title: Psychological family intervention for poorly controlled type 2 diabetes.
abstract: OBJECTIVE
  To evaluate the effectiveness of a psychological, family-based intervention to improve diabetes-related outcomes in patients with poorly controlled type 2 diabetes.
  
  
  METHODS
  This study was a randomized controlled trial of a psychological family-based intervention targeted at individuals with poorly controlled type 2 diabetes. Recruitment and follow-up occurred at specialist diabetes clinics. Patients were randomly allocated to an intervention group (n=60) or a control group (n=61). Poor control was defined as at least 2 of the patient's last 3 glycated hemoglobin (A1C) readings at >8.0%. The intervention consisted of 2 sessions delivered by a health psychologist to the patient and a family member in the patient's home, with a third session involving a 15-minute follow-up telephone call.
  
  
  RESULTS
  At 6-month follow-up, the intervention group reported significantly lower mean A1C levels than the control group (8.4% [SD=0.99%] vs 8.8% [SD=1.36%]; P=.04). The intervention was most effective in those with the poorest control at baseline (A1C>9.5%) (intervention 8.7% [SD=1.16%, n=15] vs control 9.9% [SD=1.31%, n=15]; P=.01). The intervention group also reported statistically significant improvements in beliefs about diabetes, psychological well-being, diet, exercise, and family support.
  
  
  CONCLUSIONS
  After participating in a family-based intervention targeting negative and/or inaccurate illness perceptions, patients with poorly controlled type 2 diabetes showed improvements in A1C levels and other outcomes. Our results suggest that adding a psychological, family-based component to usual diabetes care may help improve diabetes management.
authors.affiliation: Department of Public Health and Primary Care, Trinity College Dublin, Trinity College Centre for Health Sciences, AMNCH, Tallaght, Dublin 24, Ireland. keoghkm@tcd.ie
authors.forename: Karen M
authors.initials: KM
authors.lastname: Keogh
authors.forename: Susan M
authors.initials: SM
authors.lastname: Smith
authors.forename: Patricia
authors.initials: P
authors.lastname: White
authors.forename: Sinead
authors.initials: S
authors.lastname: McGilloway
authors.forename: Alan
authors.initials: A
authors.lastname: Kelly
authors.forename: James
authors.initials: J
authors.lastname: Gibney
authors.forename: Tom
authors.initials: T
authors.lastname: O'Dowd
mesh_terms: D000328:Adult; D000368:Aged; D001524:Behavioral Medicine; D015190:Blood Glucose Self-Monitoring / Q000523:psychology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000523:psychology* / Q000628:therapy; D005196:Family Therapy; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007494:Ireland; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D011446:Prospective Studies; D012959:Socioeconomic Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents