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The case for multidisciplinary input: psychosocial screening for young adults attending a multidisciplinary diabetes clinic (#78)

Helen d'Emden 1 , Brett McDermott 2 , Thomas Dover 1 , Kristen Gibbons 3 , Trisha O'Moore-Sullivan 1
  1. Mater Misericordiae Health Services Brisbane Ltd, South Brisbane, QLD, Australia
  2. School of Medicine and Dentistry, James Cooke University, Townsville, Qld, Australia
  3. Mater Research Office, University of Queensland, Brisbane, QLD, Australia

Aims

To investigate young adults with diabetes attending a multidisciplinary diabetes clinic, profiling demographic, medical and psychosocial characteristics, and to ascertain allied health service requirements.

Methods

Indices of diabetes control and recorded diabetes complications were complimented by psychosocial screening tools assessing psychological, diabetes specific, and perceived stress  (K10, PAID, PSS), well-being (WHO-5), disordered eating (EDI-3RC; compensatory behaviour questionnaire), social support (MSPSS), resilience (CD-2) and financial concerns. Service provision and demographic data were also collected.

Results

Psychosocial screening was well accepted (99% of those approached). Participants (151) were mostly Caucasian (98.7%) with type 1 diabetes (98.7%) and intensively managed (96.7%). Most (94.7%) lived in a metropolitan region. Glycaemic control was suboptimal HbA1c 8.0 IQR 1.8%/64 IQR 22 mmol/mol. Severe diabetes related distress (PAID≥40) was found in 19.4% and 26% reported difficulties managing health care costs. A mental health disorder was likely in 9.7%, whilst 52.4% had moderate/high K10 scores. Low WHO-5 scores (< 13) were seen in 29.0%. Risk for an eating disorder (EDI-3RC) was 12.7%, whereas approximately 36% had disturbed eating behaviours. Mean PSS scores were 15.8 ± 7.6, the median MSPSS 6.0 IQR 1.7, and resilience as CD-2 6.0 (IQR 2). We identified 59.1% participants would benefit from additional allied health support, above routine clinical care and education.

Conclusions

A range of psychosocial challenges were reported indicating 60% need additional allied health support over and above routine care and education. Psychosocial screening was well accepted and useful for matching impairment with more intense multidisciplinary input.

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