Carman and Ann Adams Department of Pediatrics, Wayne State University, Detroit, MI, USA.
Ann Behav Med. 2012 Oct;44(2):207-15. doi: 10.1007/s12160-012-9378-1.
Few interventions have effectively improved health outcomes among youth with diabetes in chronic poor metabolic control.
This study aims to determine whether multisystemic therapy (MST), an intensive, home-based, tailored family treatment, was superior to weekly telephone support for improving regimen adherence and metabolic control among adolescents with chronic poor metabolic control.
A randomized controlled trial was conducted with 146 adolescents with types 1 or 2 diabetes. Data were collected at baseline, 7 months (treatment termination), and 12 months (6 months follow-up).
Adolescents receiving MST had significantly improved metabolic control at 7 (1.01 % decrease) and 12 months (0.74 % decrease) compared to adolescents in telephone support. Parents of adolescents receiving MST reported significant improvements in adolescent adherence. However, adolescent-reported adherence was unchanged.
MST improved health outcomes among adolescents with chronic poor metabolic control when compared to telephone support. Home-based approaches may provide a viable means to improve access to behavioral interventions for such youth.
很少有干预措施能有效改善代谢控制不佳的青少年的健康结果。
本研究旨在确定多系统治疗（MST），一种强化的、以家庭为基础的、个性化的家庭治疗，是否优于每周电话支持，以提高青少年的治疗依从性和代谢控制，这些青少年的代谢控制不佳是慢性的。
对 146 名 1 型或 2 型糖尿病青少年进行了随机对照试验。在基线、7 个月（治疗结束）和 12 个月（6 个月随访）时收集数据。
与接受电话支持的青少年相比，接受 MST 的青少年在 7 个月（降低 1.01%）和 12 个月（降低 0.74%）时代谢控制显著改善。接受 MST 的青少年的父母报告说，青少年的依从性有了显著提高。然而，青少年自我报告的依从性没有改变。
与电话支持相比，MST 改善了代谢控制不佳的青少年的健康结果。基于家庭的方法可能为改善此类青少年获得行为干预提供可行的途径。
