Pediatric Diabetes 2010: 11: 175 – 181 doi: 10.1111/j.1399-5448.2009.00543.x  2009 John Wiley & Sons A/S All rights reserved Pediatric Diabetes Original Article Follow-up results on monitoring and discussing health-related quality of life in adolescent diabetes care: benefits do not sustain in routine practice de Wit M, Delemarre-Van de Waal HA, Bokma JA, Haasnoot K, Houdijk MC, Gemke RJ, Snoek FJ. Follow-up results on monitoring and discussing health-related quality of life in adolescent diabetes care: benefits do not sustain in routine practice. Pediatric Diabetes 2010: 11: 175 – 181. Objective: We previously demonstrated that adding monitoring and discussion of health-related quality of life (HRQoL) of adolescents with type 1 diabetes to routine periodic consultations positively impacts psychosocial well-being and satisfaction with care. The current study examines whether these positive effects are maintained 1 year after the intervention was terminated and patients received regular care again, with no formal HRQoL assessment. Patients and methods: Forty-one adolescents with type 1 diabetes were followed for 1 year after the initial HRQoL intervention, in which their HRQoL had been assessed and discussed as part of period consultations using the PedsQL. Changes in physical and psychosocial well-being [Child Health Questionnaire-Child Form 87 (CHQ-CF87), diabetes family conflict scale (DFCS), Center for Epidemiological Studies scale for Depression (CES-D)], satisfaction with care [Patients’ Evaluation of the Quality of Diabetes (PEQ-D) care], and glycemic control (HbA 1c ) were determined 12 months after the HRQoL intervention had ended. Results: One year after the HRQoL intervention, mean scores on CHQ subscales: behavior (p = 0.001), mental health (p = 0.004), and self-esteem (p < 0.001) had decreased, whereas the family activities subscale remained stable. Adolescents were less satisfied with their care (p = 0.012), and HbA 1c values had increased significantly 12 months postintervention (p = 0.002). Conclusions: The beneficial effects of an office-based HRQoL intervention in adolescents with diabetes largely disappear 1 year after withdrawing the HRQoL assessment procedure. This finding underscores the importance of integrating standardized evaluation and discussion of HRQoL in routine care for adolescents with diabetes. Maartje de Wit a,b , Henriette A. Delemarre-van de Waal c , Jan Alle Bokma d , Krijn Haasnoot e , Mieke C Houdijk f , Reinoud J Gemke g and Frank J Snoek a,b a Department of Medical Psychology, VU University Medical Center, P. O. Box 7057, 1007 MB Amsterdam, The Netherlands; b EMGO Institute, VU University Medical Center, P. O. Box 7057, 1007 MB Amsterdam, The Netherlands; c Department of Pediatrics, Leiden University Medical Center, P. O. Box 9600, 2300 RC Leiden, The Netherlands; d Department of Pediatrics, Spaarne Ziekenhuis, P. O. Box 770, 2130 AT Hoofddorp, The Netherlands; e Department of Pediatrics, Medical Center Alkmaar, P. O. Box 501, 1800 AM Alkmaar, The Netherlands; f Department of Pediatrics, Juliana Kinderziekenhuis, Sportlaan 600, 2566 MJ Den Haag, The Netherlands; and g Department of Pediatrics, VU University Medical Center, P. O. Box 7057, 1007 MB Amsterdam, The Netherlands Key words: adolescents – HbA1c – psychology – quality of life – RCT Corresponding author: M. de Wit, PhD Department of Medical Psychology, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands. Tel: +31 20 4448224; fax: +31 20 4448230; e-mail: m.dewit@vumc.nl Submitted 2 February 2009. Accepted for publication 6 May 2009 It is well recognized that optimal care for children with a chronic illness should include attention not only for medical outcomes but also for quality of life (1). The measurement of health-related quality of life (HRQoL) is therefore increasingly advocated to be included in routine care (2). Clinical guidelines indeed recommend periodic evaluation and discussion of children’s HRQoL, to ensure recognition of the child’s perspective, to identify psychosocial barriers, and to promote healthy coping (3, 4). We, recently, were the first to demonstrate in a randomized controlled trial (RCT) that monitoring and discussing HRQoL as part of routine pediatric diabetes practice significantly improves teenagers’ psychosocial well-being and 175