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. 2017 Feb 9;5(1):e000307.
doi: 10.1136/bmjdrc-2016-000307. eCollection 2017.

Problem-solving therapy for adults with diabetic retinopathy and diabetes-specific distress: a pilot randomized controlled trial

Gwyneth Rees  1 , Fleur O'Hare  1 , Marian Saeed  1 , Bronwyn Sudholz  2 , Bonnie A Sturrock  1 , Jing Xie  1 , Jane Speight  3 , Ecosse L Lamoureux  4
Affiliations

Problem-solving therapy for adults with diabetic retinopathy and diabetes-specific distress: a pilot randomized controlled trial

Gwyneth Rees et al. BMJ Open Diabetes Res Care. .

Abstract

Objective: To provide preliminary evidence for the impact of problem-solving therapy for diabetes (PST-D) in adults with diabetic retinopathy (DR) and diabetes distress.

Research design and methods: In a pilot randomized controlled trial, 40 participants with DR and diabetes distress were allocated to the PST-D or control groups. Diabetes distress (DDS), depressive symptoms (PHQ-9), self-care activities (SDSCA), and HbA1c were assessed at baseline, and 3 and 6-month follow-ups.

Results: At the 6-month follow-up, the PST-D group showed significant improvements relative to the control group, in 'regimen-related distress' (PST-D: -1.3±1.4; control: -0.4±1.1), depressive symptoms (PST-D: -4.3±6.1; control: -0.3±4.6), and HbA1c (PST-D: -1.2%±1.01; control: 0.2%±1.2%) (all p<0.05). In multiple regression analysis, adjusting for baseline values and sociodemographic factors, PST-D was associated with significant improvement in 'regimen-related distress', depressive symptoms, and HbA1c at the 6-month follow-up (p<0.05).

Conclusions: PST-D is a promising intervention for improving psychological outcomes and glycemic control. A fully powered study is required to confirm these findings and examine mechanisms of change in HbA1c.

Trial registration number: ACTRN12616001010482; results.

Keywords: Psychological Aspects; Psychology/Behavior; Psychosocial Depression; Retinopathy.

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Conflict of interest statement

Competing interests: None declared.

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