Κατεύθυνση Σχεδιασμός και Διοίκηση Υπηρεσιών ΥγείαςLibrary of the School of Health Sciences
Παύλος Σαράφης, Επίκουρος Καθηγητής, Τμήμα Νοσηλευτικής, Σχολή Επιστημών Υγείας, Τεχνολογικό Πανεπιστημίου Κύπρου, Επιβλέπων
Ιωάννης Τούντας, Καθηγητής, Ιατρική Σχολή, Εθνικό και Καποδιστριακό Πανεπιστήμιο Αθηνών
Μαρία Καντζανού, Επίκουρη Καθηγήτρια, Ιατρική Σχολή, Εθνικό και Καποδιστριακό Πανεπιστήμιο Αθηνών
Η επίδραση της Μεθόδου Υποστήριξης Ομοτίμων στη γλυκαιμική ρύθμιση ασθενών με Σακχαρώδη Διαβήτη: συστηματική ανασκόπηση τυχαιοποιημένων κλινικών μελετών
The Impact of Peer Support in Glycemic Control of patients with Diabetes Mellitus; Systematic Review of Randomized Clinical Trials
Introduction: Peer support is a new model regarding chronic diseases’ management that is proposed by the World Health Organization in order to bridge the gap resulting from the patient's healthcare provision to self-management education. It has grown globally as a low-cost intervention based on volunteering and contributes to a host of diseases, including Type 2 Diabetes Mellitus (DM2).
Purpose: The aim of this study is to present the peer support and its effect on the glycemic control of patients with DM2, especially levels of glycosylated hemoglobin (HbA1c). On this direction a systematic review of randomized clinical trials (RCTs) on DM2 was performed to evaluate the method.
Methods: We performed a research in PUBMED database, regarding RCTs of patients with DM2 who were included in a peer support program and compared with a control group that received standard treatment. Only studies with HbA1c as the primary or secondary endpoint were included in this analysis. 24 RCTs were eligible for inclusion. Their results were reviewed.
Results: Peer support interventions is expected to bring changes in HbA1c levels of patients with DM2, regardless the health services provided and the drug treatment. It appears that these intervention result in a significant clinical reduction of HbA1c levels mainly in patients with poor glycemic control while they can improve diabetes distress scores and satisfaction of self-management of the disease . However, these results are not reproduced in all studies, mainly due to the different intervention design, which is adapted to both patient's culture and resources of health systems.
This set of studies constitutes a heterogeneous mixture, thus it is difficult to draw safe conclusions on the ideally designed peer support model that will bring significant improvements in glycemic control of patients with DM2. More studies that will assess other parameters related to self-management of the disease such as compliance with treatment, increase in physical activity and improvement of quality of life are necessary to be evaluated in peer support model. The conflicting results that emanate from these studies should be carefully meta-analyzed in order to synthesize the 'strengths' of each study and propose an integrated intervention model that should yields positive results.
Main subject category:
Diabetes Mellitus, Peer support, Glycosylated hemoglobin