Main Article Content
This study was an experimental study design with randomized controlled trial.aimed to compare the reduction of HbA1c level among type 2 diabetes mellitus (T2DM) patients between the group given the reciprocal peer support program and the group given regular basis program. We conducted in uncontrolled T2DM patients in the prior six months from April 2019- February 2020, aged of 20-65 years recruited from a Diabetes clinic in Chon Buri. Sixty eligible participants were enrolled to experimental group and control group by using block random methods divided into 30 patients per group. Experimental group be received Reciprocal Peer Support Program and both groups attended the regular basis program then examine levels of HbA1c at the 12 week follow-up. The data analysis were compared between experimental and control groups for homogeneities of demographic data by using independent t-test for continuous variables and z-test for proportion of categorical variables. The main outcome: BMI, BP, FBS, and HbA1c were compared between 2 dependently time (pre- and post- intervention) in each groups by using paired t-test. The mean changes of HbA1c from baseline to 12 weeks follow-up were compared between group by independent t-test. This research was approved by IRB of Faculty of Medicine, Burapha University, number 015/2019. According to the results of the experimental group had a mean HbA1c of 8.77% at baseline, which improved to 8.35% at 12 weeks compared with control group 9.02% to 8.67%. Among patients with a baseline HbA1c >8.0%, the experimental group had a mean HbA1c decrease of 0.98% (p=0.02) compared with a 0.67% (p>0.05) decrease in control group. There were no differences between groups in mean differences of HbA1c (0.07%, p>0.05). Therefore, people with diabetes may be considered to receive the Reciprocal Peer Support program. Especially in the uncontrollable group If only more than 8% of patients with HbA1c were considered, the program was found to have a statistically significant reduction in HbA1c.
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
International Diabetes Federation. IDF Diabetes Atlas. 8th ed. Brussels, Belgium: International Diabetes Federation; 2017.
American Diabetes Association. Standards of medical care in diabetes-2018. Diabetes Care 2018;41(Suppl 1):S3.
Thai National Health Examination Survey V Study Group. Thai National Health Examination Survey, NHES V. Nonthaburi, Thailand: National Health Examination Survey Office, Health System Research Institute; 2016. (in Thai).
CRCN. An assessment on quality of care among patients diagnosed with type 2 diabetes and hypertension visiting hospitals of ministry of public health and Bangkok Metropolitan Administration in Thailand, 2012. [Internet]. [cited 2018 November 12]. Available from: http:// www.thaincd.com/2016/mission/documents-detail.php?id=12363&tid=&gid=1-027. (in Thai).
Brunisholz KD, Briot P, Hamilton S, Joy EA, Lomax M, Barton N, et al. Diabetes self-management education improves quality of care and clinical outcomes determined by a diabetes bundle measure. J Multidiscip Healthc 2014;7:533-42.
American Diabetes Association. Standards of medical care in diabetes-2017. Diabetes Care 2017;40(Suppl 1):S33-S34.
Outpatient Statistics Section at Laem Chabang Hospital. Annual outpatient statistics report 2017. Chon Buri: Laem Chabang Hospital; 2017. (in Thai).
Heisler M. Different model to mobilize peer support to improve diabetes self-management and clinical outcome: evidence, logistics, evaluation considerations and needs for future research. Fam Pract 2010;27(Suppl 1):i23-i32.
Clancy DE, Huang P, Okonofua E, Yeager D, Magruder KM. Group visits: promoting adherence to diabetes guidelines. J Gen Intern Med 2007;22(5):620-4.
Trento M, Basile M, Borgo E, Grassi G, Scuntero P, Trinetta T, et al. A randomized controlled clinical trial of nurse-, dietitian- and pedagogist-led group care for the management of Type 2 diabetes. J Endocrinol Invest 2008;31(11):1038-42.
Wagner EH, Grothaus LC, Sandhu N, Galvin MS, McGregor M, Artz K, et al. Chronic care clinics for diabetes in primary care: a system-wide randomized trial. Diabetes Care 2001;24(4):695-700.
Lorig K, Ritter PL, Villa FJ, Armas J. Community-based peer-led diabetes self-management: a randomized trial. Diabetes Educ 2009;35(4):641-51.
Griffiths C, Foster G, Ramsay J, Eldridge S, Taylor S. How effective are expert patient (lay led) education programs for chronic disease? BMJ 2007;334:1254-6.
Heisler M, Piette JD. “I help you, and you help me”: facilitated telephone peer support among patients with diabetes. Diabetes Educ 2005;31(6):869-79.
Heisler M, Vijan S, Makki F, Piette JD. Diabetes control with reciprocal peer support versus nurse care management: a randomized trial. Ann Intern Med 2010;153(8):507-15.
Schwartz CE, Sendor M. Helping others helps oneself: response shift effects in peer support. Soc Sci Med 1999;48(11):1563-75.
Nilsu J, Tatho R. The effect of peer supported self-management on HbA1C level of type II diabetic patients. The Journal of Faculty of Nursing Burapha University 2013;21(3):1-13. (in Thai).
Diabetes Association of Thailand. Clinical practice guideline for diabetes 2007. [Internet]. [cited 2018 November 12]. Available from: https://www.dmthai.org/index.php/knowledge/
healthcare-providers/cpg/443-guideline-diabetes-care-2017. (in Thai).
Numsri W. Self-care in very well-controlled versus poorly-controlled type 2 diabetes patients in out-patient department of San Pa Tong hospital, San Pa Tong district, Chiang Mai province. [Master’s Thesis, Faculty of Public Health]. Chiang Mai University; 2006. (in Thai).
Phromjak S. Factors affecting patients’ behavior in controlling blood glucose levels in non-insulin dependent diabetes mellitus. Journal of Health Systems Research 2007;1(2):10-18. (in Thai).
Ovatakanont P. The outcome of diabetes care and factors associated with poor glycemic control among type 2 diabetes patients in Saimun Hospital. Srinagarind Medical Journal 2011;26(4):339-49. (in Thai).
Siriwattanapornkul T, Oba N, Intarakumhang Na Rachasima S. Factors related to blood glucose level among patients with diabetes mellitus type II. [Internet]. [cited 2018 November 12]. Available from: http://www.nurse.nu.ac.th/Journal/data/Vol.1%20No.2/007.pdf. (in Thai).
Ho PM, Rumsfeld JS, Masoudi FA, McClure DL, Plomondon ME, et al. Effect of medicine nonadherance on hospitalization and mortality among patient with diabetes melitus. Arch Intern Med 2006;166(17):1836-41.
Heisler M, Halasyamani L, Resnicow K, Neaton M, Shanahan J, Brown S, et al. “I am not alone”: the feasibility and acceptability of Interactive Voice Response (IVR)-facilitated telephone peer support among older adults with Heart Failure (HF). Congest Heart Fail 2007;13(3):149-57.
Ghorob A, Vivas MM, De Vore D, Ngo V, Bodenheimer T, Chen E, 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;11:208. doi: 10.1186/1471-2458-11-208.
Fisher EB, Boothroyd RI, Coufal MM, Baumann LC, Mbanya JC, Rotheram-Borus MJ, et al. Peer support for self-management of diabetes improved outcomes in international setting. Health Aff (Millwood) 2012;31(1):130-9.
Paul G, Smith SM, Whitford D, O’ Kelly F, O’Dowd T. Development of a complex intervention to test the effectiveness of peer support in type2 diabetes. BMC Health Services Research 2007;7:136. doi: 10.1186/1472-6963-7-136.
Dennis CL. Peer support within a health care context: a concept analysis. Internat J Nurs Stud 2003;40(3):321-32.
Pantalone K, Misra-Hebert A, Hobbs T, Kong S, Ji X, Ganguly R, et al. The probability of A1C goal attainment in patients with uncontrolled type 2 diabetes in a large integrated delivery system: a prediction model. Diabetes Care 2020;43(8):1910-9.
Rakkwamsuk S, Reunreang T. Factors predicting health behaviors among type 2 diabetes patients dwelling in Mueng district, Chon Buri province. Royal Thai Navy Medical Journal 2020;47(3):544-61. (in Thai).
UKPDS. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group. Lancet 1998;352(9131):837-53.
Qi L, Liu Q, Qi X, Wu N, Tang W, Xiong H. Effectiveness of peer support for improving glycaemic control in patients with type 2 diabetes: a meta-analysis of randomized controlled trials. BMC Public Health 2015 May 6;15:471. doi: 10.1186/s12889-015-1798-y.