Cited by 366Diabetes Management and EducationDiabetes Management and ResearchMental Health and Patient Involvement

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Diabetes Control With Reciprocal Peer Support Versus Nurse Care Management: A Randomized Trial

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Heisler, Michele, Vijan, Sandeep, Makki, Fatima, Piette, John D.·2010·Annals of Internal Medicine

Abstract

BACKGROUND: Resource barriers complicate diabetes care management. Support from peers may help patients manage their diabetes. OBJECTIVE: To compare a reciprocal peer-support (RPS) program with nurse care management (NCM). DESIGN: Randomized, controlled trial. (ClinicalTrials.gov registration number: NCT00320112) SETTING: 2 U.S. Department of Veterans Affairs health care facilities. PATIENTS: 244 men with hemoglobin A(1c) (HbA(1c)) levels greater than 7.5% during the previous 6 months. MEASUREMENTS: The primary outcome was 6-month change in HbA(1c) level. Secondary outcomes were changes in insulin therapy; blood pressure; and patient reports of medication adherence, diabetes-related support, and emotional distress. INTERVENTION: Patients in the RPS group attended an initial group session to set diabetes-related behavioral goals, receive peer communication skills training, and be paired with another age-matched peer patient. Peers were encouraged to talk weekly using a telephone platform that recorded call occurrence and provided reminders to promote peer contact. These patients could also participate in optional group sessions at 1, 3, and 6 months. Patients in the NCM group attended a 1.5-hour educational session and were assigned to a nurse care manager. RESULTS: Of the 244 patients enrolled, 216 (89%) completed the HbA(1c) assessments and 231 (95%) completed the survey assessments at 6 months. Mean HbA(1c) level decreased from 8.02% to 7.73% (change, -0.29%) in the RPS group and increased from 7.93% to 8.22% (change, 0.29%) in the NCM group. The difference in HbA(1c) change between groups was 0.58% (P = 0.004). Among patients with a baseline HbA(1c) level greater than 8.0%, those in the RPS group had a mean decrease of 0.88%, compared with a 0.07% decrease among those in the NCM group (between-group difference, 0.81%; P < 0.001). Eight patients in the RPS group started insulin therapy, compared with 1 patient in the NCM group (P = 0.020). Groups did not differ in blood pressure, self-reported medication adherence, or diabetes-specific distress, but the RPS group reported improvement in diabetes social support. LIMITATION: The study included only male veterans and lasted only 6 months. CONCLUSION: Reciprocal peer support holds promise as a method for diabetes care management.

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Research works printed but not linked: 5

  1. Dale J, 2008, Cochrane Database Syst Rev, CD006903
  2. Doull M, 2007, Cochrane Database Syst Rev, CD005352
  3. Lorig KR, 2001, Eff Clin Pract, 4, 256
  4. 10.1037/0003-066X.55.1.68 · DOI · Paper page
  5. Knight K, 2005, Am J Manag Care, 11, 242

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Metadata

Authors
Heisler, M., Vijan, S., Makki, F., & Piette, J. D.
Affiliations
University of Michigan (US)
Venue
Annals of Internal Medicine
Published
2010-10-19
Volume
153
Issue
8
Pages
507-515
ISSN
  • 0003-4819 (ISSN-L)
  • 1539-3704
OpenAlex
W2066345304
Cited by
366
References
53
Citations by year
2026: 6 · 2025: 8 · 2024: 8 · 2023: 15 · 2022: 22 · 2021: 34 · 2020: 30 · 2019: 23 · 2018: 33 · 2017: 24 · 2016: 26 · 2015: 28 · 2014: 29 · 2013: 30 · 2012: 28
FWCI
18.97
Type
journal article
Language
en
Open access
Locations
  • Annals of Internal Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • Annals of Internal Medicine
Funders
  • National Heart, Lung, and Blood Institute (R01HL085420)
  • National Institute of Diabetes and Digestive and Kidney Diseases (P60DK020572, P30DK092926)
  • National Center for Research Resources (UL1RR024986)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Health Professions › General Health Professions › Mental Health and Patient Involvement
Keywords
nursing care management, diabetes self-management, glycemic control, HbA1c, veterans, peer support, insulin therapy, medication adherence, emotional distress, blood pressure, behavioral objectives, resource barriers, diabetes education
MeSH terms
Blood Pressure, Diabetes Mellitus, Type 1, Glycated Hemoglobin, Humans, Insulin, Male, Motivation, Psychotherapy, Group, Social Support, Stress, Psychological, Telephone, Treatment Outcome, Self Efficacy, Medication Adherence

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