A case manager plus psychoeducation reduced adverse outcomes in youth with type 1 diabetes
- case management
- diabetes mellitus (type 1)
- haemoglobin A (glycosylated)
- hypoglycaemia
- patient education
Q In children and adolescents with type 1 diabetes, does a low intensity, non-medical intervention using a case manager to monitor and encourage routine diabetes care visits, with or without supplementation by psychoeducational modules, reduce acute adverse outcomes and improve glycaemic control?
METHODS
Design:
randomised controlled trial.
Allocation:
{not concealed}.*
Blinding:
blinded {healthcare providers and data collectors}*.
Follow up period:
24 months.
Setting:
diabetes centre in Boston, Massachusetts, USA.
Patients:
301 children and adolescents aged 7–16 years (mean age 12 y, 56% girls, mean duration of diabetes 5.2 y) who had had type 1 diabetes for >6 months. Inclusion criteria included ⩾1 outpatient medical visit in the previous year, no major psychiatric problems in the patient or parent, stable living environment, and intention for routine follow up at the study centre.
Interventions:
low intensity, non-medical intervention using a case manager (called a “Care Ambassador”), who monitored clinic attendance and assisted families with appointments (CA group, n = 95); CA plus 8 sessions …
