Educational and psychosocial programmes for adolescents with diabetes: approaches, outcomes and cost-effectiveness

• Published in: Patient education and counseling 2004-06, Vol.53 (3), p.333-346
• Main Authors: Gage, Heather, Hampson, Sarah, Skinner, T.Chas, Hart, Jo, Storey, Lesley, Foxcroft, David, Kimber, Alan, Cradock, Sue, McEvilly, E.Adele
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescent Health Services - organization & administration; Adolescents; Attitude to Health; Cost-Benefit Analysis; Cost-effectiveness; Diabetes; Diabetes Mellitus, Type 1 - prevention & control; Diabetes Mellitus, Type 1 - psychology; Educational programmes; Evaluation Studies as Topic; Health Knowledge, Attitudes, Practice; Humans; Narration; Needs Assessment; Nursing; Outcome Assessment (Health Care) - organization & administration; Patient Education as Topic - organization & administration; Program Evaluation; Psychology, Adolescent; Research Design; Self Care - psychology; Self-Help Groups - organization & administration
• ISSN: 0738-3991; 1873-5134
• DOI: 10.1016/j.pec.2003.06.003

Diabetes incurs heavy personal and health system costs. Self-management is required if complications are to be avoided. Adolescents face particular challenges as they learn to take responsibility for their diabetes. A systematic review of educational and psychosocial programmes for adolescents with diabetes was undertaken. This aimed to: identify and categorise the types of programmes that have been evaluated; assess the cost-effectiveness of interventions; identify areas where further research is required. Sixty-two papers were identified and subjected to a narrative review. Generic programmes focus on knowledge/skills, psychosocial issues, and behaviour/self-management. They result in modest improvements across a range of outcomes but improvements are often not sustained, suggesting a need for continuous support, possibly integrated into normal care. In-hospital education at diagnosis confers few advantages over home treatment. The greatest returns may be obtained by targeting poorly controlled individuals. Few studies addressed resourcing issues and robust cost-effectiveness appraisals are required to identify interventions that generate the greatest returns on expenditure.