Effect of collection-assessment-plan-do-check-aggrandizement model of personalized patient education in patients with diabetes: a cluster randomized controlled study.

Abstract

The global diabetes epidemic necessitates self-management strategies, and traditional patient education faces challenges in personalization, continuity, and monitoring. This study evaluates the efficacy of the collection-assessment-plan-do-check-aggrandizement (CAPDCA) model, which is a personalized patient education framework for improving glycemic control and self-management. A multicenter, two-stage cluster randomized controlled trial was conducted across six community health centers in Beijing. Eligible participants were randomized into intervention (CAPDCA model, n = 90) or control (traditional education, n = 90) groups. Primary outcomes were HbA1c reduction and target achievement; secondary outcomes included fasting blood glucose (FBG) and 2-h postprandial blood glucose (2h-PPG), medication adherence (MMAS-8), and quality of life (SF-36). Follow-ups occurred over 18 months (11 visits). Generalized estimating equations (GEE) analyzed longitudinal trends. 178 participants completed the trial (90 in the intervention group and 88 in the control group). Compared to the control group, the intervention group demonstrated ​a significantly lower final HbA1c level​ (t = 6.356, P < .01) and ​a greater reduction in HbA1c​ (t = -6.117, P < .01). Target achievement rate of HbA1c is 83.3% in intervention and 25.0% in controls (risk ratio = 3.33, 95% CI: 2.29-4.84, P < .01). FBG (odds ratio (OR) = 0.663, 95% CI: 0.468-0.938) and 2h-PPG (OR = 0.218, 95% CI: 0.138-0.345) in intervention reductions were significantly greater (P < .05). MMAS-8 scores improved to 7.0 (inter-quartile range: 6.75-7.5) better than control group (Z = 5.912, P < .01). SF-36 scores is higher in the intervention group (t = 9.497, P < .01). The CAPDCA model enhances glycemic control, medication adherence, and quality of life in patients with diabetes through structured and personalized iterative education. Its scalability and adaptability address critical gaps in personalized diabetes education, offering a feasible framework for global implementation in primary healthcare institutions.