Abstract
BackgroundTo assess the effects of peer support at improving glycemic control in patients with type 2 diabetes.MethodsRelevant electronic databases were sought for this investigation up to Dec 2014. Randomized controlled trials involving patients with type 2 diabetes that evaluated the effect of peer support on glycated hemoglobin (HbA1c) concentrations were included. The pooled mean differences (MD) between intervention and control groups with 95% confidence interval (CI) were calculated using random-effects model. The Cochrane Collaboration’s tool was used to assess the risk of bias.ResultsThirteen randomized controlled trials met the inclusion criteria. Peer support resulted in a significant reduction in HbA1c (MD −0.57 [95% CI: −0.78 to −0.36]). Programs with moderate or high frequency of contact showed a significant reduction in HbA1c levels (MD −0.52 [95% CI: −0.60 to −0.44] and −0.75 [95% CI: −1.21 to −0.29], respectively), whereas programs with low frequency of contact showed no significant reduction (MD −0.32 [95% CI: −0.74 to 0.09]). The reduction in HbA1c were greater among patients with a baseline HbA1c ≥ 8.5% (MD −0.78 [95% CI: −1.06 to −0.51]) and between 7.5 ~ 8.5% (MD −0.76 [95% CI: −1.05 to −0.47]), than patients with HbA1c < 7.5% (MD −0.08 [95% CI: −0.32 to 0.16]).ConclusionsPeer support had a significant impact on HbA1c levels among patients with type 2 diabetes. Priority should be given to programs with moderate or high frequency of contact for target patients with poor glycemic control rather than programs with low frequency of contact that target the overall population of patients.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-1798-y) contains supplementary material, which is available to authorized users.
Highlights
To assess the effects of peer support at improving glycemic control in patients with type 2 diabetes
Details of the included studies, comprising of the characteristics of the study and participants, the mode of peer support, the characteristic of intervention of the 13 randomized controlled trials (RCTs) are shown in Tables 1 and 2
Discussions Our meta-analysis suggested that peer support has a favorable effect on improving glycemic control, with a pooled mean reduction of 0.57% in HbA1c levels compared with usual care
Summary
To assess the effects of peer support at improving glycemic control in patients with type 2 diabetes. Growing evidence suggests that peer support offers a promising solution. Peer support has been defined as ‘support from a person who possesses experiential knowledge of a specific behavior or stressor and similar characteristics as the target population [9]. Peer support helps reduce or prevent problematic health behaviours [10,11], vascular disease [12], HIV [13,14], Parkinson’s disease [15], etc. The success of peer support appears to be due in part to the nonhierarchical, reciprocal relationship that is created through the
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