Impact of Conversation Map™ Education Tools Versus Regular Care on Diabetes-Related Knowledge of People With Type 2 Diabetes: A Randomized, Controlled Study

Abstract

Objective. This study compared the effectiveness of Conversation Map™ (CM) education tools versus regular care of adults with type 2 diabetes. Methods. Participants from Spain and Germany were randomized to either four CM education sessions or regular care. Data were collected at baseline (visit 1), immediately post-education (visit 2), and 6 months later (visit 3). The primary objective was to compare diabetes knowledge between education groups at visit 3, using the Audit of Diabetes Knowledge (ADKnowl) questionnaire (score range 0–100). Results. Of 681 participants randomized (CM 330, regular care 351), 91.8% completed visit 3. Median ADKnowl scores increased significantly (P < 0.001) in both groups (CM visit 1, 60.3; visit 2, 73.5; and visit 3, 72.5; regular care visit 1, 63.3; visit 2, 73.5; and visit 3, 73.6). At visit 3, scores were not ranked significantly differently between education groups (P = 0.284). In Spain (n = 310), visit 3 scores were ranked higher for CM than for regular care (P < 0.001); in Germany (n = 371), the opposite was true (P < 0.001). Of participants receiving regular care, 78.3% of those in Germany and 13.5% of those in Spain had non-CM structured education between visits 1 and 2. In Spain, CM patients had higher satisfaction with care and goal attainment than regular-care patients at visit 2 (visit 2 P < 0.001, visit 3 P = 0.055). In Germany, CM patients had less emotional distress than regular-care patients (visit 2 P = 0.025, visit 3 P = 0.003). Median A1C decreased similarly in both groups and countries. Conclusion. Diabetes knowledge and clinical outcomes improved in both education groups. At visit 3, diabetes knowledge in the CM group was not ranked higher than in the regular-care group. In Germany, where regular care frequently involves structured education programs, diabetes knowledge was ranked higher with regular care than with CM. In Spain, where no structured national diabetes education and awareness programs are in place, scores were ranked higher with CM than with regular care.