Peer support vs nurse care management for diabetic patients

January 01, 0001

Peer support vs nurse care management for diabetic patients

These US authors compared a reciprocal peer-support (RPS) program with nurse care management (NCM) in a randomized, controlled trial conducted in 2 US Department of Veterans Affairs health care facilities. Participants were 244 men with hemoglobin A1c (HbA1c) levels greater than 7.5% during the previous 6 months. Patients in the RPS group attended an initial group session to set diabetes-related behavioral goals, receive peer communication skills training, and be paired with another age-matched peer patient. Peers were encouraged to talk weekly using a telephone platform that recorded call occurrence and provided reminders to promote peer contact. These patients could also participate in optional group sessions at 1, 3, and 6 months. Patients in the NCM group attended a 1.5-hour educational session and were assigned to a nurse care manager.

They found: "Of the 244 patients enrolled, 216 (89%) completed the HbA1c assessments and 231 (95%) completed the survey assessments at 6 months. Mean HbA1c level decreased from 8.02% to 7.73% in the RPS group and increased from 7.93% to 8.22% (change, 0.29%) in the NCM group. The difference in HbA1c change between groups was 0.58% (P = 0.004). Among patients with a baseline HbA1c level greater than 8.0%, those in the RPS group had a mean decrease of 0.88%, compared with a 0.07% decrease among those in the NCM group. Eight patients in the RPS group started insulin therapy, compared with 1 patient in the NCM group (significant). Groups did not differ in blood pressure, self- reported medication adherence, or diabetes-specific distress, but the RPS group reported improvement in diabetes social support."

The authors concluded: "Reciprocal peer support holds promise as a method for diabetes care management."

This study should be repeated in other populations.

For the full abstract, click here.

Annals of Internal Medicine 153(8):507-515, 19 October 2010
© 2010 to the American College of Physicians
Diabetes Control With Reciprocal Peer Support Versus Nurse Care Management-A Randomized Trial. Michele Heisler, Sandeep Vijan, Fatima Makki, and John D. Piette. Correspondence to Dr. Heisler: [email protected]

Category: HSR. Health Services Research, T. Endocrine/Metabolic/Nutritional. Keywords: diabetes mellitus type 2, glycohemoglobin, HbA1c, nurse care management, peer support, randomized controlled trial, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 9 November 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.