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Randomized Controlled Trial
. 2015 Mar 18;10(3):e0120277.
doi: 10.1371/journal.pone.0120277. eCollection 2015.

Impact of community based peer support in type 2 diabetes: a cluster randomised controlled trial of individual and/or group approaches

David Simmons  1 , A Toby Prevost  2 , Chris Bunn  1 , Daniel Holman  2 , Richard A Parker  2 , Simon Cohn  2 , Sarah Donald  1 , Charlotte A M Paddison  2 , Candice Ward  1 , Peter Robins  1 , Jonathan Graffy  2
Affiliations
Randomized Controlled Trial

Impact of community based peer support in type 2 diabetes: a cluster randomised controlled trial of individual and/or group approaches

David Simmons et al. PLoS One. .

Abstract

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 2·3 mm Hg (0.6 to 4.0) lower among those allocated group peer-support and 3·0 mm 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.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Recruitment and follow-up of participants.
See this image and copyright information in PMC

References

    1. National Audit Office. The management of adult diabetes services in the NHS 2012. London: National Audit Office: HC 21, Session 2012–13.
    1. Anderson RJ, Freedland KE, Clouse RE, Lustman PJ. The Prevalence of Comorbid Depression in Adults With Diabetes: A meta-analysis. Diabetes Care. 2001; 24(6):1069–1078. - PubMed
    1. Fisher L, Skaff MM, Mullan JT, Arean P, Glasgow R, Masharani U. A longitudinal study of affective and anxiety disorders, depressive affect and diabetes distress in adults with Type 2 diabetes. Diabet Med. 2008; 25(9):1096–1101. 10.1111/j.1464-5491.2008.02533.x - DOI - PMC - PubMed
    1. Holmes J, McGill S, Kind P, Bottomley J, Gillam S, Murphy M. Health-related quality of life in type 2 diabetes (TARDIS-2). Value in Health. 2000; 3 Suppl 1:47–51. - PubMed
    1. Simmons D, Weblemoe T, Voyle J, Prichard A, Leakehe L, Gatland B. Personal barriers to diabetes care: lessons from a multi-ethnic community in New Zealand. Diabet Med. 1998; 15(11):958–964. - PubMed

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