Background
Study | Country | Sample size | Chronic condition(s)* | Factor analysis | Gender (% male) | Age (mean + SD or %) | PACIC mean score (SD) |
---|---|---|---|---|---|---|---|
Maindal et al. [37] | Denmark | 481 | DM | Confirmatory | 60% | 66,4 (10,7) | 2,83 (-) |
Rosemann et al. [25] | Germany | 236 | OA | Exploratory | 45% | - | 2,44 (1,1) |
Schmittdiel et al. [46] | USA | 4,108 | RESP; DM; HF; CAD; Pain | No | 50% | 61,9 (14,7) | 2,7 (1,1) |
Vrijhoef et al. [44] | Netherlands | 89 | COPD; HF; Arthritis; Geriatric disorders | No | 49% | 56% " > 65 years" | 2,6 (-) |
Taggart et al. [42] | Australia | 2,438 | DM; IHD | Exploratory | 47% | 63,2 (-) | 3,01 (1,07) |
Taggart et al. [42] | Australia | 914 | DM; IHD | Exploratory | 43% | 57,4% " ≥ 60 years" | 3,07 (1,06) |
Aragones et al. [27] | USA (Spanish language) | 100 | DM | Confirmatory | 21% | - | 3,17 (0,82) |
Wensing et al. [41] | Netherlands | 165 | DM; COPD | Exploratory | 53% | 68 (10,3) | 2,9 (1) |
Rick et al. [39] | UK | 2,439 | Various | Confirmatory | 51% | 51,7% " ≥ 65 years" | 2,4 (0,87) |
Ludt et al. [47] | Europe | 1,745 | CVD | No | 68% | 67,8 (9,9) | 2,84 (-) |
Szecsenyi et al. [45] | Germany | 1,399 | DM | No | 46% | 70,3 (8,5) | 2,86 to 3,21 Glasgow |
Glasgow et al. [24] | USA | 266 | Various | Confirmatory | 44% | 64,2 (10,5) | 2,6 (1) |
Mackey et al. [26] | USA | 1,823 | DM | No | 35% | 51,5 (16,7) | 3,05 (1,19) |
Glasgow et al. [17] | USA | 363 | DM | No | 53% | 64,1 (11,9) | 3,2 (0,9) |
Cramm & Nieboer [38] | Netherlands | 1,321 | CVD | Confirmatory | 53% | 63,8 (10,2) | 2,68 (0,86) |
Cramm & Nieboer [38] | Netherlands | 917 | COPD | No | 52% | 63,99 (10,19) | 2,89 (0,89) |
Cramm & Nieboer [48] | Netherlands | 1,570 | CVD | No | 53% | 66,11 (10,57) | 2,77 (0,86) |
Cramm & Nieboer [50] | Netherlands | 892 | COPD | No | 54% | 66.1 (10.6) | 2.89 (0.9) |
Cramm & Nieboer [49] | Netherlands | 283 | Older people (>65 years) | Confirmatory | 46% | 75.8 (6.8) | - |
Cramm & Nieboer [51] | Netherlands | 548 | COPD | No | 54% | 69.1 (10.2) | 2.85 (0.92) |
USA | 529 | DM | Confirmatory/ Exploratory | 52.70% | 63,4 (-) | - | |
Spicer et al. [18] | New Zealand | 307 | DM; CDV; RESP; Pain | - | 56% | 68,4 (-) | - |
McIntosh [40] | Canada | 936 | - | Confirmatory | - | _ | - |
Methods
Sample of patients with multiple chronic conditions
Definition of the sample size
Identification of the patients suffering from multiple chronic conditions
Recruitment of the patients and administration of the survey
Initial version of the PACIC questionnaire
Translation and adaptation of the questionnaire
Translation
Adaptation
Validation of the questionnaire
Face validity
Construct validity
Reliability
Implementation of the CCM in the French context
Results
Sample of patients with multiple chronic conditions
Characteristic | % |
---|---|
Number of chronic conditions
| |
2 | 25.3 |
3 | 40.6 |
4+ | 34.1 |
Gender
| |
Male | 71.3 |
Female | 28.7 |
Age
| |
< 60 years | 29.5 |
[60–65] years | 32.2 |
[66–70] years | 18.1 |
> 70 years | 20.2 |
Self-reported health
| |
Excellent | 2 |
Very good | 9.3 |
Good | 36 |
Satisfactory | 44 |
Bad | 8.7 |
Same GP since
| |
< 1 year | 5.4 |
[1-5] years | 16.6 |
> 5 years | 78 |
Last GP consultation
| |
< 15 days | 20.1 |
[15-30] days | 24.1 |
[1-3] months | 37.5 |
> 3 months | 18.3 |
Medical structure of the GP
| |
GP working alone in the structure | 52.7 |
GP working with other GPs in the same structure | 40.7 |
GP working with other GPs and health professionnals in the same structure | 5.3 |
Translation and adaptation of the questionnaire
Translation
Adaptation
Validation of the questionnaire
Face validity
Item | % missing values | % never | % always | Median | Kurtosis | Skweness |
---|---|---|---|---|---|---|
1. The GP asks about my ideas when we made a treatment plan | 2.0% | 39.5% | 14.3% | 3 | -1.49 | 0.22 |
2. The GP helps me to make a treatment plan that I could do in my daily life | 4.0% | 34.7% | 13.6% | 3 | -1.44 | 0.19 |
3. The GP gives me a copy of my treatment plan | 2.0% | 83.7% | 2.7% | 1 | 6.54 | 2.73 |
4. The GP gives me choices about treatment to think about | 2.7% | 52.4% | 8.2% | 1 | -0.29 | 1.00 |
5. The GP thinks about my values and traditions when s/he recommends treatments to me | 4.0% | 73.5% | 5.4% | 1 | 1.94 | 1.81 |
6. The GP helps to plan ahead so I could take care of my illness even in hard times | 2.0% | 27.2% | 11.6% | 3 | -1.27 | 0.14 |
7. The GP told me how my visits with other types of doctors help my treatment | 3.3% | 14.3% | 51.7% | 5 | -0.54 | -1.00 |
8. The GP shows me how what I do to take care of my illness influence my condition | 3.3% | 12.2% | 42.9% | 4 | -0.54 | -0.87 |
9. The GP asks me to talk about my goals in caring for my illness | 3.3% | 50.3% | 6.1% | 1 | -0.05 | 1.07 |
10. The GP asks me questions about my health habits | 2.7% | 19.0% | 18.4% | 3 | -1.06 | -0.32 |
11. The GP helps me to list things that I can do to improve my health | 2.0% | 59.2% | 8.2% | 1 | -0.35 | 1.05 |
12. The GP refers me to a dietician, health educator, or counsellor | 2.7% | 57.8% | 4.1% | 1 | 0.88 | 1.35 |
13. The GP encourages me to go to a specific group to help me with my chronic illnesses | 2.0% | 86.4% | 0.7% | 1 | 9.00 | 3.00 |
14. The GP encourages me to attend programs in the community that could help me | 2.7% | 92.5% | 0.0% | 1 | 14.60 | 3.88 |
15. The GP asks me how my chronic illnesses affect my life | 2.0% | 32.7% | 12.2% | 2 | -0.89 | 0.60 |
16. The GP asks me to talk about any problems with my medicines or their effects | 3.3% | 15.6% | 36.1% | 4 | -1.12 | -0.49 |
17. The GP asks me if I am satisfied with the organisation of my care | 2.0% | 44.9% | 14.3% | 2 | -1.33 | 0.46 |
18. The GP contacts me to know how things are going | 2.0% | 16.3% | 33.3% | 4 | -0.99 | -0.64 |
Construct validity
Item | Kaiser MSA | Group |
---|---|---|
1 | 0.84 |
Very good
|
2 | 0.85 |
Very good
|
3 | 0.84 |
Very good
|
4 | 0.85 |
Very good
|
5 | 0.73 |
Good
|
6 | 0.85 |
Very good
|
7 | 0.85 |
Very good
|
8 | 0.82 |
Very good
|
9 | 0.83 |
Very good
|
10 | 0.84 |
Very good
|
11 | 0.78 |
Good
|
12 | 0.8 |
Very good
|
13 | 0.67 |
Bad
|
14 | 0.65 |
Bad
|
15 | 0.9 |
Excellent
|
16 | 0.91 |
Excellent
|
17 | 0.82 |
Very good
|
18 | 0.78 |
Good
|
Overall
|
0.82
|
Very good
|
Item | Factor 1 | Factor 2 | Dimension | |
---|---|---|---|---|
Factor 1
| 2. The GP helps me to make a treatment plan that I could do in my daily life | 0.707 | 0.416 | Customisation |
5. The GP thinks about my values and traditions when s/he recommends treatments to me | 0.498 | 0.373 | Customisation | |
6. The GP helps to plan ahead so I could take care of my illness even in hard times | 0.730 | 0.301 | Customisation | |
7. The GP told me how my visits with other types of doctors help my treatment | 0.544 | 0.048 | Experience | |
8. The GP shows me how what I do to take care of my illness influence my condition | 0.717 | 0.208 | Cooperation | |
10. The GP asks me questions about my health habits | 0.649 | 0.505 | Customisation | |
15. The GP asks me how my chronic illnesses affect my life | 0.710 | 0.502 | Experience | |
16. The GP asks me to talk about any problems with my medicines or their effects | 0.589 | 0.281 | Experience | |
17. The GP asks me if I am satisfied with the organisation of my care | 0.497 | 0.408 | Experience | |
18. The GP contacts me to know how things are going | 0.520 | -0.012 | Experience | |
Factor 2
| 1. The GP asks about my ideas when we made a treatment plan | 0.468 | 0.573 | Customisation |
3. The GP gives me a copy of my treatment plan | 0.638 | 0.673 | Cooperation | |
4. The GP gives me choices about treatment to think about | 0.596 | 0.684 | Cooperation | |
9. The GP asks me to talk about my goals in caring for my illness | 0.551 | 0.654 | Customisation | |
11. The GP helps me to list things that I can do to improve my health | 0.605 | 0.633 | Cooperation | |
12. The GP refers me to a dietician, health educator, or counsellor | 0.384 | 0.719 | Cooperation | |
13. The GP encourages me to go to a specific group to help me with my chronic illnesses | 0.252 | 0.888 | Cooperation | |
14. The GP encourages me to attend programs in the community that could help me | 0.318 | 0.767 | Cooperation |
Reliability
Implementation of the CCM in the French context
Characteristic | Degrees of freedom | Type III sum of squares | Mean square | P-value |
---|---|---|---|---|
Number of chronic conditions (in class) | 2 | 1.00 | 0.50 | 0.367 |
Number of GP consultations per year (in class) | 2 | 0.42 | 0.21 | 0.657 |
Gender | 1 | 0.09 | 0.09 | 0.676 |
Self-reported health | 1 | 2.43 | 2.43 | 0.028 |
Age (in class) | 3 | 1.70 | 1.70 | 0.019 |