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A multi-centre randomised controlled trial of motivational interviewing in teenagers with diabetes

¹Consultant Clinical Psychologist, Department of Child Psychology, Cardiff and Vale NHS Trust
²Lecturer in Mental Health, School of Nursing and Midwifery studies, Cardiff University
³Professor of Healthcare Communication, Department of General Practice, Cardiff University
⁴Director, South East Wales Trial Unit, Cardiff University
⁵Statistician, Department of General Practice, Cardiff University
⁶School Nurse, Department of School Health Nursing, Cardiff and Vale NHS Trust
⁷Professor of Paediatric Endocrinology, Department of Child Health, Cardiff University

sue.channon{at}cardiffandvale.wales.nhs.uk

ABSTRACT

Objective:: To examine the efficacy of Motivational Interviewing with teenagers aged 14-17 years with Type 1 diabetes.

Research Design and Methods:: In a randomised controlled trial analysed by intention to treat, 66 teenagers with Type 1 diabetes attending diabetes clinics in South Wales UK were randomly assigned to the intervention group (38) and to the control group (28). Teenagers in the intervention group received Motivational Interviewing and the control group received support visits. All participants received individual sessions over 12 months. The main outcome measures assessed at baseline, 6, 12 and 24 months were serum glycosylated haemoglobin concentrations (HbA1c), psychosocial self-report questionnaires including quality of life and well-being measures.

Results:: Sixty patients had complete data at 12 months. At the end of the intervention (12 months) the mean HbA1c in the Motivational Interviewing group was significantly lower than in the control group (p=0.04), after adjusting for baseline values. At 24 months (when N=47) this difference in HbA1c was maintained (p=0.003). There were differences in psychosocial variables at 12 months, with the Motivational Interviewing group indicating more positive well-being, improved quality of life and differences in their personal models of illness (all p<0.01). Some of these differences were maintained at 24 months.

Conclusions:: Motivational Interviewing can be an effective method of facilitating teenagers with type 1 diabetes to make behaviour changes with subsequent improvement in their glycaemic control.

Trial Registration:: Clinicaltrials.gov ID: NCT00326573

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