Authors' objectives:

This report examines the effectiveness of educational and psychosocial interventions for adolescents with type 1 diabetes designed to improve their diabetes management. Specifically, it addresses the following research questions:

1. Do educational and psychosocial interventions for adolescents with type 1 diabetes have beneficial effects on biological and psychosocial outcomes? 2. Are there types or features of interventions that have been shown to be more effective than others? 3. What evidence is there of the cost-effectiveness of interventions?

Authors' recommendations: The following conclusions were drawn from this review: 1. Educational and psychosocial interventions have small to medium beneficial effects on various diabetes management outcomes. 2. Well-designed trials of such interventions are needed in the UK (no completed RCTs of educational or psychosocial interventions for adolescents with type 1 diabetes conducted in the UK were found). 3. The evidence, arising primarily from studies in the USA, provides a starting point for the design of interventions in the UK. 4. Quantitative and narrative analysis of the evidence suggested that interventions are more likely to be effective if they demonstrate the inter-relatedness of the various aspects of diabetes management. The effectiveness of interventions should be evaluated by assessing outcomes that the intervention explicitly targets for change, and at the appropriate point in time post-intervention to reflect the impact of the intervention. 5. Interventions need to be evaluated by well-designed studies, such as RCTs, including adequately powered patient-preference trials reporting results in such a way as to enable effect sizes to be calculated. 6. An important gap in the evidence is that there is no systematic understanding of whether interventions should be targeted (e.g. modified for different disease stages, different types of diabetes management problems or the different age groups subsumed by adolescence). 7. To reap economic returns, interventions need to show durable favourable effects on behaviour and metabolic control, but there is a lack of cost-effectiveness studies that fully address the resource implications of educational interventions for adolescents and long-term consequences.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.hta.ac.uk/1019

Year Published: 2001

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: England, United Kingdom

Organisation Name: NIHR Health Technology Assessment programme

Contact Address: NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK

Contact Name: journals.library@nihr.ac.uk

Contact Email: journals.library@nihr.ac.uk

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