Cargando…
Impact of Community Based Peer Support in Type 2 Diabetes: A Cluster Randomised Controlled Trial of Individual and/or Group Approaches
BACKGROUND: Diabetes peer support, where one person with diabetes helps guide and support others, has been proposed as a way to improve diabetes management. We have tested whether different diabetes peer support strategies can improve metabolic and/or psychological outcomes. METHODS: People with typ...
Autores principales: | , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2015
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4364716/ https://www.ncbi.nlm.nih.gov/pubmed/25785452 http://dx.doi.org/10.1371/journal.pone.0120277 |
_version_ | 1782362113760559104 |
---|---|
author | Simmons, David Prevost, A. Toby Bunn, Chris Holman, Daniel Parker, Richard A. Cohn, Simon Donald, Sarah Paddison, Charlotte A. M. Ward, Candice Robins, Peter Graffy, Jonathan |
author_facet | Simmons, David Prevost, A. Toby Bunn, Chris Holman, Daniel Parker, Richard A. Cohn, Simon Donald, Sarah Paddison, Charlotte A. M. Ward, Candice Robins, Peter Graffy, Jonathan |
author_sort | Simmons, David |
collection | PubMed |
description | BACKGROUND: Diabetes peer support, where one person with diabetes helps guide and support others, has been proposed as a way to improve diabetes management. We have tested whether different diabetes peer support strategies can improve metabolic and/or psychological outcomes. METHODS: People with type 2 diabetes (n = 1,299) were invited to participate as either ‘peer’ or ‘peer support facilitator’ (PSF) in a 2x2 factorial randomised cluster controlled trial across rural communities (130 clusters) in England. Peer support was delivered over 8–12 months by trained PSFs, supported by monthly meetings with a diabetes educator. Primary end point was HbA1c. Secondary outcomes included quality of life, diabetes distress, blood pressure, waist, total cholesterol and weight. Outcome assessors and investigators were masked to arm allocation. Main factors were 1:1 or group intervention. Analysis was by intention-to-treat adjusting for baseline. RESULTS: The 4 arms were well matched (Group n = 330, 1:1(individual) n = 325, combined n = 322, control n = 322); 1035 (79•7%) completed the mid-point postal questionnaire and 1064 (81•9%) had a final HbA1c. A limitation was that although 92.6% PSFs and peers were in telephone contact, only 61.4% of intervention participants attended a face to face session. Mean baseline HbA1c was 57 mmol/mol (7•4%), with no significant change across arms. Follow up systolic blood pressure was 2•3mm Hg (0.6 to 4.0) lower among those allocated group peer-support and 3•0mm Hg (1.1 to 5.0) lower if the group support was attended at least once. There was no impact on other outcomes by intention to treat or significant differences between arms in self-reported adherence or medication. CONCLUSIONS: Group diabetes peer support over 8–12 months was associated with a small improvement in blood pressure but no other significant outcomes. Long term benefits should be investigated. TRIAL REGISTRATION: ISRCTN.com ISRCTN6696362166963621 |
format | Online Article Text |
id | pubmed-4364716 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-43647162015-03-23 Impact of Community Based Peer Support in Type 2 Diabetes: A Cluster Randomised Controlled Trial of Individual and/or Group Approaches Simmons, David Prevost, A. Toby Bunn, Chris Holman, Daniel Parker, Richard A. Cohn, Simon Donald, Sarah Paddison, Charlotte A. M. Ward, Candice Robins, Peter Graffy, Jonathan PLoS One Research Article BACKGROUND: Diabetes peer support, where one person with diabetes helps guide and support others, has been proposed as a way to improve diabetes management. We have tested whether different diabetes peer support strategies can improve metabolic and/or psychological outcomes. METHODS: People with type 2 diabetes (n = 1,299) were invited to participate as either ‘peer’ or ‘peer support facilitator’ (PSF) in a 2x2 factorial randomised cluster controlled trial across rural communities (130 clusters) in England. Peer support was delivered over 8–12 months by trained PSFs, supported by monthly meetings with a diabetes educator. Primary end point was HbA1c. Secondary outcomes included quality of life, diabetes distress, blood pressure, waist, total cholesterol and weight. Outcome assessors and investigators were masked to arm allocation. Main factors were 1:1 or group intervention. Analysis was by intention-to-treat adjusting for baseline. RESULTS: The 4 arms were well matched (Group n = 330, 1:1(individual) n = 325, combined n = 322, control n = 322); 1035 (79•7%) completed the mid-point postal questionnaire and 1064 (81•9%) had a final HbA1c. A limitation was that although 92.6% PSFs and peers were in telephone contact, only 61.4% of intervention participants attended a face to face session. Mean baseline HbA1c was 57 mmol/mol (7•4%), with no significant change across arms. Follow up systolic blood pressure was 2•3mm Hg (0.6 to 4.0) lower among those allocated group peer-support and 3•0mm Hg (1.1 to 5.0) lower if the group support was attended at least once. There was no impact on other outcomes by intention to treat or significant differences between arms in self-reported adherence or medication. CONCLUSIONS: Group diabetes peer support over 8–12 months was associated with a small improvement in blood pressure but no other significant outcomes. Long term benefits should be investigated. TRIAL REGISTRATION: ISRCTN.com ISRCTN6696362166963621 Public Library of Science 2015-03-18 /pmc/articles/PMC4364716/ /pubmed/25785452 http://dx.doi.org/10.1371/journal.pone.0120277 Text en © 2015 Simmons et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. |
spellingShingle | Research Article Simmons, David Prevost, A. Toby Bunn, Chris Holman, Daniel Parker, Richard A. Cohn, Simon Donald, Sarah Paddison, Charlotte A. M. Ward, Candice Robins, Peter Graffy, Jonathan Impact of Community Based Peer Support in Type 2 Diabetes: A Cluster Randomised Controlled Trial of Individual and/or Group Approaches |
title | Impact of Community Based Peer Support in Type 2 Diabetes: A Cluster Randomised Controlled Trial of Individual and/or Group Approaches |
title_full | Impact of Community Based Peer Support in Type 2 Diabetes: A Cluster Randomised Controlled Trial of Individual and/or Group Approaches |
title_fullStr | Impact of Community Based Peer Support in Type 2 Diabetes: A Cluster Randomised Controlled Trial of Individual and/or Group Approaches |
title_full_unstemmed | Impact of Community Based Peer Support in Type 2 Diabetes: A Cluster Randomised Controlled Trial of Individual and/or Group Approaches |
title_short | Impact of Community Based Peer Support in Type 2 Diabetes: A Cluster Randomised Controlled Trial of Individual and/or Group Approaches |
title_sort | impact of community based peer support in type 2 diabetes: a cluster randomised controlled trial of individual and/or group approaches |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4364716/ https://www.ncbi.nlm.nih.gov/pubmed/25785452 http://dx.doi.org/10.1371/journal.pone.0120277 |
work_keys_str_mv | AT simmonsdavid impactofcommunitybasedpeersupportintype2diabetesaclusterrandomisedcontrolledtrialofindividualandorgroupapproaches AT prevostatoby impactofcommunitybasedpeersupportintype2diabetesaclusterrandomisedcontrolledtrialofindividualandorgroupapproaches AT bunnchris impactofcommunitybasedpeersupportintype2diabetesaclusterrandomisedcontrolledtrialofindividualandorgroupapproaches AT holmandaniel impactofcommunitybasedpeersupportintype2diabetesaclusterrandomisedcontrolledtrialofindividualandorgroupapproaches AT parkerricharda impactofcommunitybasedpeersupportintype2diabetesaclusterrandomisedcontrolledtrialofindividualandorgroupapproaches AT cohnsimon impactofcommunitybasedpeersupportintype2diabetesaclusterrandomisedcontrolledtrialofindividualandorgroupapproaches AT donaldsarah impactofcommunitybasedpeersupportintype2diabetesaclusterrandomisedcontrolledtrialofindividualandorgroupapproaches AT paddisoncharlotteam impactofcommunitybasedpeersupportintype2diabetesaclusterrandomisedcontrolledtrialofindividualandorgroupapproaches AT wardcandice impactofcommunitybasedpeersupportintype2diabetesaclusterrandomisedcontrolledtrialofindividualandorgroupapproaches AT robinspeter impactofcommunitybasedpeersupportintype2diabetesaclusterrandomisedcontrolledtrialofindividualandorgroupapproaches AT graffyjonathan impactofcommunitybasedpeersupportintype2diabetesaclusterrandomisedcontrolledtrialofindividualandorgroupapproaches |