The collaborative care planning scale: A new measure of shared decision making in chronic illness care

Project Coordinator

Tim Shortus

Chief Investigators

Tim Shortus

Associate Investigators

Suzanne McKenzie, Mark Harris, Lynn Kemp

Rationale

People with diabetes and cardiovascular comorbidities are at high risk of significant morbidity and mortality. Involving these patients in decisions about their care through the preparation of a care plan may improve the health outcomes by enhancing patient self-management and adherence to treatment. The Collaborative Care Planning Scale (CCPS) is the first measure of shared decision making in chronic illness care. This study will use standard psychometric techniques to ensure that the CCPS is a reliable and valid scale for use in studies of interventions to improve the health outcomes of people with chronic and complex illnesses.

Aims

To measure the reliability and validity of the CCPS when completed by patients with diabetes and cardiovascular co-morbidities.

Design and Method

Fifteen GPs participated by inviting 957 patients with diabetes and
cardiovascular co-morbidities to complete a questionnaire package. One hundred and sixty six patients consented, with 58 providing re-test data at two months.
Patients completed the CCPS, validated scales of related constructs, and questions about demographics, health and health service usage.

Psychometrics tests included exploratory factor analysis, test-retest reliability and internal consistency. Construct validity was assessed by
multi-level regression modelling of relationships between total CCPS scores and related variables.

Results
The final CCPS has 27 items comprising two factors (‘receiving appropriately personalised care’ and ‘feeling actively involved in decision-making’) that explain approximately 60% of the variance. The factors have high internal consistency (alpha 0.96 and 0.94 respectively) and there is adequate test-retest reliability.

Multi-level modelling reveals that all variance in CCPS scores at the GP level is accounted for by the GP’s degree of patient-centred communication. Patients whose GPs communicate well report greater collaborative care planning.

Sixty-seven percent of patient-level variance is accounted for by patient activation and the patient’s insulin status. Patients who are more activated or take insulin report greater collaborative care planning. This model supports construct validity of the CCPS.


Conclusions
The CCPS appears to be a valid and reliable measure of patient perceptions of
collaborative care planning.