Long Term Effectiveness of the Diabetes Conversation Map™ Program on Health Outcomes: A Case-Control Retrospective Cohort Study.

AIM To evaluate the clinical and health behavioral outcomes of a large sample of participants from the Diabetes Conversation Map™ Program. DESIGN A matched case-control study that was performed on a retrospective cohort study. METHODS Participants were 11,053 Clalit Health Services members with type 2 diabetes who enrolled in the Diabetes Conversation Map™ Program between January 2010 and April 2016. The matched-control group was formulated using sequential matching, by matching cases to controls at a ratio of 1:3, based on age, sex and HbA1c level. The associations between the program group and annual clinical and health behaviors were assessed between cases and controls at five time points using linear and Poisson regression analyses. RESULTS The intervention group had significantly lower HbA1c, glucose and low-density lipoprotein levels and more frequent glucose blood testing each year up to 36 months post-enrollment compared with the matched-controls. Other outcomes were significantly different for shorter time periods, including higher high-density lipoprotein and lower triglyceride levels at 6 and 12 months follow-up and lower diastolic blood pressure and greater medication adherence at 6 months follow-up. CONCLUSIONS Enrollment in the program was associated with improved clinical and health behavior outcomes for at least 6 months and most outcomes persisted for up to 36 months. IMPACT This is the first study to evaluate the Diabetes Conversation Map™ Program with a large sample over long period of time. This nurse-led group intervention evaluation adds to the literature on health outcomes on the lives of patients with type 2 diabetes.