Jochen Gensichen Institute of General Practice Friedrich Schiller-University, Medical School, Jena Measurement of provider-support for chronic illness.

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Jochen Gensichen Institute of General Practice Friedrich Schiller-University, Medical School, Jena Measurement of provider-support for chronic illness care Arthritis, Depression and Diabetes Bellagio, April 2008

PRAXARTH Patient Assessment of Chronic Illness Care (PACIC) (German validation – Arthritis, N=236, sample characteristics) Rosemann T, Laux G, Droesemeyer S, Gensichen J, Szecsenyi J. Evaluation of a culturally adapted German version of the Patient Assessment of Chronic Illness Care (PACIC 5A) questionnaire in a sample of osteoarthritis patients. J Eval Clin Pract 2007; 13:

PRAXARTH PACIC (German validation – Arthritis, N=236)

PROMPT PACIC (12 months, cluster randomised intervention trial on simple case management for Major depression, N=555, sample) Gensichen J et al. Case Management improves clinical outcome for patients with major depression in primary care mini-practices: The PRoMPT project. Abstract. Conference of the North American Primary Care Research Group, Okt 2007, Vancouver, Canada

PROMPT PACIC (12 months simple case management, Major depression, N=555, sample characteristics) **„linear mixed model“, Adjustiered for Cluster-Effects; N=520

ELSID PACIC (Evaluation of a large scale implementation of disease management programmes DMP, Diabetes, N=1399 sample characteristics) Szecsenyi J, Rosemann T, Joos S, Peters-Klimm F, Miksch A. German diabetes disease management programs are appropriate to restructure care according to the Chronic Care Model. An evaluation withthe Patient Assessment of Chronic Illness Care (PACIC-5A) instrument. Diabetes Care Publish Ahead of Print, published online February 25, 2008 A random, heterogeneous sample of 3,546 patients received a mailed questionnaire from their regional health fund. DMP enrolled verus not enrolled

decision support MeanSDCeilin g, % Floor, % Item-scale- correlation Reliability (Cronbach’s alpha) Test-retest correlation (ICC) Overall PACIC2.44(1.1) Patient activation2.79(1.1) Delivery system/ 2.56(1.2) Goal setting/tailoring 2.31(1.1) Problem solving/contextual 2.48( Follow up/coordination 2.01(1.3) ELSID PACIC (Evaluation of a large scale implementation of disease management programmes, Diabetes, N=1399)

PACIC - Experiences from PRAXARTH, PROMPT and ELSID Provider support for chronic illness care:  German primary care validation (Arthritis): age, female -> pos. correlation; education -> neg. correlation in PACIC  PACIC as a outcome in a randomized intervention trial (Depression): significant higher ratings in intervention, major effects in „problem solving“ scale  PACIC as a outcome in a large scale disease management evaluation (Diabetes): significant higher ratings in intervention, all subscales -> The PACIC is a reliable and valid instrument to assess the congruency of care to the CCM of patients with chronic diseases.