN15448074], evaluating implementation (action plan ownership) and health outcomes (unscheduled care).

UR - https://www.scopus.com/pages/publications/105033259558

U2 - 10.1371/journal.pone.0336745

DO - 10.1371/journal.pone.0336745

M3 - Article

C2 - 41860818

AN - SCOPUS:105033259558

SN - 1932-6203

VL - 21

JO - PLoS ONE

JF - PLoS ONE

IS - 3

M1 - e0336745

ER -