PMID- 24781960
OWN - NLM
STAT- MEDLINE
DCOM- 20140812
LR  - 20220317
IS  - 2168-6114 (Electronic)
IS  - 2168-6106 (Linking)
VI  - 174
IP  - 6
DP  - 2014 Jun
TI  - Effects of telephone-based peer support in patients with type 2 diabetes mellitus 
      receiving integrated care: a randomized clinical trial.
PG  - 972-81
LID - 10.1001/jamainternmed.2014.655 [doi]
AB  - IMPORTANCE: In type 2 diabetes mellitus (T2DM), team management using protocols 
      with regular feedback improves clinical outcomes, although suboptimal 
      self-management and psychological distress remain significant challenges. 
      OBJECTIVE: To investigate if frequent contacts through a telephone-based peer 
      support program (Peer Support, Empowerment, and Remote Communication Linked by 
      Information Technology [PEARL]) would improve cardiometabolic risk and health 
      outcomes by enhancing psychological well-being and self-care in patients 
      receiving integrated care implemented through a web-based multicomponent quality 
      improvement program (JADE [Joint Asia Diabetes Evaluation]). DESIGN, SETTING, AND 
      PARTICIPANTS: Between 2009 and 2010, 628 of 2766 Hong Kong Chinese patients with 
      T2DM from 3 publicly funded hospital-based diabetes centers were randomized to 
      the JADE + PEARL (n = 312) or JADE (n = 316) groups, with comprehensive 
      assessment at 0 and 12 months. INTERVENTIONS: Thirty-three motivated patients 
      with well-controlled T2DM received 32 hours of training (four 8-hour workshops) 
      to become peer supporters, with 10 patients assigned to each. Peer supporters 
      called their peers at least 12 times, guided by a checklist. MAIN OUTCOMES AND 
      MEASURES: Changes in hemoglobin A(1c) (HbA(1c)) level (primary), proportions of 
      patients with attained treatment targets (HbA(1c) <7%; blood pressure <130/80 mm 
      Hg; low-density lipoprotein cholesterol <2.6 mmol/L [to convert to milligrams per 
      deciliter, divide by 0.0256]) (secondary), and other health outcomes at month 12. 
      RESULTS: Both groups had similar baseline characteristics (mean [SD] age, 54.7 
      [9.3] years; 57% men; disease duration, 9.4 [7.7] years; HbA(1c) level, 8.2% 
      [1.6%]; systolic blood pressure, 136 [19] mm Hg; low-density lipoprotein 
      cholesterol level, 2.89 [0.82] mmol/L; 17.4% cardiovascular-renal complications; 
      and 34.9% insulin treated). After a mean (SD) follow-up period of 414 (55) days, 
      5 patients had died, 144 had at least 1 hospitalization, and 586 had repeated 
      comprehensive assessments. On intention-to-treat analysis, both groups had 
      similar reductions in HbA(1c) (JADE + PEARL, 0.30% [95% CI, 0.12%-0.47%], vs 
      JADE, 0.29% [95% CI, 0.12%-0.47%] [P = .97]) and improvements in treatment 
      targets and psychological-behavioral measures. In the JADE + PEARL group, 90% of 
      patients maintained contacts with their peer supporters, with a median of 20 
      calls per patient. Most of the discussion items were related to self-management. 
      CONCLUSIONS AND RELEVANCE: In patients with T2DM receiving integrated care, peer 
      support did not improve cardiometabolic risks or psychological well-being. TRIAL 
      REGISTRATION: clinicaltrials.gov Identifier: NCT00950716.
FAU - Chan, Juliana C N
AU  - Chan JC
AD  - Department of Medicine and Therapeutics, The Chinese University of Hong Kong, 
      Prince of Wales Hospital, Hong Kong2Hong Kong Institute of Diabetes and Obesity, 
      The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong3Asia 
      Diabetes Foundatio.
FAU - Sui, Yi
AU  - Sui Y
AD  - Asia Diabetes Foundation, Prince of Wales Hospital, Shatin, Hong Kong.
FAU - Oldenburg, Brian
AU  - Oldenburg B
AD  - Monash University, Melbourne, Victoria, Australia.
FAU - Zhang, Yuying
AU  - Zhang Y
AD  - Department of Medicine and Therapeutics, The Chinese University of Hong Kong, 
      Prince of Wales Hospital, Hong Kong.
FAU - Chung, Harriet H Y
AU  - Chung HH
AD  - Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, 
      Prince of Wales Hospital, Hong Kong.
FAU - Goggins, William
AU  - Goggins W
AD  - Jockey Club School of Public Health, The Chinese University of Hong Kong, Prince 
      of Wales Hospital, Shatin, Hong Kong.
FAU - Au, Shimen
AU  - Au S
AD  - Ruttonjee Hospital, Hong Kong.
FAU - Brown, Nicola
AU  - Brown N
AD  - Asia Diabetes Foundation, Prince of Wales Hospital, Shatin, Hong Kong.
FAU - Ozaki, Risa
AU  - Ozaki R
AD  - Department of Medicine and Therapeutics, The Chinese University of Hong Kong, 
      Prince of Wales Hospital, Hong Kong2Hong Kong Institute of Diabetes and Obesity, 
      The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong.
FAU - Wong, Rebecca Y M
AU  - Wong RY
AD  - Department of Medicine and Therapeutics, The Chinese University of Hong Kong, 
      Prince of Wales Hospital, Hong Kong.
FAU - Ko, Gary T C
AU  - Ko GT
AD  - Department of Medicine and Therapeutics, The Chinese University of Hong Kong, 
      Prince of Wales Hospital, Hong Kong.
FAU - Fisher, Ed
AU  - Fisher E
AD  - University of North Carolina, Chapel Hill.
CN  - JADE and PEARL Project Team
LA  - eng
SI  - ClinicalTrials.gov/NCT00950716
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - JAMA Intern Med
JT  - JAMA internal medicine
JID - 101589534
SB  - IM
CIN - JAMA Intern Med. 2014 Jun;174(6):982-3. PMID: 24781654
MH  - Adult
MH  - Aged
MH  - Cardiovascular Diseases/etiology/prevention & control
MH  - Diabetes Mellitus, Type 2/complications/*psychology/*therapy
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Peer Group
MH  - Risk Factors
MH  - Self Care
MH  - Social Support
MH  - Telephone
FIR - Ma, Ronald C W
IR  - Ma RC
FIR - Kong, Alice P S
IR  - Kong AP
FIR - Chow, Chun-Chung
IR  - Chow CC
FIR - So, Wing-Yee
IR  - So WY
FIR - Lau, Winnie
IR  - Lau W
FIR - Luk, Andrea
IR  - Luk A
FIR - Loo, Kitman
IR  - Loo K
FIR - So, Tammy
IR  - So T
FIR - Yeung, Theresa
IR  - Yeung T
FIR - Chan, Samsonly
IR  - Chan S
FIR - Tsang, C C
IR  - Tsang CC
FIR - Lau, Maggie
IR  - Lau M
FIR - Lau, K P
IR  - Lau KP
FIR - Lin, Grace
IR  - Lin G
EDAT- 2014/05/02 06:00
MHDA- 2014/08/13 06:00
CRDT- 2014/05/01 06:00
PHST- 2014/05/01 06:00 [entrez]
PHST- 2014/05/02 06:00 [pubmed]
PHST- 2014/08/13 06:00 [medline]
AID - 1863924 [pii]
AID - 10.1001/jamainternmed.2014.655 [doi]
PST - ppublish
SO  - JAMA Intern Med. 2014 Jun;174(6):972-81. doi: 10.1001/jamainternmed.2014.655.