The DOI matches its Crossref record; 47 of the 48 references it cites were found in a registry or an index.
Motivational Enhancement Therapy with and without Cognitive Behavior Therapy to Treat Type 1 Diabetes: A Randomized Trial
Abstract
BACKGROUND: Although psychological issues can interfere with diabetes care, the effectiveness of psychological treatments in improving diabetes outcomes is uncertain. OBJECTIVE: To determine whether motivational enhancement therapy with or without cognitive behavior therapy improves glycemic control in type 1 diabetes compared with usual care. DESIGN: Randomized, controlled trial. SETTING: 8 diabetes centers in London and Manchester, United Kingdom. PATIENTS: 344 adults with type 1 diabetes for longer than 2 years, with hemoglobin A(1c) levels of 8.2% to 15%, and without complications or severe comorbid disease. INTERVENTION: Nurse-delivered motivational enhancement therapy (4 sessions over 2 months), motivational enhancement therapy plus cognitive behavior therapy (12 sessions over 6 months), or usual care. MEASUREMENTS: 12-month change in hemoglobin A(1c) levels (primary outcome), hypoglycemic events, depression, quality of life, fear of hypoglycemia, diabetes self-care activities, and body mass index (secondary outcomes). RESULTS: In an analysis including all randomly assigned patients, the 12-month change in hemoglobin A(1c) levels compared with usual care was -0.46% (95% CI, -0.81% to -0.11%) in the motivational enhancement therapy plus cognitive behavior therapy group and -0.19% (CI, -0.53% to 0.16%) in the motivational enhancement therapy group alone. There was no evidence of treatment effects on secondary outcomes. LIMITATIONS: Of 1659 screened patients, only 507 were eligible and 344 participated. Data on the primary outcome were unavailable for 11.3% of the participants. Study design did not permit distinction of the additive effect of cognitive behavior therapy plus motivational enhancement therapy from the effect of greater intensity and duration of the combined intervention compared with the motivational enhancement therapy alone. CONCLUSION: Nurse-delivered motivational enhancement therapy and cognitive behavior therapy is feasible for adults with poorly controlled type 1 diabetes. Combined therapy results in modest 12-month improvement in hemoglobin A(1c) levels compared with usual care, but motivational enhancement therapy alone does not.
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“For example, in a comparative effectiveness trial, MET alone was not effective in improving outcomes in patients with type 1 diabetes, but when combined with a second intervention it did result in improved clinical outcomes [121].”
From Positive Psychological Interventions for Patients with Type 2 Diabetes: Rationale, Theoretical Model, and Intervention Development (2015) · cites this paper as [121]
In the citing paper
“Fortunately, MI and MET have been successfully combined with additional interventions in numerous populations, including interventions targeting weight control or health behaviors in those with medical illness.”
From Positive Psychological Interventions for Patients with Type 2 Diabetes: Rationale, Theoretical Model, and Intervention Development (2015) · cites this paper as [121]
Citations
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Lundahl, B., Moleni, T., Burke, B. L., Butters, R., Tollefson, D., Butler, C., & Rollnick, S. (2013) · Patient Education and Counseling · doi:10.1016/j.pec.2013.07.012 · Cited by 909
“Six research groups assessed other quality of life indicators [45–50] including worry, anxiety, depression, pain, and adjustment to diseases such as diabetes, stroke, and chronic heart failure, which together showed a statistically significant advantage for MI.”
BackgroundReview of Motivational Interviewing in promoting health behaviors
Martins, R. K., & McNeil, D. W. (2009) · Clinical Psychology Review · doi:10.1016/j.cpr.2009.02.001 · Cited by 584
“Participants in five studies were diagnosed with Type 1 diabetes (i.e., Channon et al., 2003, 2007; Ismail et al., 2008; Knight et al., 2003; Viner et al., 2003), whereas four studies focused on individuals with Type 2 diabetes (i.e., Brug et al., 2007; Clark & Hampson, 2001; Smith et al., 1997;…”
BackgroundHarkness, E., Macdonald, W., Valderas, J., Coventry, P., Gask, L., & Bower, P. (2010) · Diabetes Care · doi:10.2337/dc09-1519 · Cited by 188
“Effective treatment of depressive symptoms in patients with diabetes often fails to improve glycemic control (12) and vice versa (13).”
BackgroundChristie, D., & Channon, S. (2014) · Diabetes, Obesity and Metabolism · doi:10.1111/dom.12195 · Cited by 180
Behavioral Programs for Type 1 Diabetes Mellitus
Pillay, J., Armstrong, M. J., Butalia, S., Donovan, L., Sigal, R. J., Chordiya, P., Dhakal, S., Vandermeer, B., Hartling, L., Nuspl, M., et al. (2015) · Annals of Internal Medicine · doi:10.7326/m15-1399 · Cited by 183
“Favors Behavioral Program Favors Usual Care −3 −2 −1 0 1 2 3 Mean Difference (95% CI) Study, Year (Reference) Youths Boardway et al, 1993 (41) Cook et al, 2002 (43) Couper et al, 1999 (44) Ellis et al, 2007 (46) Husted et al, 2014 (51) McNabb et al, 1994 (59) Murphy et al, 2012 (60) Nansel et al, 2007 (63) Nansel et a…”
Background
Metadata
- Authors
- Ismail, K., Thomas, S. M., Maissi, E., Chalder, T., Schmidt, U., Bartlett, J., Patel, A., Dickens, C. M., Creed, F., & Treasure, J.
- Affiliations
- St Thomas' Hospital (GB)
- From King's College London, Guy's and St Thomas' Hospitals, and London School of Hygiene & Tropical Medicine, London, United Kingdom, and the University of Manchester, Manchester, United Kingdom.
- ORCID
- Venue
- Annals of Internal Medicine
- Publisher
- American College of Physicians
- Published
- 2008-11-18
- Volume
- 149
- Issue
- 10
- Pages
- 708-719
- ISSN
- 0003-4819 (ISSN-L)
- 1539-3704
- OpenAlex
- W2004352160
- Cited by
- 91
- References
- 48
- Citations by year
- 2025: 3 · 2024: 5 · 2023: 2 · 2022: 1 · 2021: 4 · 2020: 3 · 2019: 3 · 2018: 8 · 2017: 3 · 2016: 4 · 2015: 10 · 2014: 4 · 2013: 5 · 2012: 8
- FWCI
- 6.75
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- Research Explorer (The University of Manchester) (submittedVersion)
- Funders
- National Institute for Health and Care Research (01/17/05)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Keywords
- type 1 diabetes, motivational enhancement therapy, cognitive behavioral therapy, glycemic control, HbA1c, psychological intervention, hypoglycemia, diabetes self-care, depression, quality of life, fear of hypoglycemia
- MeSH terms
- Adult, Aged, Combined Modality Therapy, Depression, Diabetes Mellitus, Type 1, Female, Glycated Hemoglobin, Humans, Hypoglycemia, Hypoglycemic Agents, Insulin, Male, Middle Aged, Motivation, Nursing Care, Sensitivity and Specificity, Cognitive Behavioral Therapy, Young Adult
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