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

Simmons, D., Prevost, T., Bunn, C. , Holman, D., Parker, R., Cohn, S., Donald, S., Ward, C., Robins, P. and Graffy, J. (2015) Impact of community based peer support in type 2 diabetes: a cluster randomised controlled trial of individual and/or group approaches. PLoS ONE, 10(3), e0120277. (doi:10.1371/journal.pone.0120277) (PMID:25785452) (PMCID:PMC4364716)

[img]
Preview
Text
101631.pdf - Published Version
Available under License Creative Commons Attribution.

1MB

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 pragmatic 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 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. Systolic blood pressure was reduced by -2·3mm Hg (-4·0 to -0·6) among those allocated group peer-support and -3·0mm Hg (-5·0 to -1·1) among those who attended group peer-support 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 benefits. Long term benefits should be investigated.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Bunn, Dr Christopher
Authors: Simmons, D., Prevost, T., Bunn, C., Holman, D., Parker, R., Cohn, S., Donald, S., Ward, C., Robins, P., and Graffy, J.
College/School:College of Social Sciences > School of Social and Political Sciences > Sociology Anthropology and Applied Social Sciences
Journal Name:PLoS ONE
Publisher:Public Library of Science
ISSN:1932-6203
ISSN (Online):1932-6203
Copyright Holders:Copyright © 2015 The Authors
First Published:First published in PLoS ONE 10(3):e0120277
Publisher Policy:Reproduced under a Creative Commons License

University Staff: Request a correction | Enlighten Editors: Update this record