Krishnamoorthy Yuvaraj, Sakthivel Manikandanesan, Sarveswaran Gokul, Eliyas Salin Kandanalil
Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry 605008, India.
Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry 605008, India.
Prim Care Diabetes. 2019 Apr;13(2):158-169. doi: 10.1016/j.pcd.2018.11.007. Epub 2018 Dec 8.
Peer-led intervention allows the patients to develop knowledge, skills and confidence in managing their own conditions. Hence this review was done to assess the effectiveness of peer-led intervention in improving the clinical outcomes of DM and HTN patients. We conducted systematic search in Medline, CENTRAL, Sciencedirect and Google-Scholar from inception till May 2018 and retrieved 3654 citations. Meta-analysis was performed using random-effects model and pooled mean difference (MD) was reported with 95% CI. Publication bias was assessed using Egger's test. 29 trials (26 DM and 3 HTN) with 6363 participants were included. There was positive effect of peer led intervention on DM and HTN with pooled MD of -0.28% [95%CI: -0.45 to -0.11] and -7.52mmHg [95%CI: -14.39 to -0.66]. There was significant heterogeneity and publication bias in both DM and HTN trials. Sensitivity analysis showed only little improvement in the final estimate. Peer support intervention is effective and causes statistically significant reduction in HbA1C and systolic blood pressure among DM and HTN patients.
同伴主导的干预措施能让患者在管理自身病情方面增长知识、提升技能并增强信心。因此，开展此项综述以评估同伴主导的干预措施在改善糖尿病和高血压患者临床结局方面的有效性。我们从数据库建库至2018年5月在Medline、CENTRAL、Sciencedirect和谷歌学术进行了系统检索，共检索到3654篇文献。采用随机效应模型进行荟萃分析，并报告合并均数差（MD）及95%置信区间（CI）。使用Egger检验评估发表偏倚。纳入了29项试验（26项糖尿病试验和3项高血压试验），共6363名参与者。同伴主导的干预措施对糖尿病和高血压有积极影响，合并MD分别为-0.28% [95%CI：-0.45至-0.11]和-7.52mmHg [95%CI：-14.39至-0.66]。糖尿病和高血压试验均存在显著的异质性和发表偏倚。敏感性分析显示最终估计值仅有微小改善。同伴支持干预措施是有效的，且能使糖尿病和高血压患者的糖化血红蛋白和收缩压在统计学上显著降低。
