title: Challenges of a pharmacist-directed peer support program among adolescents with diabetes.
abstract: OBJECTIVE
  To describe the development and challenges of a pharmacist-directed peer support program among adolescents with diabetes.
  
  
  METHODS
  The program was designed as adjunctive therapy for adolescents receiving care at the Diabetes Education and Research Center (DERC). DERC is an interdisciplinary facility at which the clinical pharmacist provides direct, diabetes-related patient care services. Through collaboration with DERC, pharmacists developed and facilitated each component of the program.
  
  
  METHODS
  The U. S. Diabetes Conversation Map program was used for the educational component of the program. This is an innovative, American Diabetes Association-approved tool for providing group education on diabetes self-management. As trained facilitators of the conversation maps, the investigators educated group leaders on how to be facilitators for their peers.
  
  
  METHODS
  Glycosylated hemoglobin (A1C), diabetes self-management skills, and diabetes-related quality of life were measured at baseline and following program completion. Qualitative outcomes were measured via validated questionnaires in adolescents with type 1 diabetes. The investigators facilitated the gathering of all quantitative and qualitative data.
  
  
  RESULTS
  Several participants did not meet all inclusion criteria; therefore, data from only six participants were assessed. A1C increased among participants, affirming the challenge of metabolic control during adolescence. Despite this, qualitative analysis of questionnaires revealed improvements in adherence to lifestyle modifications and health perception after program completion.
  
  
  CONCLUSIONS
  Evidence illustrates beneficial effects of peer-facilitated support on the physical and psychological challenges of diabetes self-management; however, challenges existed when implementing this program among adolescents. Suggestions to overcome these challenges include same-sex support groups, use of an appealing setting for participants, incorporation into camps or after-school programs, and extended program length. Pharmacists are well equipped to assist individuals in comprehensive diabetes management programs such as the one described here because of their education and training in medication management, therapeutic lifestyle changes, and patient communication.
authors: Lloyd L. Gregory School of Pharmacy, Palm Beach Atlantic University, West Palm Beach, FL, USA. lsimsx@midwestern.edu
authors: Lisa M
authors: LM
authors: Sims
authors: Seena L
authors: SL
authors: Haines
mesh_terms: D000293:Adolescent; D001294:Attitude to Health; D003299:Cooperative Behavior; D003922:Diabetes Mellitus, Type 1 / Q000523:psychology* / Q000628:therapy; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008019:Life Style; D008297:Male; D005791:Patient Care; D010349:Patient Compliance; D010379:Peer Group; D010593:Pharmaceutical Services / Q000458:organization & administration*; D010595:Pharmacists / Q000458:organization & administration*; D011788:Quality of Life; D012648:Self Care / Q000523:psychology; D012944:Social Support; D011795:Surveys and Questionnaires; D014481:United States
chemical_list: D006442:Glycated Hemoglobin