Multisystemic therapy compared to telephone support for youth with poorly controlled diabetes: findings from a randomized controlled trial.
BACKGROUND
Few interventions have effectively improved health outcomes among youth with diabetes in chronic poor metabolic control.


OBJECTIVE
This study aims to determine whether multisystemic therapy (MST), an intensive, home-based, tailored family treatment, was superior to weekly telephone support for improving regimen adherence and metabolic control among adolescents with chronic poor metabolic control.


METHODS
A randomized controlled trial was conducted with 146 adolescents with types 1 or 2 diabetes. Data were collected at baseline, 7 months (treatment termination), and 12 months (6 months follow-up).


RESULTS
Adolescents receiving MST had significantly improved metabolic control at 7 (1.01 % decrease) and 12 months (0.74 % decrease) compared to adolescents in telephone support. Parents of adolescents receiving MST reported significant improvements in adolescent adherence. However, adolescent-reported adherence was unchanged.


CONCLUSIONS
MST improved health outcomes among adolescents with chronic poor metabolic control when compared to telephone support. Home-based approaches may provide a viable means to improve access to behavioral interventions for such youth.
Carman and Ann Adams Department of Pediatrics, Wayne State University, Detroit, MI, USA. dellis@med.wayne.edu
Deborah A
DA
Ellis
Sylvie
S
Naar-King
Xinguang
X
Chen
Kathleen
K
Moltz
Phillippe B
PB
Cunningham
April
A
Idalski-Carcone
D000293:Adolescent; D001521:Behavior Therapy / Q000379:methods*; D001786:Blood Glucose / Q000378:metabolism; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000523:psychology / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000523:psychology / Q000628:therapy*; D005196:Family Therapy / Q000379:methods*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D010349:Patient Compliance / Q000523:psychology*; D019114:Remote Consultation / Q000379:methods*; D013689:Telephone; D016896:Treatment Outcome
D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin