Abstract
Aims To assess whether the improved service provision introduced under the new Paediatric Diabetes Best Practice Tariff, which includes increased contact with the multi-disciplinary team and greater access to psychology support, has impacted positively on the quality of life of young people with diabetes. Method In 2011 n=55 children and young people completed the Generic Paediatric Quality of Life Inventory (PedsQL) and the PedsQL Diabetes Module, while waiting for their clinic review appointment with the Paediatric Diabetes team at a large teaching hospital. Following the introduction of an enhanced service under the Best Practice Tariff in 2012, n=77 children and young people completed the same questionnaires in 2015, as part of their standard annual wellbeing review. The two cohorts were comparable in terms of gender and age. Results Quality of life scores relating to the management of diabetes and adherence to treatment were significantly higher in the 2015 cohort as compared with the 2011 cohort: mean (SD) Treatment Barriers score 77.4 (18.4) v 68.9 (19.0), p = 0.012; mean (SD) Treatment Adherence score 83.1 (14.3) v 77.6 (15.5), p=0.036. Other comparisons between cohorts were not statistically significant. Further analyses performed on the 2015 cohort, to determine associations with gender and age, revealed that older children ( r = 0.24, p=0.036) and girls (mean (SD): girls 73.7 (13.6) v boys 81.7 (11.2), p=0.007) were found to have lower total scores on the Generic PedsQL. Conclusion The increased provision of support following the introduction of the Best Practice Tariff in 2012, was associated with an improvement in the self-reported quality of life of children and young people seen by the Paediatric Diabetes team, in relation to the management of their condition. However older children and girls appeared to be at greater risk of poor quality of life generally and therefore may need additional provision specifically geared to their needs.
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