Peer support to decrease diabetes-related distress in patients with type 2 diabetes mellitus: design of a randomised controlled trial

Lianne de Vries, Amber Awa van der Heijden, Esther van 't Riet, Caroline A Baan, Piet J Kostense, Mieke Rijken, Guy Ehm Rutten, Giel Nijpels, Lianne de Vries, Amber Awa van der Heijden, Esther van 't Riet, Caroline A Baan, Piet J Kostense, Mieke Rijken, Guy Ehm Rutten, Giel Nijpels

Abstract

Background: Many type 2 diabetes mellitus patients face difficulties self-managing their illness, which can lead to high levels of diabetes-related distress. Diabetes distress may be decreased by peer support, as peers understand and have dealt with similar problems, and can help motivate each other. A recent systematic review concluded that evidence of benefits of peer support in patients with type 2 diabetes mellitus is too inconsistent due to weak theoretical foundation of the interventions. This study describes the design of a trial evaluating the effectiveness of a group-based, peer support programme with a strong theoretical foundation on diabetes-related distress in type 2 diabetes patients.

Methods: This is a parallel group randomised controlled trial of a six session group-based peer support intervention, delivered by peer leaders and group psychotherapists, compared with one educational meeting on diabetes. At least 152 patients with a type 2 diabetes duration of three years or more and between 50 and 70 years of age, recruited via their general practitioner, will be randomised to receive the peer support intervention or one educational meeting. The intervention is developed in line with three key stages of research development of the Medical Research Council framework. The primary outcome measure for this study is diabetes-related distress. Secondary outcomes include self-management behaviour, well-being and health-related quality of life. Perceived social support is a process measure. Outcomes will be measured one month before, and 6, and 12 months after the intervention by means of self-reported questionnaires. Analysis will be on an intention-to-treat basis.

Discussion: This article contains a description of the design of a study that will investigate the effect of a group-based, peer support intervention on diabetes-related distress in type 2 diabetes patients. The intervention was developed in recognition of the limited evidence, and the importance of a theoretical foundation and its implementation. Findings will contribute to knowledge in the field of peer support and patient-important outcomes in type 2 diabetes patients.

Trial registration: Dutch Trial Registry: NTR3474.

Figures

Figure 1
Figure 1
Theoretical model: hypothesised effects of peer support.

References

    1. Whiting DR, Guariguata L, Weil C, Shaw J. IDF diabetes atlas: global estimates of the prevalence of diabetes for 2011 and 2030. Diabetes Res Clin Pract. 2011;94:311–321. doi: 10.1016/j.diabres.2011.10.029.
    1. Vinicor F. The public health burden of diabetes and the reality of limits. Diabetes Care. 1998;21(Suppl 3):C15–C18.
    1. Fisher L. REDEEM: A pragmatic trial to reduce diabetes distress. Diabetes Care. 2013;36:2551–2558. doi: 10.2337/dc12-2493.
    1. Snoek F, Pouwer F, Welch G, Polonsky W. Diabetes-related emotional distress in Dutch and U.S. diabetic patients. Diabetes Care. 2000;23:1305–1309. doi: 10.2337/diacare.23.9.1305.
    1. Carper MM, Traeger L, Gonzalez JS, Wexler DJ, Psaros C, Safren SA. The differential associations of depression and diabetes distress with quality of life domains in type 2 diabetes. J Behav Med. 2013. pp. 1–10.
    1. Polonsky W, Fisher L, Earles J, Dudl R, Lees J, Mullan J, Jackson R. Assessing psychosocial distress in diabetes: development of the diabetes distress scale. Diabetes Care. 2005;28:626–631. doi: 10.2337/diacare.28.3.626.
    1. Dennis C-L. Peer support within a health care context: a concept analysis. Int J Nurs Stud. 2003;40:321–332. doi: 10.1016/S0020-7489(02)00092-5.
    1. Brownson CA, Heisler M. The role of peer support in diabetes care and self-management. Patient. 2009;2:5–17. doi: 10.2165/01312067-200902010-00002.
    1. Boothroyd RI, Fisher EB. Peers for progress: promoting peer support for health around the world. Fam Pract. 2010;27:62–68. doi: 10.1093/fampra/cmp076.
    1. Dale JR, Williams SM, Bowyer V. What is the effect of peer support on diabetes outcomes in adults? A systematic review. Diabet Med. 2012;29:1361–1377. doi: 10.1111/j.1464-5491.2012.03749.x.
    1. Medical Research Council. A framework for the development and evaluation of RCTs for complex interventions to improve health. London: Medical Research Council; 2000. p. 18.
    1. Heisler M, Vijan S, Makki F, Piette JD. Original research diabetes control with reciprocal peer support versus nurse. Ann Intern Med. 2010;153:507–516. doi: 10.7326/0003-4819-153-8-201010190-00007.
    1. Heisler M. Overview of peer support models to improve diabetes self-management and clinical outcomes. Diabetes Spectr. 2007;20:214–221. doi: 10.2337/diaspect.20.4.214.
    1. Van Dam HA, van der Horst FG, Knoops L, Ryckman RM, Crebolder HFJM, van den Borne BHW. Social support in diabetes: a systematic review of controlled intervention studies. Patient Educ Couns. 2005;59:1–12. doi: 10.1016/j.pec.2004.11.001.
    1. Wills TA, Shinar O. In: Social Support Measurement and Intervention: A Guide for Health and Social Scientists. Cohen S, Underwood LG, Gottlieb B, editor. Toronto: Oxford University Press; 2000. Measuring perceived and received social support; p. 86.
    1. Burleson BR, Albrecht TL, Sarason IG. Communication of social support. Thousand Oaks, CA: Sage; 1994.
    1. Heisler M. Building peer support programs to manage chronic disease: seven models for success. California HealthCare Foundation: Oakland; 2006.
    1. Heisler M. Different models to mobilize peer support to improve diabetes self-management and clinical outcomes: evidence, logistics, evaluation considerations and needs for future research. Fam Pract. 2010;27:i23–i32. doi: 10.1093/fampra/cmp003.
    1. Dutch Diabetes Association. [ ]
    1. ATLAS.ti. [ ]
    1. Welch G, Weinger K, Anderson B, Polonsky WH. Responsiveness of the problem areas in diabetes (PAID) questionnaire. Diabet Med. 2003;20:69–72. doi: 10.1046/j.1464-5491.2003.00832.x.
    1. Cleveringa FGW, Minkman MH, Gorter KJ, van den Donk M, Rutten GEHM. Diabetes care protocol: effects on patient-important outcomes: a cluster randomized, non-inferiority trial in primary care. Diabet Med. 2010;27:442–450. doi: 10.1111/j.1464-5491.2010.02968.x.
    1. WHO-Five Well-being Index. [ ]
    1. Bech P, Gudex C, Johansen KS. The WHO (Ten) well-being index: validation in diabetes. Psychother Psychosom. 1996;65:183–190. doi: 10.1159/000289073.
    1. Toobert D, Hampson S, Glasgow R. The summary of diabetes self-care activities measure: results from 7 studies and a revised scale. Diabetes Care. 2000;23:943–950. doi: 10.2337/diacare.23.7.943.
    1. Barrera M, Glasgow RE, McKay HG, Boles SM, Feil EG. Do Internet-based support interventions change perceptions of social support? An experimental trial of approaches for supporting diabetes self-management. Am J Community Psychol. 2002;30:637–654. doi: 10.1023/A:1016369114780.

Source: PubMed

Sponsorer og samarbejdspartnere

Medicinske tilstande

Narkotikainterventioner

3
Abonner