title: Randomized controlled effectiveness trial of reciprocal peer support in heart failure.
abstract: BACKGROUND
  Although disease management programs for patients hospitalized with heart failure (HF) are effective, they are, however, often resource intensive, limiting their uptake. Peer support programs have led to improved outcomes among patients with other chronic conditions and may result in similar improvements for patients with HF.
  
  
  RESULTS
  In this randomized controlled trial, reciprocal peer support (RPS) arm patients participated in a HF nurse practitioner-led goal setting group session, received brief training in peer communication skills, and were paired with another participant in their cohort with whom they were encouraged to talk weekly using a telephone platform. Participants were also encouraged to attend 3 nurse practitioner-facilitated peer support group sessions. Patients in the nurse care management arm attended a nurse practitioner-led session to address their HF care questions and receive HF educational materials and information on how to access care management services. The median age of the patients was 69 years; 51% were female and 26% were racial/ethnic minorities. Only 55% of RPS patients participated in peer calls or group sessions. In intention-to-treat analyses, the RPS and nurse care management groups did not differ in time-to-first all-cause rehospitalization or death or in mean numbers of rehospitalizations or deaths. There were no differences in improvements in 6-month measures of HF-specific quality of life or social support. Conclusions- Among patients recently hospitalized for HF, more than half of RPS participants had no or minimal engagement with the RPS program, and the program did not improve outcomes compared with usual HF nurse care management.
  
  
  BACKGROUND
  URL: http://www.clinicaltrials.gov. UNIQUE IDENTIFIER: NCT00508508.
authors: Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA. mheisler@umich.edu
authors: Michele
authors: M
authors: Heisler
authors: Lakshmi
authors: L
authors: Halasyamani
authors: Mark E
authors: ME
authors: Cowen
authors: Matthew D
authors: MD
authors: Davis
authors: Ken
authors: K
authors: Resnicow
authors: Robert L
authors: RL
authors: Strawderman
authors: Hwajung
authors: H
authors: Choi
authors: Rebecca
authors: R
authors: Mase
authors: John D
authors: JD
authors: Piette
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D003142:Communication; D018572:Disease-Free Survival; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006333:Heart Failure / Q000175:diagnosis / Q000401:mortality / Q000451:nursing / Q000523:psychology / Q000628:therapy*; D006801:Humans; D008297:Male; D008824:Michigan; D008875:Middle Aged; D009722:Nurse Practitioners; D010349:Patient Compliance; D010353:Patient Education as Topic; D010359:Patient Readmission; D010379:Peer Group; D016016:Proportional Hazards Models; D011788:Quality of Life; D012648:Self Care; D012657:Self-Help Groups; D012944:Social Support; D013689:Telephone; D013997:Time Factors; D016896:Treatment Outcome
references: Health Educ Q. 1985 Winter;12(4):315-31
references: 4077544
references: Circ Cardiovasc Qual Outcomes. 2009 Sep;2(5):407-13
references: 20031870
references: Am J Prev Med. 2006 Jan;30(1):67-73
references: 16414426
references: Ann Intern Med. 2010 Oct 19;153(8):507-15
references: 20956707
references: JAMA. 2004 Mar 17;291(11):1358-67
references: 15026403
references: JAMA. 2007 Jan 3;297(1):61-70
references: 17200476
references: JAMA. 2010 Sep 22;304(12):1331-8
references: 20858878
references: Diabetes Care. 2001 Apr;24(4):695-700
references: 11315833
references: Int J Cardiol. 2008 Apr 10;125(2):203-8
references: 18031843
references: J Card Fail. 2006 Sep;12(7):554-67
references: 16952790
references: Am Heart J. 2009 Sep;158(3):459-66
references: 19699871
references: BMJ. 2007 Jun 16;334(7606):1254-6
references: 17569933
references: J Am Coll Cardiol. 2004 Aug 18;44(4):810-9
references: 15312864
references: J Endocrinol Invest. 2008 Nov;31(11):1038-42
references: 19169063
references: J Hosp Med. 2007 Nov;2(6):409-14
references: 18081171
references: N Engl J Med. 2010 Dec 9;363(24):2301-9
references: 21080835
references: Ann Intern Med. 2012 Mar 20;156(6):416-24
references: 22431674
references: J Gen Intern Med. 2007 May;22(5):620-4
references: 17443369
references: J Am Coll Cardiol. 2002 Jan 2;39(1):83-9
references: 11755291
references: Heart Fail Rev. 2002 Jan;7(1):9-16
references: 11790919
references: Arch Intern Med. 1997 Jan 13;157(1):99-104
references: 8996046
references: Biostatistics. 2005 Jul;6(3):404-19
references: 15831581
references: Psychol Sci. 2003 Jul;14(4):320-7
references: 12807404
references: Behav Cogn Psychother. 2012 Jul;40(4):474-80
references: 22414686
references: BMC Cardiovasc Disord. 2006 Nov 02;6:43
references: 17081306
references: J Behav Med. 2013 Apr;36(2):199-211
references: 22481214
references: Int J Behav Nutr Phys Act. 2012 Mar 02;9:19
references: 22385702
references: Soc Sci Med. 1999 Jun;48(11):1563-75
references: 10400257
references: Health Aff (Millwood). 2009 Jan-Feb;28(1):179-89
references: 19124869
references: Diabetes Educ. 2009 Jul-Aug;35(4):641-51
references: 19407333
references: Cochrane Database Syst Rev. 2008 Oct 08;(4):CD006903
references: 18843736
references: N Engl J Med. 2010 Apr 29;362(17):1553-5
references: 20375400
references: Ann Intern Med. 2006 Oct 3;145(7):544-6
references: 17015873
references: Congest Heart Fail. 2007 May-Jun;13(3):149-57
references: 17541307
references: Eff Clin Pract. 2001 Nov-Dec;4(6):256-62
references: 11769298
references: Patient Educ Couns. 2009 Aug;76(2):174-80
references: 19560895
references: J Cardiovasc Nurs. 2004 May-Jun;19(3):174-83
references: 15191260
references: Am J Community Psychol. 2002 Oct;30(5):637-54
references: 12188054
references: J Am Coll Cardiol. 2009 Jul 28;54(5):397-401
references: 19628113
references: Stat Med. 1995 Sep 15;14(17):1913-25
references: 8532984