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

DOI 10.7326/0003-4819-153-8-201010190-00007PMC PMC4117390

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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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Authors: Heisler, M., Vijan, S., Makki, F., & Piette, J. D.
Affiliations: University of Michigan (US)
ORCID: Heisler, Michele
Vijan, Sandeep
Piette, John D.
Venue: Annals of Internal Medicine
Publisher: American College of Physicians
Published: 2010-10-19
Volume: 153
Issue: 8
Pages: 507-515
ISSN: 0003-4819 (ISSN-L)
1539-3704
DOI: 10.7326/0003-4819-153-8-201010190-00007
PMC: PMC4117390
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: green
www.ncbi.nlm.nih.gov
Licence: www.acpjournals.org/journal/aim/text-and-data-mining (tdm)
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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Diabetes Control With Reciprocal Peer Support Versus Nurse Care Management: A Randomized Trial

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