Monitoring of psychological well-being in outpatients with diabetes - Effects on mood, HbA(1c), and the patient's evaluation of the quality of diabetes care: a randomized controlled trial

OBJECTIVE - To investigate whether monitoring and discussing psychological well-being in outpatients,,vith diabetes improves mood, glycemic control, a nd the patient's evaluation of the quality of diabetes care. RESEARCH DESIGN AND METHODS - This study was a randomized controlled trial of 461 outpatients with diabetes who were randomly assigned to standard car e or to the monitoring condition. In the latter group, the diabetes nurse s pecialist assessed and discussed Psychological well-being with the patient (with an interval of 6 months) in addition to standard care. The computeriz ed Well-being Questionnaire was used for this purpose. Primary outcomes wer e mood, HbA(1c), and the patient's evaluation of the quality of diabetes ca re at I-year follow-up. The number of referrals to the psychologist was ana lyzed as a secondary outcome, Intention-to-treat analysis was used. RESULTS - The monitoring group reported better mood compared with the stand ard care group, as indicated by significantly lower negative well-being and significantly higher levels of energy, higher general well-being, better m ental health, and a more positive evaluation of the quality of the emotiona l support received from the diabetes nurse. The two groups did not differ f or HbA(1c) or in their overall evaluation of the quality of diabetes care. In the monitoring condition, significantly more subjects were referred to t he psychologist. CONCLUSIONS - Monitoring and discussing psychological well-being as part of routine diabetes outpatient care had favorable effects on the mood of pati ents but did not affect their HbA(1c). Our results support the recommendati on to monitor psychological well-being in patients with diabetes.