Follow-up results on monitoring and discussing health-related quality of life in adolescent diabetes care: benefits do not sustain in routine practice

Pediatr Diabetes. 2010 May;11(3):175-81. doi: 10.1111/j.1399-5448.2009.00543.x. Epub 2009 Jun 16.


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.

Patients and 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.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Adolescent Health Services*
  • Child
  • Continuity of Patient Care
  • Counseling / methods
  • Diabetes Mellitus, Type 1 / therapy*
  • Female
  • Follow-Up Studies
  • Health Status
  • Humans
  • Male
  • Mental Health
  • Monitoring, Physiologic / methods*
  • Patient Satisfaction
  • Professional Practice
  • Psychometrics
  • Quality of Life*
  • Self Concept
  • Surveys and Questionnaires