Informing the development of asthma review templates: A mixed-studies systematic review of long-term condition review templates in clinical consultations

Aim: Review templates are widely used in primary care consultations to promote guideline-driven management for patients with long-term conditions (LTCs) e.g. asthma. We wanted to inform the development of a comprehensive asthma review template that facilitates a patient-centred approach. Our mixed-studies systematic review aimed to identify quantitative and qualitative studies investigating the effectiveness of templates in improving asthma and LTC care, and to explore healthcare professional (HCP) and patient views of template use during consultations.Method: Following Cochrane methodology, we searched nine electronic databases for relevant quantitative and qualitative literature. We assessed quality using Cochrane risk-of-bias and ROBINS-I tools (quantitative), and the Critical Appraisal Skills Programme checklist (qualitative). Independent quantitative/qualitative syntheses were combined in a narrative synthesis.Results: We included 13 quantitative studies from 10,795 records; and 11 qualitative studies from 5,982 records. Findings showed that templates can improve documentation (e.g. symptom history), and promote guideline adherence (e.g. to tests; treatment), but clinical outcomes were only measured in one trial (no effect on glycaemic control). HCPs appreciated that templates provided structure to consultations, and acted as reminders. However, they were also viewed as ‘tick box’, which prioritised the clinical agenda over the patients. There was concern that templates acted as a barrier to providing patient-centred care, limiting the opportunity to support self-management.Conclusion: Review templates improve documentation of care and guideline adherence, however may impact on patient-centred care and risk overriding the patient agenda. This highlights a need to develop review templates which address these issues to support asthma care. Implementation Science/Service Development Research Ideas on Respiratory Conditions and Tobacco Dependency Abstract Declaration of Interest This abstract presents independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research Programme (Ref: RP-PG-1016-20008). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. References and Clinical Trial Registry Information