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Peer support for patients with type 2 diabetes: cluster randomised controlled trial.
Smith, S M; Paul, G; Kelly, A; Whitford, David L; O'Shea, E; O'Dowd, T
<p>This article is also available at http://www.bmj.com/content/342/bmj.d715</p> <p>OBJECTIVE: To test the effectiveness of peer support for patients with type 2 diabetes.</p> <p>DESIGN: Cluster randomised controlled.</p> <p>SETTING: 20 general practices in the east of the Republic of Ireland.</p> <p>PARTICIPANTS: 395 patients (192 in intervention group, 203 in control group) and 29 peer supporters with type 2 diabetes.</p> <p>INTERVENTION: All practices introduced a standardised diabetes care system. The peer support intervention ran over a two year period and contained four elements: the recruitment and training of peer supporters, nine group meetings led by peer supporters in participant's own general practice, and a retention plan for the peer supporters.</p> <p>MAIN OUTCOME MEASURES: HbA(1c); cholesterol concentration; systolic blood pressure; and wellbeing score.</p> <p>RESULTS: There was no difference between intervention and control patients at baseline. All practices and 85% (337) of patients were followed up. At two year follow-up, there were no significant differences in HbA(1c) (mean difference -0.08%, 95% confidence interval -0.35% to 0.18%), systolic blood pressure (-3.9 mm Hg, -8.9 to 1.1 mm Hg), total cholesterol concentration (-0.03 mmol/L, -0.28 to 0.22 mmol/L), or wellbeing scores (-0.7, -2.3 to 0.8). While there was a trend towards decreases in the proportion of patients with poorly controlled risk factors at follow-up, particularly for systolic blood pressure (52% (87/166) >130 mm Hg in intervention v 61% (103/169) >130 mm Hg in control), these changes were not significant. The process evaluation indicated that the intervention was generally delivered as intended, though 18% (35) of patients in the intervention group never attended any group meetings.</p> <p>CONCLUSIONS: A group based peer support intervention is feasible in general practice settings, but the intervention was not effective when targeted at all patients with type 2 diabetes. While there was a trend towards improvements of clinical outcomes, the results do not support the widespread adoption of peer support. Trial registration Current Controlled Trials ISRCTN42541690.</p>
Keyword(s): General practice; type 2 diabetes; cluster; randomised trial; Community Health and Preventive Medicine; Medicine and Health Sciences; Public Health
Publication Date:
2011
Type: Journal article
Peer-Reviewed: Yes
Institution: Royal College of Surgeons in Ireland
Citation(s): Smith SM, Paul G, Kelly A, Whitford DL, O'Shea E, O'Dowd T. Peer support for patients with type 2 diabetes: cluster randomised controlled trial. British Medical Journal. 2011 Feb 15;342:d715.
Publisher(s): British Medical Association
File Format(s): application/pdf
Related Link(s): http://epubs.rcsi.ie/fcmmubart/9/
First Indexed: 2015-07-31 15:35:54 Last Updated: 2018-02-13 07:21:40