The ADKnowl: identifying knowledge deficits in diabetes care

Aims To present the ADKnowl measure of diabetes-related knowledge and evalu ate its use in identifying the nature and extent of patient and health prof essional knowledge deficits. Method The ADKnowl was used in a large-scale study of 789 patients (451 tre ated with insulin and 338 treated with tablets and/or diet) attending for a nnual review at one of two hospital out-patient diabetes clinics Results Knowledge deficits were apparent in the patients. For example, 57% did not recognize the inaccuracy of the statement 'fresh fruit can be eaten freely with little effect on blood glucose levels'. Seventy-five percent o f patients did not know that it is advisable to trim toenails to the shape of the toe. Knowledge deficits were identified for many other areas of diab etes management, e.g. prevention of hypoglycaemia, avoidance of ketoacidosi s. Sixteen health professionals at the clinics answered the same items. Con trary to recommendations, 25% of health professionals thought that fresh fr uit could be eaten freely. Seventy-five percent of health professionals did not know the current recommendations for trimming toenails. As expected, H bA(1c) did correlate with scores from two specific items, while HbA(1c) did not correlate with summed ADKnowl score. Conclusions Patient knowledge deficits were identified. Some specific knowl edge deficits among health professionals may be the cause of some patient k nowledge deficits. The ADKnowl is a useful tool in assessing both patient a nd health professional knowledge deficits and is available for use in a con text of continuing evaluation.