The feasibility of assessing the Flinders Programme of Patient Self-Management in New Zealand primary care settings

Abstract

The Flinders Program™ has been adopted in New Zealand as a useful and appropriate approach for self-management with primary care clients who have chronic conditions. The Flinders Program™ has not been evaluated in New Zealand settings. To assess the feasibility of undertaking a substantive long-term trial to gauge the effectiveness of primary care nurses using the Flinders Program™ to improve health outcomes for New Zealand populations. A pilot study was undertaken considering four components of feasibility of conducting a long-term trial: practice recruitment, participant recruitment, delivery of the intervention and outcome measures. This included comparing 27 intervention and 30 control patients with long-term health conditions with respect to change in self-management capacity-Partners in Health (PIH) scale-quality of care using the Patient Assessment of Chronic Illness Care (PACIC) scale and self-efficacy across six months. Intervention participants received care planning with practice nurses using the Flinders Program™ in general practices, while control participants received usual care in comparable practices. General practice and participant recruitment was challenging, together with a lack of organisational capacity and resources in general practice for the Flinders Program™. The measures of self-management capacity (PIH), quality of care (PACIC) and self-efficacy were useful and valuable primary outcome measures. The overall findings do not support a substantive trial of the Flinders Program™ in primary care. Difficulties associated with participant recruitment and ability of practice nurses to undertake the Flinders Program™ within general practice need to be resolved.