SYLVIE NAAR-KING, PHD1

OBJECTIVE — The study aim was to determine if multisystemic therapy (MST), an intensive home-based psychotherapy, could reduce hospital admissions for diabetic ketoacidosis (DKA) in youth with poorly controlled type 1 diabetes over 24 months. Potential cost savings from reductions in admissions were also evaluated. RESEARCHDESIGNANDMETHODS — A total of 127 youth were randomly assigned to MST or control groups and also received standard medical care. RESULTS — Youth who received MST had significantly fewer hospital admissions than con-trol subjects (2 11.77, 4 d.f., n 127; P 0.019). MST-treated youth had significantly fewer admissions versus their baseline rate at 6-month (P 0.004), 12-month (P 0.021), 18-month (P 0.046), and 24-month follow-up (P 0.034). Cost to provide MST was 6,934 USD per youth; however, substantial cost offsets occurred from reductions in DKA admissions. CONCLUSIONS — The study demonstrates the value of intensive behavioral interventions for high-risk youth with diabetes for reducing one of the most serious consequences of medica-tion noncompliance. Diabetes Care 31:1746–1747, 200