Treatment patterns and factors associated with adherence in pulmonary arterial hypertension.

OBJECTIVE: Improving understanding of actual pulmonary hypertension (PH) treatment adherence patterns is crucial to properly treating these patients. We aimed to primarily assess adherence to treatments used for pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) specific therapies, identify potential factors related to it and secondly describe its treatment patterns. METHODS: A 6-month observational cross-sectional study in a tertiary care hospital was conducted. Patients with PH-targeted therapy who picked it up in the ambulatory hospital pharmacy and who had been on treatment with the same drug for at least 1 year were included. Adherence was assessed as: 1) Proportion of days covered (PDC); and 2) Simplified Medication Adherence Questionnaire (SMAQ). PDC ≥80% was considered adherent. Statistical analyses were performed to evaluate the study outcomes. Logistic regressions were estimated to identify the association between baseline characteristics and factors associated with adherence. P < 0.05 indicated statistical significance. RESULTS: A total of 63 patients with 127 different treatments were included, 71.4% were females with a mean age (SD) of 59 (15) years. PAH was the most common diagnosis (74.6%). Double therapy was used in 39.7% of patients, being the combination of Macitentan + Tadalafil and Ambrisentan + Tadalafil the most prescribed. Endothelin receptor antagonists were the most used treatment (40.2%). Adherence according to PDC was 93.7%, showing no great differences depending on the targeted drug used, and according to SMAQ 61.9%. The agreement degree of both methods was slight (65.1%; Kappa 0.12). Only female sex (OR: 0.23, 95% CI: 0.06-0.90; p = 0.035) was associated with worse adherence in the SMAQ method but not in the PDC. Adverse events were reported by a 55.6% of participants and the perception of effective treatment was high (95.2%). CONCLUSIONS: Adherence to PH therapy differs depending on the assessment method; PDC showed greater adherence rate than SMAQ. According to SMAQ, female sex may have a negative impact on adherence in this cohort, but PDC revealed no factors influencing it. No notable differences in adherence between treatment types were found and generally patients felt the treatments were effective in controlling their disease.

Non-saccharomyces yeast probiotics: revealing relevance and potential.

Non-Saccharomyces yeasts are unicellular eukaryotes that play important roles in diverse ecological niches. In recent decades, their physiological and morphological properties have been reevaluated and reassessed, demonstrating the enormous potential they possess in various fields of application. Non-Saccharomyces yeasts have gained relevance as probiotics, and in vitro and in vivo assays are very promising and offer a research niche with novel applications within the functional food and nutraceutical industry. Several beneficial effects have been described, such as antimicrobial and antioxidant activities and gastrointestinal modulation and regulation functions. In addition, several positive effects of bioactive compounds or production of specific enzymes have been reported on physical, mental and neurodegenerative diseases as well as on the organoleptic properties of the final product. Other points to highlight are the multiomics as a tool to enhance characteristics of interest within the industry; as well as microencapsulation offer a wide field of study that opens the niche of food matrices as carriers of probiotics; in turn, non-Saccharomyces yeasts offer an interesting alternative as microencapsulating cells of various compounds of interest.

Selection of a novel cell-internalizing RNA aptamer specific for CD22 antigen in B cell acute lymphoblastic leukemia.

Despite improvements in B cell acute lymphoblastic leukemia (B-ALL) treatment, a significant number of patients experience relapse of the disease, resulting in poor prognosis and high mortality. One of the drawbacks of current B-ALL treatments is the high toxicity associated with the non-specificity of chemotherapeutic drugs. Targeted therapy is an appealing strategy to treat B-ALL to mitigate these toxic off-target effects. One such target is the B cell surface protein CD22. The restricted expression of CD22 on the B-cell lineage and its ligand-induced internalizing properties make it an attractive target in cases of B cell malignancies. To target B-ALL and the CD22 protein, we performed cell internalization SELEX (Systematic Evolution of Ligands by EXponential enrichment) followed by molecular docking to identify internalizing aptamers specific for B-ALL cells that bind the CD22 cell-surface receptor. We identified two RNA aptamers, B-ALL1 and B-ALL2, that target human malignant B cells, with B-ALL1 the first documented RNA aptamer interacting with the CD22 antigen. These B-ALL-specific aptamers represent an important first step toward developing novel targeted therapies for B cell malignancy treatments.

Differences between Novice and Expert Raters Assessing Trunk Control Using the Trunk Control Measurement Scale Spanish Version (TCMS-S) in Children with Cerebral Palsy.

The Trunk Control Measurement Scale (TCMS) is a valid and reliable tool to assess static and dynamic trunk control in cerebral palsy. However, there is no evidence informing about differences between novice and expert raters. A cross-sectional study was conducted with participants between the ages of 6 and 18 years with a CP diagnosis. The TCMS Spanish version (TCMS-S) was administered in-person by an expert rater, and video recordings were taken for later scoring by the expert and three other raters with varying levels of clinical experience. The intraclass correlation coefficient (ICC) was used to evaluate reliability between raters for the total and subscales of the TCMS-S scores. Standard Error of Measurement (SEM) and Minimal Detectable Change (MDC) were also calculated. There was a high level of agreement between expert raters (ICC ≥ 0.93), while novice raters demonstrated good agreement (ICC > 0.72). Additionally, it was observed that novice raters had a slightly higher SEM and MDC than expert raters. The Selective Movement Control subscale exhibited slightly higher SEM and MDC values compared to the TCMS-S total and other subscales, irrespective of the rater's level of expertise. Overall, the study showed that the TCMS-S is a reliable tool for evaluating trunk control in the Spanish pediatric population with cerebral palsy, regardless of the rater's experience level.

[Epidemiology of leptospirosis in the wetlands of Southern Spain]. / Epidemiología de la leptospirosis en los humedales del sur de España.

OBJECTIVE: To find out whether the leptospirosis incidence rate among red swamp crayfish collectors in the harvesting season is higher than in the general population, and to identify risk factors and assess the direct and indirect health costs associated with leptospirosis seroconversion. METHOD: This study was carried out between 1 July 2017 and 31 March 2018 in the municipality of Isla Mayor (Seville, Spain). It took the form of a prospective cohort study (exposed population: swamp crayfish collectors; non-exposed population: general population). The population was invited to take part in a prevalence study to be conducted using the ELISA qualitative technique, and informed consent was obtained from those who agreed. Negative serology cases were then included in the cohort study. Both cohorts were monitored clinically and symptomatic cases were serology tested. A second serum sample was taken from the swamp crayfish collectors at the end of the monitoring period to detect asymptomatic cases. Serovars were confirmed by microscopic agglutination testing. A bivariate descriptive analysis was carried out and cumulative incidence and relative risk were calculated, with positive serology being taken as the dependent variable. RESULTS: A total of 278 people were included in the study, of whom 92 made up the swamp crayfish collectors cohort and 186 the general population cohort. Women made up 46.8% of the sample, but only 29.3% of the collectors cohort. The mean age was 45.1 (±16.4) years. Nine cases of seroconversion were detected: eight among swamp crayfish collectors and one in the general population. Overall cumulative incidence was therefore 3.2%: 8.7% in the exposed group and 0.5% in the non-exposed group. Relative risk was 16.2% (95% confidence interval: 2.1-127.4). The total cost of medical assistance and illness-related losses associated with leptospirosis was 1568€/case. CONCLUSIONS: Leptospirosis in Isla Mayor is strongly associated with red swamp crayfish collecting. It's incidence here is much higher than that reported in studies published in other countries.

Epidemiología de la leptospirosis en los humedales del sur de España / Epidemiology of leptospirosis in the wetlands of Southern Spain

Objetivo: Conocer si la incidencia de leptospirosis en los capturadores de cangrejo rojo durante el periodo de captura es superior a la de la población general, así como identificar factores de riesgo y estimar los costes sanitarios directos e indirectos asociados a los casos de seroconversión de dicha enfermedad.Método: Este estudio se realizó desde el 1 de julio de 2017 hasta el 31 de marzo de 2018. Se llevó a cabo un estudio de cohortes prospectivo (población expuesta: capturadores de cangrejo rojo; población no expuesta: población general) en el municipio de Isla Mayor (Sevilla, España). Previo consentimiento informado, se invitó a la población al estudio de prevalencia mediante la técnica cualitativa ELISA. Los que tuvieron serología negativa fueron incluidos en el estudio de cohortes. Ambas cohortes se siguieron clínicamente y a los casos sintomáticos se les realizó serología. A los capturadores de cangrejo rojo se les tomó una segunda muestra de suero al final del seguimiento para detectar asintomáticos. La serovariedad se confirmó mediante aglutinación microscópica. Se realizó un análisis descriptivo bivariado y se calcularon la incidencia acumulada y el riesgo relativo. La serología positiva se tomó como variable dependiente.Resultados:Se incluyeron en el estudio 278 personas, de las que 92 constituían la cohorte de capturadores y 186 la de población general. El 46,8% de la muestra eran mujeres, aunque entre los capturadores de cangrejo rojo estas solo representaban el 29,3%. La edad media de la muestra fue de 45,1 (± 16,4) años. Se detectaron nueve seroconversiones: ocho en capturadores de cangrejo rojo y una en población general. Por lo tanto, la incidencia acumulada fue de 8,7% en capturadores de cangrejo rojo y de 0,5% en población general, siendo el riesgo relativo de 16,2 (intervalo de confianza del 95%: 2,1-127,4). El coste total de la asistencia sanitaria y de las pérdidas por enfermedad asociadas a la leptospirosis fue de 1568 € por caso(AU)

Objective: To find out whether the leptospirosis incidence rate among red swamp crayfish collectors in the harvesting season is higher than in the general population, and to identify risk factors and assess the direct and indirect health costs associated with leptospirosis seroconversion. Method: This study was carried out between 1 July 2017 and 31 March 2018 in the municipality of Isla Mayor (Seville, Spain). It took the form of a prospective cohort study (exposed population: swamp crayfish collectors; non-exposed population: general population). The population was invited to take part in a prevalence study to be conducted using the ELISA qualitative technique, and informed consent was obtained from those who agreed. Negative serology cases were then included in the cohort study. Both cohorts were monitored clinically and symptomatic cases were serology tested. A second serum sample was taken from the swamp crayfish collectors at the end of the monitoring period to detect asymptomatic cases. Serovars were confirmed by microscopic agglutination testing. A bivariate descriptive analysis was carried out and cumulative incidence and relative risk were calculated, with positive serology being taken as the dependent variable. Results: A total of 278 people were included in the study, of whom 92 made up the swamp crayfish collectors cohort and 186 the general population cohort. Women made up 46.8% of the sample, but only 29.3% of the collectors cohort. The mean age was 45.1 (±16.4) years. Nine cases of seroconversion were detected: eight among swamp crayfish collectors and one in the general population. Overall cumulative incidence was therefore 3.2%: 8.7% in the exposed group and 0.5% in the non-exposed group. Relative risk was 16.2% (95% confidence interval: 2.1-127.4). The total cost of medical assistance and illness-related losses associated with leptospirosis was 1568€/case. (AU)

Longitudinal paths between parents' use of rewards and young adolescents' moral traits and prosocial behaviors.

BACKGROUND: Although prior research shows supportive evidence that parental practices are associated with adolescents' prosocial behaviors, limited evidence exists on the effects of parents' use of social and material rewards on distinct forms of prosocial behaviors, and the mediating effects of sociocognitive and socioemotive traits in these relations. AIMS: The present study was designed to examine the longitudinal relations among parents' use of social and material rewards, youth prosocial traits, and prosocial behaviors. MATERIALS & METHODS: Participants were 417 adolescents (M age = 14.70 years; 225 girls) from Valencia, Spain who completed surveys on parents' use of social and material reward practices, prosocial moral reasoning, empathic concern, and six types of prosocial behaviors. RESULTS: Path analyses showed that parents' use of social rewards was indirectly, positively related to emotional, dire, altruistic, public (negatively), and compliant prosocial behaviors via empathic concern. The use of social rewards was also indirectly positively linked to altruistic prosocial behaviors via both empathic concern and prosocial moral reasoning. In contrast, parents' use of material rewards predicted less prosocial moral reasoning, which in turn, was linked to more altruistic, prosocial behaviors. DISCUSSION AND CONCLUSIONS: The implications for parental socialization and self-determination theories of prosocial and moral development are discussed.

Predictive Validity of the Postural Assessment Scale for Stroke (PASS) to Classify the Functionality in Stroke Patients: A Retrospective Study.

The analysis of the predictive validity of a scale allows us to establish objectives in rehabilitation and to make decisions in the clinical setting. The objective of this study was to determine the validity of the Postural Assessment Scale for Stroke (PASS) to predict functionality at each stage of recovery in stroke patients. Methods: A retrospective study was carried out collecting data from patients admitted to a neurorehabilitation hospital. All patients having suffered a stroke less than two months before hospital admission were included in the study. The balance was measured with the PASS scale and the functionality with the Functional Independence Measure (FIM) scale. Simple linear regressions were performed to model the relationship between the PASS and FIM scores in the acute, subacute and chronic stages (6 and 12 months), as well as between the PASS scores at admission and the FIM values in the chronic stage. Results: The PASS scale showed a good predictive validity (R2 values from 0.54 to 0.87; ß values from 1.99 to 2.62; p < 0.001) for FIM scores at acute, subacute and chronic stages, with lower goodness-of-fit for PASS scores at admission and FIM scores at 12 months (R2 = 0.383; ß = 1.61 (0.96−2.26); p < 0.001). Cut-off points in the PASS scale to predict high functional level were 17.5 for the acute stage and 16.5 for the subacute and chronic stages. A score of 8.5 on the PASS scale measured in the acute phase predicted a high functional level at 12 months. Conclusion: The PASS scale is a useful tool to classify the functionality of stroke patients in the acute, subacute and chronic phases. The PASS score upon admission into the hospital can predict the functionality of the stroke patients after 12 months. However, future studies should be carried out to corroborate our findings with larger sample sizes.

Evaluation and selection of culture media for the detection of auxin-like compounds and phosphate solubilization on soil yeasts.

The detection of characteristics associated with plant growth promotion has been studied frequently on bacteria and some of these detection methods were also used on yeasts. Sometimes, these methods, designed for prokaryotes, were used with no prior analysis regarding growth and production on eukaryotes. The aim of the present study was to assess and select the best suitable media for the detection of auxin-like compound production and inorganic-P solubilization on yeast strains. Already published media and new formulations, as well as yeasts with different genetic backgrounds were used for the comparison. Media were selected based on the adequate growth of yeast strains and reliable recognition of the studied features either by an easy detection of the metabolite (color or halo production) or simple medium preparation (low number of reagent and regular autoclaving). We propose here the use of the new DEV medium with glucose and with tryptophan to identify auxin-like compounds producers; and CPM medium (a variation from Custer's Chalk Medium) as base medium to identify yeasts capable of inorganic-P solubilization.

Challenges and barriers in mental healthcare systems and their impact on the family: A systematic integrative review.

The aim of this systematic integrative review is to analyse the challenges and barriers found in mental healthcare systems and the impact they have on the family. Searches were made of the Web of Science, Scopus, Medline and Cochrane databases using terms relating to mental health, family care and healthcare systems. We included and critically evaluated studies published in English between 2015 and 2019 that directly or indirectly analysed public mental health policies and the consequences they have for the family. We analysed our findings following the inductive content analysis approach. A total of 32 articles that met quality indicators were identified. Very closely related structural, cultural, economic and healthcare barriers were found that contribute to the treatment gap in mental health. The family covers the care systems' deficiencies and weaknesses, and this leads to overload and a diminishing quality of life for caregivers. It is acknowledged that people with mental illness and their families should be able to participate in the development of policies and thus contribute to strengthening mental healthcare systems worldwide.

Determinants of health literacy in the general population: results of the Catalan health survey.

BACKGROUND: Health Literacy (HL) is the knowledge and competence to access, understand, appraise, and apply health information for health judgment. We analyze for the first time HL level of Catalonia's population. Our objective was to assess HL of population in our area and to identify social determinants of HL in order to improve the strategies of the Healthcare Plan, aimed at establishing a person-centered system and reducing social inequalities in health. METHODS: This was a cross-sectional study based on the Health Survey for Catalonia (ESCA, Enquesta de Salut de Catalunya), which included the 16 items of the European Health Literacy Survey Questionnaire (HLS-EU-Q16). The statements in the questionnaire cover three different health literacy domains: Health Care, Disease Prevention, and Health Promotion. HL was categorized in three levels: Sufficient, Problematic and Inadequate. Chi-square tests were performed to compare the percentages of subjects with adequate or inadequate HL across sociodemographic and health-related variables. Variables showing significant differences were included in a stepwise logistic regression to predict inadequate HL level. RESULTS: The questionnaire was administered to 2433 subjects aged between 15 and 98 years old (mean of 45.9 years, SD 18.0). Overall, 2059 subjects (84.6%) showed sufficient HL, 250 (10.3%) inadequate HL, and 124 (5.1%) problematic HL, with no significant differences between men and women (p = 0.070). A logistic regression analysis showed that low health literacy is associated with a lower level of education (OR 2.08, CI 95% 1.32-3.28, p = 0.002), low socioeconomic status (OR 2.11, CI 95% 1.42-3.15, p <  0.001) and a physical limitation to perform everyday activities (OR 2.50, CI 95% 1.34-4.66, p = 0.004). We also found a more modest association with low physical activity, having a self-perceived chronic disorder and performing preventive activities. CONCLUSIONS: Catalonia has a high percentage of subjects with sufficient HL. Education level, socioeconomic status and physical limitations were the factors with the strongest contribution to inadequate or problematic health literacy. Although these results are likely to be country-specific, the factors identified will allow policymakers of areas with similar socioeconomic profiles to identify groups with high risk of problematic or inadequate HL, which is essential for a successful patient-centered model of care.

Risk factors associated with the family care of people with serious mental illness

Background: The aim of the present study is to analyse the variables associated with the family care of people diagnosed with serious mental illness. Material and Methods: A cross-sectional study was carried out involving caregivers of people with serious men-tal illness (SMI) who were known to the mental health services in Valencia (España) and associations for those with SMI. The sample comprised 417 caregivers who completed a sociodemographic questionnaire and the Zarit Burden Interview. Bivariate analyses (t-test, analysis of variance and Pearson correlation) were performed, as was a multiple linear regression model. Values of p < .05 were considered significant. The study was carried out in accordance with the recommendations of the ethics committees of the participating institutions. Results: The statistical analyses showed significant associations between the sociodemographic and clinical variables of the caregivers and patients and the burden felt by caregivers of people with SMI. The importance of both formal and informal social support stands out as a protective factor against the consequences of the illness's impact on the main caregiver. Conclusions: The role of spaces of mutual support is crucial. The results suggest that family psychoeducational programmes should be created, applied and evaluated in all mental healthcare services so as to reinforce training in mental health matters and provide support and assessment to caregivers in order to ease their burden

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Aptamers as Diagnostic Tools in Cancer.

Cancer is the second leading cause of death worldwide. Researchers have been working hard on investigating not only improved therapeutics but also on early detection methods, both critical to increasing treatment efficacy, and developing methods for disease prevention. The use of nucleic acids, or aptamers, has emerged as more specific and accurate cancer diagnostic and therapeutic tools. Aptamers are single-stranded DNA or RNA molecules that recognize specific targets based on unique three-dimensional conformations. Despite the fact aptamer development has been mainly restricted to laboratory settings, the unique attributes of these molecules suggest their high potential for clinical advances in cancer detection. Aptamers can be selected for a wide range of targets, and also linked with an extensive variety of diagnostic agents, via physical or chemical conjugation, to improve previously-established detection methods or to be used as novel biosensors for cancer diagnosis. Consequently, herein we review the principal considerations and recent updates in cancer detection and imaging through aptamer-based molecules.

Asociación entre disglucemia y el consumo crónico de arsénico en aguas de zonas rurales de la provincia de San Juan / Association between dysglycemia and chronic consumption of arsenic in water from rural areas of the province of San Juan

La contaminación por arsénico (As) de las aguas subterráneas es un problema muy extendido; varias regiones presentan niveles importantes de consumo de agua contaminada, lo que determina en la población afectada signos de exposición aguda (toxicológica) y crónica. Con respecto a la exposición crónica, existen estudios previos que muestran como el consumo afecta adversamente la salud cardiometabólica. Estudios experimentales sugirieron que el As puede afectar la función de las células ß pancreáticas y la sensibilidad de la insulina mediante el mecanismo del estrés oxidativo; la captación y transporte de glucosa, la gluconeogénesis y la diferenciación de adipocitos; y a su vez, actuar como un disruptor endócrino afectando la función de los receptores hormonales e impactar sobre la diabetes a través de mecanismos epigenéticos. El objetivo de este estudio fue evaluar directamente el rol de la exposición a arsénico inorgánico en la homeostasis de la glucosa, cuya disfunción está ligada a la Diabetes. Concretamente se estudió la relación entre As urinario y disglicemia (a través de biomarcadores como la glucemia en ayunas y la hemoglobina glicosilada (HbA1C)) en personas de zonas rurales de los departamentos de Calingasta e Iglesia de la provincia de San Juan. Se encontró una gran diferencia en la prevalencia de disglicemias entre los pacientes que presentaron elevados niveles de As en orina (48,98%) y los controles no expuestos al consumo de agua con As (8,75 %)

The Catalonian Expert Patient Programme for Chagas Disease: An Approach to Comprehensive Care Involving Affected Individuals.

The Catalonian Expert Patient Programme on Chagas disease is a initiative, which is part of the Chronic Disease Programme. It aims to boost responsibility of patients for their own health and to promote self-care. The programme is based on nine sessions conducted by an expert patient. Evaluation was focusing in: habits and lifestyle/self-care, knowledge of disease, perception of health, self-esteem, participant satisfaction, and compliance with medical follow-up visits. Eighteen participants initiated the programme and 15 completed it. The participants were Bolivians. The 66.7 % of them had been diagnosed with chagas disease in Spain. The 100 % mentioned that they would participate in this activity again and would recommend it to family and friends. The knowledge about disease improve after sessions. The method used in the programme could serve as a key strategy in the field of comprehensive care for individuals with this disease.

Analysis of the mutational landscape of classic Hodgkin lymphoma identifies disease heterogeneity and potential therapeutic targets.

Defining the mutational landscape of classic Hodgkin lymphoma is still a major research goal. New targeted next-generation sequencing (NGS) techniques may identify pathogenic mechanisms and new therapeutic opportunities related to this disease. We describe the mutational profile of a series of 57 cHL cases, enriched in Hodgkin and Reed-Sternberg (HRS) cells. Overall, the results confirm the presence of strong genomic heterogeneity. However, several variants were consistently detected in genes related to relevant signaling pathways, such as GM-CSF/IL-3, CBP/EP300, JAK/STAT, NF-kappaB, and numerous variants of genes affecting the B-cell receptor (BCR) pathway, such as BTK, CARD11, BCL10, among others. This unexpectedly high prevalence of mutations affecting the BCR pathway suggests some requirement for active BCR signaling for cHL cell viability. Additionally, incubation of a panel of cHL cellular models with selective BTK inhibitors in vitro constrains cell proliferation and causes cell death. Our results indicate new pathogenic mechanisms and therapeutic opportunities in this disease.

Detection of plant growth enhancing features in psychrotolerant yeasts from Patagonia (Argentina).

This study explores the biotechnological potential for plant production of twelve psychrotolerant yeasts strains from Northwest-Patagonia. These strains were isolated from different substrates associated with Nothofagus sp. in native forests and Vaccinium sp. in a commercial plantation. Yeasts characterization was performed using in vitro assays to evaluate the production of auxin-like compounds and siderophores, ability to solubilize inorganic phosphate and to reduce common plant pathogen growth. Strain YF8.3 identified as Aureobasidium pullullans was the main producer of auxin-like and siderophores compounds. Phosphate solubilization was a characteristic observed by strains L8.12 and CRUB1775 identified as Holtermaniella takashimae and Candida maritima, respectively. Different yeast strains were able to inhibit the growth of Verticillium dahliae PPRI5569 and Pythium aphanidermatum PPRI 9009, but they all failed to inhibit the growth of Fusarium oxysporum PPRI5457. The present study, suggests that yeasts present in different environments in Northwestern-Patagonian have physiological in vitro features which may influence plant growth. These results are promising for the developing of biological products based on Patagonian yeasts for plant production in cold-temperate regions.

Development and Validation of an Instrument for Assessing Patient Experience of Chronic Illness Care.

INTRODUCTION: The experience of chronic patients with the care they receive, fuelled by the focus on patient-centeredness and the increasing evidence on its positive relation with other dimensions of quality, is being acknowledged as a key element in improving the quality of care. There are a dearth of accepted tools and metrics to assess patient experience from the patient's perspective that have been adapted to the new chronic care context: continued, systemic, with multidisciplinary teams and new technologies. METHODS: Development and validation of a scale conducting a literature review, expert panel, pilot and field studies with 356 chronic primary care patients, to assess content and face validities and reliability. RESULTS: IEXPAC is an 11+1 item scale with adequate metric properties measured by Alpha Chronbach, Goodness of fit index, and satisfactory convergence validity around three factors named: productive interactions, new relational model and person's self-management. CONCLUSIONS: IEXPAC allows measurement of the patient experience of chronic illness care. Together with other indicators, IEXPAC can determine the quality of care provided according to the Triple Aim framework, facilitating health systems reorientation towards integrated patient-centred care.