Psychological family intervention for poorly controlled type 2 diabetes

Am J Manag Care. 2011 Feb;17(2):105-13.

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.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Behavioral Medicine
  • Blood Glucose Self-Monitoring / psychology
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / psychology*
  • Diabetes Mellitus, Type 2 / therapy
  • Family Therapy*
  • Female
  • Glycated Hemoglobin A / metabolism
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Ireland
  • Male
  • Middle Aged
  • Patient Education as Topic / methods*
  • Prospective Studies
  • Socioeconomic Factors
  • Treatment Outcome
  • Young Adult

Substances

  • Glycated Hemoglobin A
  • Hypoglycemic Agents