Follow-up results on monitoring and discussing health-related quality of life in adolescent diabetes care: benefits do not sustain in routine practice.
OBJECTIVE
We previously demonstrated that adding monitoring and discussion of health-related quality of life (HRQoL) of adolescents with type 1 diabetes to routine periodic consultations positively impacts psychosocial well-being and satisfaction with care. The current study examines whether these positive effects are maintained 1 year after the intervention was terminated and patients received regular care again, with no formal HRQoL assessment.


METHODS
Forty-one adolescents with type 1 diabetes were followed for 1 year after the initial HRQoL intervention, in which their HRQoL had been assessed and discussed as part of period consultations using the PedsQL. Changes in physical and psychosocial well-being [Child Health Questionnaire-Child Form 87 (CHQ-CF87), diabetes family conflict scale (DFCS), Center for Epidemiological Studies scale for Depression (CES-D)], satisfaction with care [Patients' Evaluation of the Quality of Diabetes (PEQ-D) care], and glycemic control (HbA(1c)) were determined 12 months after the HRQoL intervention had ended.


RESULTS
One year after the HRQoL intervention, mean scores on CHQ subscales: behavior (p = 0.001), mental health (p = 0.004), and self-esteem (p < 0.001) had decreased, whereas the family activities subscale remained stable. Adolescents were less satisfied with their care (p = 0.012), and HbA(1c) values had increased significantly 12 months postintervention (p = 0.002).


CONCLUSIONS
The beneficial effects of an office-based HRQoL intervention in adolescents with diabetes largely disappear 1 year after withdrawing the HRQoL assessment procedure. This finding underscores the importance of integrating standardized evaluation and discussion of HRQoL in routine care for adolescents with diabetes.
de Wit
Maartje
M
Department of Medical Psychology, VU University Medical Center, P. O. Box 7057, 1007 MB Amsterdam, The Netherlands. m.dewit@vumc.nl
Delemarre-van de Waal
Henriette A
HA
Bokma
Jan Alle
JA
Haasnoot
Krijn
K
Houdijk
Mieke C
MC
Gemke
Reinoud J
RJ
Snoek
Frank J
FJ
D000293:Adolescent; D016497:Adolescent Health Services; D002648:Child; D003266:Continuity of Patient Care; D003376:Counseling / Q000379:methods; D003922:Diabetes Mellitus, Type 1 / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008297:Male; D008603:Mental Health; D008991:Monitoring, Physiologic / Q000379:methods*; D017060:Patient Satisfaction; D011364:Professional Practice; D011594:Psychometrics; D011788:Quality of Life; D012649:Self Concept; D011795:Surveys and Questionnaires