Diabetes care: comparison of patients’ and healthcare professionals’ assessment using the PACIC instrument

Abstract (i) Rationale and objective: The Patient Assessment of Chronic Illness Care (PACIC) is a validated instrument to measure the extent to which care received by patients is congruent with the Chronic Care Model. We aimed at comparing diabetes care, as reported by patients with diabetes and by healthcare professionals (HCPs), using this instrument. (ii) Methods: Two independent samples, patients with diabetes (n=395) and HCPs (including primary care physicians, primary care nurses, diabetologists and diabetes specialized nurses; n=287), responded to the 20-item PACIC and the six 5As model questions. The PACIC-5A (questions scored on a five-point scale, 1=never to 5=always) was adapted for HCPs (modified-PACIC-5A). In both samples, means and standard deviations for each question as well as proportions of responses to each response modality were computed, and an overall score was calculated over the 20- item PACIC. (iii) Results: Patients’ and HCPs’ overall scores were 2.6 (SD 0.9) and 3.6 (SD 0.5) respectively, with HCP reporting higher scores for all questions except one. Patients’ education and self-management, referral/follow-up and participation in community programs were rated as insufficient by patients and HCPs. (iv) Conclusion: HCPs, particularly diabetes specialists, tended to report better PACIC scores than patients, suggesting that care was not reported similarly when received or provided. To decrease evaluation differences, a closer collaboration between patients and HCPs, as well as the implementation of community-based interventions considering patients’ perspectives and including, among others, patients’ education and self-management, may be necessary