TY - JOUR
T1 - A pragmatic randomized controlled trial of the Flinders Program of chronic condition management in community health care services
AU - Battersby, Malcolm
AU - Harris, Melanie
AU - Smith, David
AU - Reed, Richard
AU - Woodman, Richard
PY - 2015/11
Y1 - 2015/11
N2 - Objectives: To evaluate the Flinders Program in improving self-management in common chronic conditions. To examine properties of the Partners in Health scale (PIH). Methods: Participants were randomized to usual care or Flinders Program plus usual care. Self-management competency, quality of life, and other outcomes were measured at baseline, 6 months, and 12 months. Results: Of 231 participants, 172 provided data at 6 months and 61 at 12 months. At 6 months, intention-to-treat outcomes favoured the intervention group for SF-12 physical health (p= 0.043). Other pre-determined outcomes did not show significance. At 6 months intervention participants' problem severity scores reduced (p< 0.001) and goal achievement scores increased (p< 0.001). Only 55% of the intervention group received a Flinders Program, compromising study power. The PIH was associated with other measures at baseline and for change over time. Conclusion: In a pragmatic community trial, the Flinders Program improved quality of life at 6 months. Incomplete in-practice intervention delivery limited trial power. Studies are now needed on improving delivery. The PIH has potential as a generic risk screening tool and predictive measure of change in self-management and chronic condition outcomes over time. Practice implications: Better implementation including service integration is required for improved chronic disease management.
AB - Objectives: To evaluate the Flinders Program in improving self-management in common chronic conditions. To examine properties of the Partners in Health scale (PIH). Methods: Participants were randomized to usual care or Flinders Program plus usual care. Self-management competency, quality of life, and other outcomes were measured at baseline, 6 months, and 12 months. Results: Of 231 participants, 172 provided data at 6 months and 61 at 12 months. At 6 months, intention-to-treat outcomes favoured the intervention group for SF-12 physical health (p= 0.043). Other pre-determined outcomes did not show significance. At 6 months intervention participants' problem severity scores reduced (p< 0.001) and goal achievement scores increased (p< 0.001). Only 55% of the intervention group received a Flinders Program, compromising study power. The PIH was associated with other measures at baseline and for change over time. Conclusion: In a pragmatic community trial, the Flinders Program improved quality of life at 6 months. Incomplete in-practice intervention delivery limited trial power. Studies are now needed on improving delivery. The PIH has potential as a generic risk screening tool and predictive measure of change in self-management and chronic condition outcomes over time. Practice implications: Better implementation including service integration is required for improved chronic disease management.
KW - Chronic disease management
KW - Pragmatic randomized trial
KW - Primary care
KW - Self-management support
UR - http://www.scopus.com/inward/record.url?scp=84943821000&partnerID=8YFLogxK
U2 - 10.1016/j.pec.2015.06.003
DO - 10.1016/j.pec.2015.06.003
M3 - Article
SN - 0738-3991
VL - 98
SP - 1367
EP - 1375
JO - Patient Education and Counseling
JF - Patient Education and Counseling
IS - 11
ER -