Using the Medical Research Council framework to develop a complex intervention to improve delivery of care for young people with type 1 diabetes

Diabet Med. 2013 Jun;30(6):e223-8. doi: 10.1111/dme.12185. Epub 2013 Apr 12.


Aims: We describe how we have used the development phase of the Medical Research Council (MRC) Guidelines to construct a complex intervention to improve physical and psychological health among young people (16-21 years) with Type 1 diabetes.

Methods: We consulted previous reviews where available and conducted systematic searches of electronic databases to determine physical and mental health among the population, audited medical records, surveyed self-reported psychological health among our clinic population; and interviewed staff (n = 13), young people (n = 27) and parents (n = 18) about their views of current care.

Results: Our audit (n = 96) confirmed a high HbA1c [86 mmol/mol (10.0%)] and one third (36.1%) reported significant eating problems. Young people did not attend 12% of their clinic appointments. Staff described difficulties communicating with young people who wanted staff to take account of their individual lifestyle when giving information.

Conclusion: Based on the findings of the systematic reviews and our audit, we concluded that there was sufficient evidence to justify development of a model of care specific to this age group. The components of the complex intervention include changes to standard care, an optional 5-day self-management course directed at young people and a separate family communication programme. The MRC Guidelines provided a valuable structure to guide development and evaluation of this intervention.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adolescent Behavior
  • Adolescent Development
  • Adolescent Medicine / methods
  • Adult
  • Depression / epidemiology
  • Depression / prevention & control
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / psychology
  • Diabetes Mellitus, Type 1 / therapy*
  • Evidence-Based Medicine*
  • Feeding and Eating Disorders / epidemiology
  • Feeding and Eating Disorders / prevention & control
  • Female
  • Glycated Hemoglobin A / analysis
  • Government Agencies
  • Humans
  • Hyperglycemia / epidemiology
  • Hyperglycemia / prevention & control*
  • Life Style*
  • Male
  • Patient Compliance
  • Practice Guidelines as Topic*
  • Precision Medicine*
  • Prevalence
  • Social Support
  • United Kingdom / epidemiology
  • Young Adult


  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human