title: Effectiveness of a Peer Support Programme versus Usual Care in Disease Management of Diabetes Mellitus Type 2 regarding Improvement of Metabolic Control: A Cluster-Randomised Controlled Trial.
abstract: OBJECTIVE
  Testing the effectiveness of peer support additionally to a disease management programme (DMP) for type 2 diabetes patients.
  
  
  METHODS
  Unblinded cluster-randomised controlled trial (RCT) involving 49 general practices, province of Salzburg, Austria. All patients enrolled in the DMP were eligible, n = 337 participated (intervention: 148 in 19 clusters; control: 189 in 20 clusters). The peer support intervention ran over 24 months and consisted of peer supporter recruitment and training, and group meetings weekly for physical exercise and monthly for discussion of diabetes related topics.
  
  
  RESULTS
  At two-year follow-up, adjusted analysis revealed a nonsignificant difference in HbA1c change of 0.14% (21.97 mmol/mol) in favour of the intervention (95% CI -0.08 to 0.36%, p = 0.22). Baseline values were 7.02 ± 1.25% in the intervention and 7.08 ± 1.25 in the control group. None of the secondary outcome measures showed significant differences except for improved quality of life (EQ-5D-VAS) in controls (4.3 points on a scale of 100; 95% CI 0.08 to 8.53, p = 0.046) compared to the intervention group.
  
  
  CONCLUSIONS
  Our peer support intervention as an additional DMP component showed no significant effect on HbA1c and secondary outcome measures. Further RTCs with a longer follow-up are needed to reveal whether peer support will have clinically relevant effects.
  
  
  BACKGROUND
  This trial has been registered with Current Controlled Trials Ltd. (ISRCTN10291077).
authors: Institute of General Practice, Family Medicine, and Preventive Medicine, Paracelsus Medical University, 5020 Salzburg, Austria.
authors: Tim
authors: T
authors: Johansson
authors: Institute of General Practice, Family Medicine, and Preventive Medicine, Paracelsus Medical University, 5020 Salzburg, Austria.
authors: Sophie
authors: S
authors: Keller
authors: Paris Lodron University, 5020 Salzburg, Austria.
authors: Henrike
authors: H
authors: Winkler
authors: Centre for Integrative Medicine, University of Witten/Herdecke, 58448 Witten, Germany.
authors: Thomas
authors: 0000-0003-2695-0701
authors: T
authors: Ostermann
authors: Department of Internal Medicine, Wehrle-Diakonissen Hospital, 5026 Salzburg, Austria; Paracelsus Medical University, 5020 Salzburg, Austria.
authors: Raimund
authors: R
authors: Weitgasser
authors: Institute of General Practice and Family Medicine, University of Witten/Herdecke, 58448 Witten, Germany.
authors: Andreas C
authors: AC
authors: Sönnichsen
mesh_terms: D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism / Q000523:psychology / Q000628:therapy*; D019468:Disease Management; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human