medwireNews: Results of a cluster randomized trial suggest that supplementing diabetes education programs with peer support could lessen disease-associated distress for patients with type 2 diabetes.
Zilin Sun, from Southeast University in Nanjing, China, and study co-authors found that the 142 patients who were randomly assigned to receive peer support in addition to usual diabetes education reported significantly lower levels of overall diabetes distress at the 1-year follow-up than the 163 patients who received education alone, with mean scores of 1.2 versus 1.3 points on a 1–6 point scale.
The peer support intervention was led by trained peer leaders, who shared diabetes knowledge and skills with participants through guided activities at least once a month, as well as via regular communication including home visits, emails, and telephone calls for 1 year. Sun and team explain that “[m]any participants knew each other and had frequent occasion to meet each other informally within their communities,” meaning that “there was a variety of ways to increase knowledge about diabetes and self-management.”
Participants in both the peer support and control groups received 2 hours of standard diabetes self-management education per month from a variety of healthcare providers including physicians, nurses, psychologists, and certified diabetes educators.
In addition to the overall benefit of the intervention on diabetes distress, the researchers found that patients in the peer support group experienced improvement in some of the diabetes distress subscales at the 1-year follow-up.
For example, those receiving peer support had significantly lower average scores for emotional burden (1.2 vs 1.4 points) and physician-related distress (1.1 vs 1.3 points) than those given standard education alone, but there was no significant difference in regimen- and interpersonal-related distress between the two groups at this timepoint.
Furthermore, patients in the peer support group had significantly lower levels of fasting plasma glucose than those in the control group, at a mean of 7.0 versus 7.6 mmol/mol. There was no significant difference in postprandial glucose and glycated hemoglobin levels between the two groups, however.
These results suggest that “[e]ducational interventions that involve patient collaboration may be more effective than didactic interventions aimed at improving glycaemic control,” write the study authors in Diabetic Medicine.
They concede that their trial was limited by a number of factors, including generalizability to other settings and high dropout rates over the 1-year study period, at 29.0% in the peer support group and 18.5% in the control group.
“The greater drop-out rate in the usual education with peer support arm may have reflected the time demands of participation in the peer support group and may have biased results in favour of that study arm,” they suggest.
Nonetheless, Sun and team believe that “[f]or community health centres, peer support could be a viable and economical evidence-based option that needs fewer financial and human resources than interventions involving professional staff.”
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