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The impact of peer coach-led type 2 diabetes mellitus interventions on glycaemic control and self-management outcomes: A systematic review and meta-analysis

Published:October 25, 2022DOI:https://doi.org/10.1016/j.pcd.2022.10.007

      Highlights

      • Disease-specific support from peers have improved diabetes self-management outcomes.
      • Peer support is important for low-income population with poorly controlled diabetes.
      • Peer coaching improves HbA1c levels, quality of life, self-efficacy & diabetes distress.
      • Community based peer-led interventions are more efficient for diabetes management.

      Abstract

      Type 2 diabetes mellitus (T2DM) is a major health risk and dominant cause of global mortality and morbidity. Disease-specific support from peers with similar chronic condition has shown to improve chronic disease self-management outcomes. The purpose of this systematic review is to summarise the existing evidence on the impact of peer coach-led type 2 diabetes mellitus self-management interventions on glycaemic control and self-management outcomes. Databases including MEDLINE, PubMed, CINAHL Plus, Scopus, ProQuest Central, ScienceDirect, web of science, Wiley Online Library and UOW Library were searched for eligible papers. Thirteen randomised controlled trials (RCTs) published between 2008 and 2021 were included in this review. Random-effects meta-analyses found that there were statistically significant changes in Haemoglobin A1c HbA1c) after the interventions. However, the meta-analyses showed no significant changes in LDL (low-density lipoprotein), BMI (Body mass index), systolic BP (Blood Pressure), and HRQoL (Health-related quality of life) among intervention and control groups after the intervention. The identified studies mainly recruited patients with suboptimal glucose levels; majority of them belonging to low-income population. Our findings showed that peer coaching was helpful in improving HbA1c levels, quality of life, self-efficacy, diabetes distress and patient activation. Moreover, peer coaching associations with medication adherence, hypoglycaemic symptoms, diabetes specific social support and depression were inconclusive. This review concludes that peer-led community-based interventions with longer follow up, using a mixed method of delivery among patients with suboptimal levels of HbA1c were more efficient compared to usual care for improving T2DM self-management.

      Keywords

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      References

      1. WHO, Global report on diabetes. 2017 [cited 2020 29 August]; Available from: 〈https://www.who.int/publications/i/item/9789241565257〉.

      2. IDF, Diabetes around the world in 2021. 2021 [cited 2021 9 December]; Available from: 〈https://diabetesatlas.org/〉.

      3. WHO. Diabetes- Key facts 2021 [cited 2021 29 August 2021]; Available from: 〈https://www.who.int/news-room/fact-sheets/detail/diabetes〉.

        • Lorig K.
        • et al.
        Spanish diabetes self-management with and without automated telephone reinforcement: two randomized trials.
        Diabetes Care. 2008; 31: 408-414
      4. WHO, Noncommunicable diseases: Progress monitor, 2020 [cited 2021 30 August]; Available from: 〈https://www.who.int/publications/i/item/ncd-progress-monitor-2020〉.

        • Murea M.
        • Ma L.
        • Freedman B.I.
        Genetic and environmental factors associated with type 2 diabetes and diabetic vascular complications.
        Rev. Diabet. Stud.: RDS. 2012; 9: 6
        • Tuei V.C.
        • Maiyoh G.K.
        • Ha C.E.
        Type 2 diabetes mellitus and obesity in sub‐Saharan Africa.
        Diabetes/Metab. Res. Rev. 2010; 26: 433-445
        • Caro J.F.
        • Fisher E.B.
        A solution might be within people with diabetes themselves.
        Fam. Pract. 2010; 27: i1-i2
        • Golden S.H.
        • et al.
        The case for diabetes population health improvement: evidence-based programming for population outcomes in diabetes.
        Curr. Diabetes Rep. 2017; 17: 1-17
        • Gallant M.P.
        The influence of social support on chronic illness self-management: a review and directions for research.
        Health Educ. Behav. 2003; 30: 170-195
        • Heisler M.
        • et al.
        Diabetes control with reciprocal peer support versus nurse care management: a randomized trial.
        Ann. Intern. Med. 2010; 153: 507-515
        • Hosseinzadeh H.
        • Verma I.
        • Gopaldasani V.
        Patient activation and Type 2 diabetes mellitus self-management: a systematic review and meta-analysis.
        Aust. J. Prim. Health. 2021; 26: 431-442
        • Hosseinzadeh H.
        • Downie S.
        • Shnaigat M.
        Effectiveness of health literacy-and patient activation-targeted interventions on chronic disease self-management outcomes in outpatient settings: a systematic review.
        Aust. J. Prim. Health. 2022;
        • Dahal P.K.
        • Hosseinzadeh H.
        Association of health literacy and diabetes self-management: a systematic review.
        Aust. J. Prim. Health. 2020; 25: 526-533
        • DePue J.D.
        • et al.
        Nurse–community health worker team improves diabetes care in American Samoa: results of a randomized controlled trial.
        Diabetes Care. 2013; 36: 1947-1953
        • Robson N.
        • Hosseinzadeh H.
        Impact of telehealth care among adults living with type 2 diabetes in primary care: a systematic review and meta-analysis of randomised controlled trials.
        Int. J. Environ. Res. Public Health. 2021; 18: 12171
        • Edwards J.
        • Hosseinzadeh H.
        The impact of structured physical activity on glycaemic control in diabetes prevention programmes: a systematic review.
        Proc. Singap. Healthc. 2018; 27: 193-204
        • Gæde P.
        • et al.
        Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes.
        N. Engl. J. Med. 2003; 348: 383-393
        • Foster G.
        • et al.
        Self‐management education programmes by lay leaders for people with chronic conditions.
        Cochrane Database Syst. Rev. 2007;
        • Perry H.B.
        • Zulliger R.
        • Rogers M.M.
        Community health workers in low-, middle-, and high-income countries: an overview of their history, recent evolution, and current effectiveness.
        Annu. Rev. Public Health. 2014; 35: 399-421
        • Almutairi N.
        • Hosseinzadeh H.
        • Gopaldasani V.
        The effectiveness of patient activation intervention on type 2 diabetes mellitus glycemic control and self-management behaviors: A systematic review of RCTs.
        Prim. care Diabetes. 2020; 14: 12-20
      5. Ansari, R.M., et al., A Quantitative Research on Self-management of Type 2 Diabetes, 2017.

        • Rosenthal E.L.
        • et al.
        Community health workers: part of the solution.
        Health Aff. 2010; 29: 1338-1342
        • Ansari R.M.
        • et al.
        Implementation of chronic care model for diabetes self-management: a quantitative analysis.
        Diabetology. 2022; 3: 407-422
        • Boothroyd R.I.
        • Fisher E.B.
        Peers for progress: promoting peer support for health around the world.
        Fam. Pract. 2010; 27: i62-i68
        • Tang T.S.
        • et al.
        Training peers to provide ongoing diabetes self-management support (DSMS): results from a pilot study.
        Patient Educ. Couns. 2011; 85: 160-168
        • Grant R.
        • Greene D.
        The health care home model: primary health care meeting public health goals.
        Am. J. Public Health. 2012; 102: 1096-1103
        • Niknami M.
        • et al.
        Association of health literacy with type 2 diabetes mellitus self-management and clinical outcomes within the primary care setting of Iran.
        Aust. J. Prim. Health. 2018; 24: 162-170
        • Furlan A.D.
        • et al.
        2009 updated method guidelines for systematic reviews in the Cochrane Back Review Group.
        Spine. 2009; 34: 1929-1941
        • McEachan R.R.
        • et al.
        Testing a workplace physical activity intervention: a cluster randomized controlled trial.
        Int. J. Behav. Nutr. Phys. Act. 2011; 8: 1-12
        • Moher D.
        • et al.
        Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.
        PLoS Med. 2009; 6e1000097
        • Higgins J.P.
        • et al.
        Cochrane Handbook for Systematic Reviews of Interventions.
        John Wiley & Sons,, 2019
        • Higgins J.
        • et al.
        A meta-analysis on the effectiveness of smart-learning.
        BMJ. 2003; 327: 557-560
        • Debussche X.
        • et al.
        Structured peer-led diabetes self-management and support in a low-income country: The ST2EP randomised controlled trial in Mali.
        PLoS One. 2018; 13e0191262
        • Thom D.H.
        • et al.
        Impact of peer health coaching on glycemic control in low-income patients with diabetes: a randomized controlled trial.
        Ann. Fam. Med. 2013; 11: 137-144
        • Lorig K.
        • et al.
        Community-based peer-led diabetes self-management.
        Diabetes Educ. 2009; 35: 641-651
        • Smith S.
        • et al.
        Peer support for patients with type 2 diabetes: cluster randomised controlled trial.
        Bmj. 2011; : 342
        • Cade J.
        • et al.
        Can peer educators influence healthy eating in people with diabetes? Results of a randomized controlled trial.
        Diabet. Med. 2009; 26: 1048-1054
        • Tang T.S.
        • et al.
        Comparative effectiveness of peer leaders and community health workers in diabetes self-management support: results of a randomized controlled trial.
        Diabetes Care. 2014; 37: 1525-1534
        • Andreae S.J.
        • et al.
        Peer coach delivered storytelling program improved diabetes medication adherence: A cluster randomized trial.
        Contemp. Clin. Trials. 2021; 104106358
        • Philis-Tsimikas A.
        • et al.
        Peer-led diabetes education programs in high-risk Mexican Americans improve glycemic control compared with standard approaches: a Project Dulce promotora randomized trial.
        Diabetes Care. 2011; 34: 1926-1931
        • Safford M.M.
        • et al.
        Peer coaches to improve diabetes outcomes in rural Alabama: a cluster randomized trial.
        Ann. Fam. Med. 2015; 13: S18-S26
        • Andreae S.J.
        • et al.
        Peer-delivered cognitive behavioral training to improve functioning in patients with diabetes: a cluster-randomized trial.
        Ann. Fam. Med. 2020; 18: 15-23
        • Long J.A.
        • et al.
        Effect of peer mentors in diabetes self-management vs usual care on outcomes in US veterans with type 2 diabetes: a randomized clinical trial.
        JAMA Netw. Open. 2020; 3 (e2016369-e2016369)
        • Long J.A.
        • et al.
        Peer mentoring and financial incentives to improve glucose control in African American veterans: a randomized trial.
        Ann. Intern. Med. 2012; 156: 416-424
        • Van der Wulp I.
        • et al.
        Effectiveness of peer‐led self‐management coaching for patients recently diagnosed with type 2 diabetes mellitus in primary care: A randomized controlled trial.
        Diabet. Med. 2012; 29: e390-e397
        • Aalaa M.
        • et al.
        The effectiveness of a peer coaching education on control and management of type 2 diabetes in women: a protocol for a randomized controlled trial.
        Int. J. Community Based Nurs. Midwifery. 2017; 5: 153
        • Moskowitz D.
        • et al.
        Peer coaching to improve diabetes self-management: which patients benefit most?.
        J. Gen. Intern. Med. 2013; 28: 938-942
        • Zhao X.
        • Yu X.
        • Zhang X.
        The role of peer support education model in Management of Glucose and Lipid Levels in patients with type 2 diabetes mellitus in Chinese adults.
        J. Diabetes Res. 2019; (2019)
        • Ghorob A.
        • et al.
        The effectiveness of peer health coaching in improving glycemic control among low-income patients with diabetes: protocol for a randomized controlled trial.
        BMC Public Health. 2011; 11: 1-6
        • Rogers E.A.
        • et al.
        Diabetes peer coaching: do “better patients” make better coaches?.
        Diabetes Educ. 2014; 40: 107-115
        • Inzucchi S.E.
        • et al.
        Management of hyperglycemia in type 2 diabetes, 2015: a patient-centered approach: update to a position statement of the American Diabetes Association and the European Association for the Study of Diabetes.
        Diabetes Care. 2015; 38: 140-149
        • McGowan P.
        • Lynch S.
        • Hensen F.
        The role and effectiveness of telephone peer coaching for adult patients with type 2 diabetes.
        Can. J. Diabetes. 2019; 43: 399-405
      6. WHO, Hypertension, 2021 [cited 2021 28 August]; Available from: 〈https://www.who.int/health-topics/hypertension#tab=tab_1〉.

      7. Healthline, Cholesterol Levels: By age, LDL, HDL, and More, 2021 [cited 2021 28 August]; Available from: 〈https://www.healthline.com/health/high-cholesterol/levels-by-age〉.

      8. AusGovt. Body mass index (BMI) | Healthy Weight Guide, 2021 [cited 2021 28 August]; Available from: 〈https://healthyweight.health.gov.au/wps/portal/Home/get-started/are-you-a-healthy-weight/bmi/〉.

        • McGowan P.
        Effectiveness and applicability of self-management peer coaching in the continuity of diabetes care.
        Am. Diabetes Assoc. 2018;
        • Funnell M.M.
        Peer-based behavioural strategies to improve chronic disease self-management and clinical outcomes: evidence, logistics, evaluation considerations and needs for future research.
        Fam. Pract. 2010; 27: i17-i22
        • Yadav U.N.
        • Hosseinzadeh H.
        • Baral K.P.
        Self-management and patient activation in COPD patients: an evidence summary of randomized controlled trials.
        Clin. Epidemiol. Glob. Health. 2018; 6: 148-154
      9. Ansari, R.M., H. Hosseinzadeh, and N.A. Zwar, Primary healthcare system of Pakistan: challenges to self-management of type 2 diabetes, 2016.

        • Pienaar M.
        • Reid M.
        • Nel M.
        The impact of a face-to-face peer-support intervention on adults with type 2 diabetes: a cluster-randomised trial.
        J. Endocrinol., Metab. Diabetes South Afr. 2021; 26: 34-39
      10. Orem, D., S. Taylor, and K. Renpenning, Nursing Concep Prac, 2001.

      11. IDF, Peer Leader Manual, 2022 [cited 2022 21 Jul 2022]; Available from: 〈https://www.idf.org/component/attachments/attachments.html?id=710&task=download〉.

        • Captieux M.
        • et al.
        Supported self-management for people with type 2 diabetes: a meta-review of quantitative systematic reviews.
        BMJ Open. 2018; 8e024262
        • Norris S.L.
        • et al.
        Self-management education for adults with type 2 diabetes: a meta-analysis of the effect on glycemic control.
        Diabetes care. 2002; 25: 1159-1171
        • Kirkman M.S.
        • et al.
        Diabetes in older adults.
        Diabetes Care. 2012; 35: 2650-2664
        • De Boer I.H.
        • et al.
        Diabetes and hypertension: a position statement by the American Diabetes Association.
        Diabetes Care. 2017; 40: 1273-1284