CHICAGO — Health care professionals are trying a new tack to better engage diabetes patients in the self-management of their disease.
The American Diabetes Association (ADA) and Healthy Interactions Inc. are launching an initiative centered on a series of visual aids called U.S. Diabetes Conversation Maps. The 3-by-5-foot “maps,” which depict symbolic images that can be used as conversation starters to help small groups explore a variety of diabetes-related facts and issues, are designed to be used in conjunction with a structured series of questions and activities.
The aim is for the maps to shift diabetes education from a one-way lecture to an interactive discussion that increases patients' ability to understand and manage their illness, said diabetes educator Martha M. Funnell, R.N., past president of health care and education for the ADA, and member of the ADA team that helped develop the content for the maps.
“One of the reasons I'm so excited about these maps is they provide an opportunity to be truly patient centered in our delivery of education,” Ms. Funnell said at a press briefing during the annual scientific sessions of the ADA, where the initiative was unveiled.
Roughly 150 training sessions are planned for 2007, with a goal to have more than 10,000 health care professionals incorporate the maps into their diabetes education programs within the next 3 years. The U.S. Diabetes Conversation Maps initially are being promoted to the 2,800 ADA-recognized education programs, but also will be available to other health care professionals conducting group education including physicians, nurses, and pharmacists. The five Conversation Maps will be provided free to those who go through the 3-hour training program, thanks to corporate sponsorship from Merck & Co., Peter Gorman, president of Healthy Interactions, said at the press briefing.
The five maps—diabetes overview, healthy eating, blood glucose monitoring, natural course of diabetes, and gestational diabetes—are designed for either type 1 or type 2 diabetes. They contain up-to-date clinical content, and address a wide range of topics, from food and exercise to ways to talk more effectively about the emotional and behavioral component of the disease.
Each map comes with a guide and a set of questions that is used as a framework by the facilitator to lead the discussion. For example, the first question patients are asked when using the diabetes overview map is to explain their understanding of what diabetes is and the difference between the two types of diabetes. For women using the gestational diabetes map, much of the discussion centers on diet and exercise plans, as well as on what to expect after childbirth and with subsequent pregnancies.
“A lot of people don't even believe they have diabetes,” Mr. Gorman said in an interview. “So we have a lot of conversations and activities that get them to look at their assumptions and [whether] those assumptions are correct.
“It's through those questions and answers that they come to their own conclusions and [to] conclusions they are willing to act on,” he added.
All patients are asked to identify near- and long-term goals and to write out an action plan detailing how they will engage their health care team and family to support their accomplishment of those goals. “People can talk about things they want to do, but until they take an active step of writing things down, it doesn't get done,” Mr. Gorman said. The action plan also provides educators with something concrete to follow up on at the next session.
A similar approach to diabetes education was introduced last year in Canada, and preliminary data showed high satisfaction among both patients and educators. At one pilot site with an already well-established diabetes education program, the patient return rate increased 15% between the first and second education sessions, and by 50% between the second and third sessions, Mr. Gorman said.
The company has not evaluated how effective the Canadian maps have been in improving outcomes such as reaching target hemoglobin A1c levels or medication compliance. A protocol is under development in the United States to evaluate such outcomes in the future, he explained.
The wide range of subjects addressed by the maps is particularly attractive to patient advocate Michael Weiss, past chair of the ADA board and member of the ADA content team, who said the only education he received in 1984 when diagnosed with type 1 diabetes was a single session devoted to how the pancreas works.
“This is the validation that patients have a seat at the table,” Mr. Weiss told reporters. “To my knowledge, this is the only educational product developed by physicians and patients working together, and I think that says a lot about the project.”