Evidence Supporting the ACIC

Uptake, usage and adaptation of the Assessment of Chronic Illness Care scale has steadily increased since it was first published in 2000. In 2006, formal evidence reviews were compiled through bibliographic searches by an expert panel and published online In 2012, the ICIC team compiled an informal, selected update to the evidence base by identifying noteworthy peer-reviewed articles dated 2006-present and coming to consensus on those of special note or interest.
2006 Review of evidence supporting the ACIC
Bonomi AE, Wagner EH, Glasgow RE, VonKorff M. Assessment of chronic illness care (ACIC): a practical tool to measure quality improvement. Health Serv Res 2002; 37(3):791-820.[Link]
  • Correlation between ACIC subscales and faculty ratings of quality improvement were moderate to strong among teams enrolled in collaboratives to improve chronic illness care.
Si D, Bailie R, Connors C et al. Assessing health centre systems for guiding improvement in diabetes care. BMC Health Serv Res 2005;5:56. [Link]
  • In the Aboriginal community in Australia, the ACIC was used to explore if more developed systems were associated with better quality of diabetes care. Four of the six subscales were independently associated with quality of diabetes care. Increases in ACIC scores on the organizational influence, community linkages, clinical information systems scales were associated with improved adherence to process measures and improved outcomes including HbA1c, blood pressure, and total cholesterol. 
Solberg LI, Crain AL, Sperl-Hillen JM, Hroscikoski MC, Engebretson KI, O'Connor PJ. Care quality and implementation of the chronic care model: a quantitative study. Ann Fam Med 2006; 4(4):310-6. [Link]
  • Solberg et al show that improvements in ACIC score and clinical process and outcome measures were achieved after system changes to improve the quality of care for diabetes, heart disease and depression. However, only diabetes measures were correlated with improved ACIC scores & only on two subscales: clinical information systems & decision support. 
2012 Evidence update
Reciprocal learning and chronic care model implementation in primary care: results from a new scale of learning in primary care. Leykum LK, Palmer R, Lanham H, Jordan M, McDaniel RR, Nol PH, Parchman M. BMC Health Serv Res. 2011 Feb 23;11:44. [Link]
The Chronic Care Model and Exercise Discussions during Primary Care Diabetes Encounters. Patel NK, Parchman ML. J Am Board Fam Med. 2011 Jan-Feb;24(1):26-32. [Link]
A multi-institutional quality improvement initiative to transform education for chronic illness care in resident continuity practices. Stevens DP, Bowen JL, Johnson JK, Woods DM, Provost LP, Holman HR, Sixta CS, Wagner EH. J Gen Intern Med. 2010 Sep;25 Suppl 4:S574-80. [Link]
Assessing Chronic Illness Care Education (ACIC-E): a tool for tracking educational re-design for improving chronic care education. Bowen JL, Provost L, Stevens DP, Johnson JK, Woods DM, Sixta CS, Wagner EH. J Gen Intern Med. 2010 Sep;25 Suppl 4:S593-609. [Link]
Implementation of a chronic illness model for diabetes care in a family medicine residency program. Yu GC, Beresford R. J Gen Intern Med. 2010 Sep;25 Suppl 4:S615-9. [Link]
Defining and measuring the patient-centered medical home. Stange KC, Nutting PA, Miller WL, Jan CR, Crabtree BF, Flocke SA, Gill JM. J Gen Intern Med. 2010 Jun;25(6):601-12. [Link]
Features of the Chronic Care Model (CCM) associated with behavioral counseling and diabetes care in community primary care. Strickland PA, Hudson SV, Piasecki A, Hahn K, Cohen D, Orzano AJ, Parchman ML, Crabtree BF. J Am Board Fam Med. 2010 May-Jun;23(3):295-305. [Link]
Implementation of a program for type 2 diabetes based on the Chronic Care Model in a hospital-centered health care system: "the Belgian experience". Sunaert P, Bastiaens H, Feyen L, Snauwaert B, Nobels F, Wens J, Vermeire E, Van Royen P, De Maeseneer J, De Sutter A, Willems S. BMC Health Serv Res. 2009 Aug 23;9:152. [Link]
Are elements of the chronic care model associated with cardiovascular risk factor control in type 2 diabetes? Parchman M, Kaissi AA. Jt Comm J Qual Patient Saf. 2009 Mar;35(3):133-8. [Link]
Risk of coronary artery disease in type 2 diabetes and the delivery of care consistent with the chronic care model in primary care settings: a STARNet study. Parchman ML, Zeber JE, Romero RR, Pugh JA. Med Care. 2007 Dec;45(12):1129-34. [Link]
Glucose control, self-care behaviors, and the presence of the chronic care model in primary care clinics. Parchman ML, Pugh JA, Wang CP, Romero RL. Diabetes Care. 2007 Nov;30(11):2849-54. Epub 2007 Aug 6. [Link]
Assessing the implementation of the chronic care model in quality improvement collaboratives. Pearson ML, Wu S, Schaefer J, Bonomi AE, Shortell SM, Mendel PJ, Marsteller JA, Louis TA, Rosen M, Keeler EB. Health Serv Res. 2005 Aug;40(4):978-96. [Link]