Patient Assessment of Chronic Illness Care (PACIC)⁽¹⁾

The PACIC has been developed as a tool to gather data on the receipt of quality chronic condition care from the patient’s perspective. It collates patient data on the extent to which specific actions and care have been received in the previous six months. The scale has been created to assess the level of patient-centred care provided, the key elements of which are central to self-management support (collaborative goal setting, problem solving and follow-up). Studies support the PACIC as a practical instrument that is reliable and has face, construct and concurrent validity.^(2,3)

The PACIC is a 20 item survey which is divided into five sub-scales:

• Patient Activation (items 1–3)
• Delivery System Design/Decision Support (items 4–6)
• Goal Setting (items 7–11)
• Problem-solving/Contextual Counselling (items 12–15)
• Follow-up/Coordination (items 16–20)

A copy of the PACIC survey is attached. PACIC.pdf

Each of the five sub-scales is scored by averaging the items completed within that scale. The overall PACIC score is determined by averaging scores across all 20 items. Research results highlight that goal setting and follow-up support activities were conducted significantly less often than other actions.^(2,3)

The MacColl Institute for Healthcare Innovation requests that users share results and provide feedback about the instrument to facilitate continual update of its work and improvements to the instrument. Further information on the PACIC is available at http://www.improvingchroniccare.org/index.php?p=PACIC_Survey&s=36.

 The PACIC and the 5 As model (optional)

The 5 As model of behaviour change has been recommended throughout this resource as a method to enhance self-management support. There are limited assessment tools to determine the quality of its delivery.

Glasgow et al have included additional items to the PACIC to measure the delivery of each of the 5 As as well as an overall 5 As score.⁽³⁾ Conclusions for this study support the PACIC and the new 5 As scoring method as useful for diabetic patients and encourages further research.

For practices that use the 5 As model to implement self-management support, the additional questions added to the PACIC survey may prove an ideal quality improvement tool. The use of this tool is optional and the additional questions are on the attached pdfs. Click to view PACIC and 5 As.pdf

References

1. Available from http://www.improvingchroniccare.org/index.php?p=PACIC_Survey&s=36
2. Glasgow RE, Wagner EH, Schaefer J, Mahoney LD, Reid RJ, Greene SM. Development and validation of the Patient Assessment of Chronic Illness Care (PACIC). Med Care 2005;43(5):436–44
3. Glasgow RE, Whitesides H, Nelson CC, King DK. Use of the Patient Assessment of Chronic Illness Care (PACIC) with diabetic patients: relationship to patient characteristics, receipt of care, and self-management. Diabetes Care 2005;28(11):2655–61.