An Integrated Care Model to Support Adolescents With Diabetes-related Quality-of-life Concerns: An Intervention Study

Our aim in this study was to determine whether participating in an integrated stepped care model for adolescents with type 1 diabetes (T1D) would lead to improvements in overall quality of life (QoL), diabetes-related quality of life (DRQoL) and glycated hemoglobin (A1C) levels compared with usual care. A nonrandomized, 2-group, pre/post, delayed-intervention design was used for this study. The Mind Youth Questionnaire (MY-Q) was used to assess QoL and DRQoL. Adolescents attending the diabetes clinic using the stepped care model formed the intervention group (n=77). These adolescents completed the MY-Q, and the identified concerns were discussed and addressed with them by their care team as part of the care model. Adolescents attending a pediatric diabetes clinic on another site completed the MY-Q as a comparison group (n=39), results were not shared with their care team, and they received the standard care. There were 116 adolescents between 13 to 17 years of age, who completed the MY-Q on 2 occasions. Baseline data were obtained on the first occasion, and, on the second occasion, an average of 12 months later, there was a follow-up assessment. At follow-up, adolescents in the intervention group had a significantly higher overall QoL and reported significantly fewer concerns on DRQoL domains than those in the comparison group. Participation in the intervention group, however, did not lead to improvements in A1C. This study shows that implementing an integrated stepped care model within an interprofessional pediatric diabetes clinic can lead to the improvement of adolescents’ overall QoL and DRQoL. L’objectif de notre étude était de déterminer si la participation des adolescents atteints du diabète de type 1 (DT1) à un modèle de soins intégrés par paliers plutôt qu’à un modèle de soins courants contribuait à améliorer la qualité de vie (QdV) globale, la qualité de vie liée au diabète (QdVLD) et les concentrations de l’hémoglobine glyquée (A1c). Pour cette étude, nous avons utilisé un plan d’intervention tardive non randomisé, avant/après, en 2 groupes. Nous avons utilisé le Mind Youth Questionnaire (MY-Q) pour évaluer la QdV et la QdVLD. Les adolescents qui fréquentaient la clinique spécialisée en diabète utilisant un modèle de soins par paliers ont constitué le groupe d’intervention (n = 77). Après que ces adolescents ont rempli le MY-Q, les préoccupations relevées ont fait l’objet de discussions et ont été abordées avec eux par leur équipe de soins dans