Hitting The Bullseye: The Psychometric Properties of the Assessment of Burden of Chronic Conditions (ABCC)-Scale in The Netherlands

Abstract

Background Chronic conditions impose a major impact on quality of life and on healthcare. The Assessment of Burden of Chronic Conditions (ABCC-)tool was developed to improve experienced quality of care and quality of life by facilitating shared decision-making and self-management. It assesses the experienced burden of one or multiple conditions, and visualises and integrates the burden in daily care. However, its scale’s validity and reliability are yet unknown. The aim of this study is to evaluate whether the ABCC-scale is valid and reliable in people with Chronic Obstructive Pulmonary Disease (COPD), asthma, or Type 2 Diabetes Mellitus (T2DM). Methods The Saint George Respiratory Questionnaire (SGRQ), the Standardized Asthma Quality of Life Questionnaire (AQLQ-S), and the Audit of Diabetes Dependent Quality of Life Questionnaire (ADDQoL19) were compared to the ABCC-scale to assess convergent validity. Convergent validity was assumed when at least 75% of the postulated correlations were higher than 0.7, or between 0.3 and 0.7 for single-item subscales. To measure known-group validity, participants were categorized according to exacerbation status, depression, asthma control, insulin dependence, complications and obesity. The ABCC-scale was deemed internally consistency upon a Cronbach’s alpha ≥ 0.90 for the total scale, and ≥ 0.70 for subscales. Test-retest reliability was evaluated at a two-week interval. Results A total of 65, 62, and 60 people with COPD, asthma, T2DM respectively were included. The ABCC-scale correlated, in accordance with hypotheses, with the SGRQ (75%), AQLQ-S (100%), and ADDQoL19 (75%). Differentiation of known-groups based on the ABCC-scale was possible for all specified groups. The total score and subscores of the ABCC-scale were internally consistent with a Cronbach’s alpha of 0.90, 0.92, and 0.91 for the total score for people with COPD, asthma, and T2DM respectively. The ABCC-scale had a good test-retest reliability with an Intraclass Correlation Coefficient of 0.95, 0.93, and 0.95 for people with COPD, asthma and T2DM respectively. Conclusions The ABCC-scale is a valid and reliable questionnaire that can be used within the ABCC-tool for people with COPD, asthma or T2DM. Future research should indicate whether this also applies to people with multimorbidity, and what the effects and experiences are upon clinical use.

Expanding the ABCC-tool for osteoarthritis: Development and content validation

“…The strength of the previous developed ABCC-tool with modules for asthma, COPD, DM2 and chronic heart failure is that it includes care on a physical, emotional and social level, and facilitates shared-decision making. Studying the effectiveness of the ABCC-tool, it showed that patient experienced quality of care and patient activation improves [ 21 , 24 , 48 ]. Therefore, it was deemed desirable to create an OA module for the ABCC-tool because comparable effects might be expected.…”

Understanding the healthcare providers’ perspective for bringing the assessment of burden of chronic conditions tool to practice: a protocol for an implementation study

“…The Assessment of Burden of Chronic Conditions (ABCC) tool includes a PROM of which the outcomes are visualised into a balloon chart for easy comprehension. The tool is developed to guide care conversations towards the personal experienced burden of someone with chronic obstructive pulmonary disease (COPD), asthma, type 2 diabetes mellitus (T2DM) and/or chronic heart failure (CHF) 6 7. The tool consists of a scale that validly and reliably measures a patient’s experienced burden (ie, the PROM), a visualisation of the outcomes of that scale (figure 1) and domain-specific treatment advice based on the outcome of the scale 6–8.…”

“…The tool is developed to guide care conversations towards the personal experienced burden of someone with chronic obstructive pulmonary disease (COPD), asthma, type 2 diabetes mellitus (T2DM) and/or chronic heart failure (CHF) 6 7. The tool consists of a scale that validly and reliably measures a patient’s experienced burden (ie, the PROM), a visualisation of the outcomes of that scale (figure 1) and domain-specific treatment advice based on the outcome of the scale 6–8. As such, the ABCC-tool enables HCP and patient to address the experienced burden and to formulate personalised goals for the domains of choice.…”