Reciprocal peer support good option for improving diabetes management
MedWire News: Study findings support reciprocal peer support as a method of improving diabetes management.
Many patients with diabetes would benefit from assistance in self-managing their condition between clinic visits, say Michele Heisler (University of Michigan Medical School, Ann Arbor, Michigan, USA) and colleagues.
Nurse-led assistance has been shown to be effective, but providing this sort of care can be difficult in a real-life setting, especially when resources are low.
In this study, Heisler and team assessed the efficacy of reciprocal peer support (RPS), where patients are paired with another age-matched patient and given peer communication skills training, versus nurse care management (NCM) for improvement of diabetes self-management.
The researchers recruited 244 men with diabetes and glycated hemoglobin (HbA1c) levels during the preceding 6 months greater than 7.5%.
The primary outcome was 6-month change in HbA1c. In total, 113 and 103 men were randomly assigned to and completed the 6-month RPS or NCM interventions, respectively.
Mean HbA1c decreased by 0.29% in the RPS group, but increased by 0.29% in the NCM group, amounting to a significant 0.58% between-group difference.
When the researchers looked at men with an initial HbA1c greater than 8%, those in the RPS group had a reduction in HbA1c of 0.88% versus 0.07% for those in the NCM group.
The RPS patients were encouraged to talk to their paired partner at least once a week on the telephone and were given the option to attend occasional group sessions at 1, 3, and 6 months. Those in the NCM group attended an initial 1.5-hour diabetes education session and were then assigned to a Nurse Care Manager and encouraged to contact them if they needed help with their diabetes management.
Writing in the Annals of Internal Medicine, the authors write that "periodic nurse-facilitated, patient driven group sessions supplemented with one-on-one peer-support telephone calls between age-matched partners improved glycemic control and other key outcomes more than providing NCM services alone among diabetic men."
They say: "Because many chronically ill patients need more support for self-care than most health care systems can provide, models that increase the quality and intensity of assistance through peer support, such as ours, deserve further exploration."
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By Helen Albert