OBJECTIVES: The Chronic Care Model (CCM) is an accepted framework for delivering care to patients with chronic illnesses. The Patient Assessment of Chronic Illness Care (PACIC) is a questionnaire designed to assess the CCM from the patient´s perspective. Our aim was to document if patient´s assessment of chronic illness care changed at two time points. PACIC has been validated in Spanish

METHODS: This prospective study included patients with colo-rectal (CCR), breast or prostate cancer. PACIC was administered by mail at 1-year and 2-years after finishing treatment. Questionnaire has 5 subscales, patient activation (PA), delivery system design (DSD), goal setting (GS), problem solving (PS) and follow-up coordination (FU). In addition there is a global score (G). Each subscale and the global are scored from 1 to 5 with higher scores indicating patient´s perception of greater involvement in self- management and receipt of chronic care counseling. Data are expressed as mean change (standard deviation of change). Comparison amongst two times was performed through non-parametric Wilcoxon test.

RESULTS: There were 477 patients included, 106 prostate, 251 breast and 120 with CCR. 1-year scores were: PA: 3.3 (1.3), DSD: 3.6 (1.2), GS: 2.8 (1.3), PS: 3.0 (1.5), FU: 2.3 (1.3) and G: 2.9 (1.1). The mean change (SD) by dimensions were: PA: 0.1 (1.3), DSD: 0.11 (1.2), GS: 0.1 (1.1), PS: 0.09 (1.3), FU: 0.01 (1.1) and global: 0.07 (0.9). There were no statistically significant differences amongst both follow-up periods in any dimension, but DSD. However the effect size of this change was as small as 0.09 (mean change divided by SD of change).

CONCLUSIONS: Based on these data the patient´s assessment of chronic illness care in these short-term cancer survivors does not change along the first two years of follow-up.