Improving treatment adherence in adolescents with type 1 diabetes

Abstract

Compliance with physicians’ recommendations depends on the patient’s emotional state, awareness of one’s illness, parent–child relationships, social environment, level of trust in the physician, acceptance of the diagnosis, access to treatment, and many other factors. Given its distinctive characteristics, adolescence often has a negative impact on treatment adherence. Teenagers have difficulty seeing long-term consequences, and they tend to rebel and disobey the adults, aligning themselves with their peers instead. The aim of our study was to develop a program of activities to explore various psychological aspects of treatment. We created a ten-session group training program, each focusing on a specific topic: diagnosis, internal picture of the disease, treatment adherence, the impact of emotions on the course of diabetes, the impact of diabetes on the emotional state, relationships with the treating physician, communication with parents about treatment, the impact of relationships with friends on diabetes treatment, and vision of the future. Ten adolescents aged 13 to 17 with type 1 diabetes participated in the study. Quantitative and qualitative analyses of the data were used to assess changes in treatment adherence. The initial diagnosis revealed that adolescents with diabetes predominantly exhibit low to moderate levels of compliance. Following the training, a statistically significant increase in the behavioral component of compliance and a trend toward an increase in overall adherence were identified. Glycated hemoglobin (HbA1) levels were also obtained for the adolescents in November/December (before the program) and March/April (after it). Data from all the ten adolescents was available, with positive trends in seven of them, unchanged levels in two, and an increased glycated hemoglobin level (negative trend) in one. The study concluded that the program has a positive impact on the adolescents’ compliance, contributing to their feeling of peer support and acceptance and also helping parents understand adolescent behavior and get support from other parents. These results highlight the importance of testing the program on a larger sample and the potential for adapting it to adolescents with other chronic conditions.