Heisler says she and her fellow researchers expected to see benefits from the peer support, but were surprised at how large the improvement in glycemic control from the program after six months was. The patients who were randomly assigned to the peer support program achieved HbA1c levels that were 0.58 percentage points lower on average than those in the nurse care management group. And patients in the peer support group with baseline HbA1c levels greater than 8 percent achieved a mean decrease of 0.88 percentage points, compared with a 0.07-percentage point decrease among those in the nurse care management group. This is equivalent to that achieved by starting another oral anti-hyperglyemic medication.

More patients in the peer support group also started insulin therapy at much higher rates than those in the nurse care management group, a step that many patients resist.

"The higher rate of insulin therapy initiation in the peer support group suggests that patents' concerns about insulin may be best addressed by another person who also is coping with insulin management," Heisler says.

Heisler says this is the first randomized controlled trial to examine reciprocal peer support in chronic disease management. This can be a low-cost, easy-to-implement system that allows patients to get more one-on-one support in managing a chronic illness, Heisler says.

"Most chronically ill patients need more support for self-care than most health care systems can provide. That's why programs like this, that increase the quality and intensity of assistance through peer support, deserve further exploration," Heisler says.

Source: University of Michigan Health System