Multisystemic therapy compared to telephone support for youth with poorly controlled diabetes: findings from a randomized controlled trial

Abstract

Background: Few interventions have effectively improved health outcomes among youth with diabetes in chronic poor metabolic control.

Purpose: 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.

Conflict of interest statement

Conflict of Interest Statement

Three of the authors are board members of Evidence Based Services, which has a licensing agreement with MST Services, LLC, for dissemination of multisystemic therapy treatment technology. There are no other potential author conflicts of interest.

Figures

Figure 1

CONSORT diagram showing flow of participants through the study

Figure 2

Changes in hemoglobin A1c (HbA1c) from baseline to seven months (treatment termination) and twelve months (six months post-treatment).

Figure 3

Changes in parent-reported regimen adherence on the Diabetes Management Scale from baseline to seven months (treatment termination) and twelve months (six months post-treatment).