Implementation of remote asthma consulting in general practice in response to the COVID19 pandemic: evaluation using extended normalisation process theory

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Abstract

BACKGROUND: The COVID-19 pandemic has led to the rapid and reactive deployment of remote consulting in UK General Practice. The delivery of acute and chronic asthma care has been affected. Extended Normalisation Process Theory (eNPT) provides a framework for evaluating the implementation of new complex interventions in routine practice, including examination of how context-intervention interactions affect Implementation.

AIM: To explore the implementation of remote asthma consulting in UK General Practice in response to the COVID-19 pandemic.

DESIGN & SETTING: Mixed methods evaluation, informed by eNPT.

SETTING: General Practice in Northern Ireland.

METHOD: Data was collected from a range of healthcare professionals who provide asthma care using online questionnaires, interviews and multidisciplinary focus groups. Analysis was informed by eNPT.

RESULTS: We identified ten themes to describe and explain the contribution of General Practice staff to implementation of remote asthma consulting. Staff identified novel alternatives to in-person review. Having a practice champion to drive implementation forward, and engage other Practice staff, was important. Patient, staff and healthcare system contextual factors influencing implementation were identified including access to, understanding of and willingness to use the technology required for remote consulting.

CONCLUSION: The experiences of frontline healthcare professionals in this study indicate that remote asthma consulting has potential benefits in terms of access and effectiveness when implementation integrates seamlessly with face-to-face care for those who want or need it. Work is required at Practice and healthcare system levels to realise this potential, and ensure implementation does not exacerbate existing healthcare inequalities.

Original languageEnglish
JournalBJGP Open
Early online date03 Dec 2021
DOIs
Publication statusEarly online date - 03 Dec 2021

Bibliographical note

Copyright © 2021, The Authors.

Keywords

  • Asthma
  • Qualitative research
  • Remote consulting

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