School of Health and Society, University of Wollongong, Building 29, Room 315, NSW 2522, Australia.
School of Health and Society, University of Wollongong, Building 29, Room 315, NSW 2522, Australia.
Prim Care Diabetes. 2022 Dec;16(6):719-735. doi: 10.1016/j.pcd.2022.10.007. Epub 2022 Oct 25.
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.
2 型糖尿病（T2DM）是一个主要的健康风险，也是全球死亡率和发病率的主要原因。有类似慢性疾病的同伴提供的特定于疾病的支持已被证明可以改善慢性病自我管理的结果。本系统评价的目的是总结关于同伴教练主导的 2 型糖尿病自我管理干预对血糖控制和自我管理结果的现有证据。检索了 MEDLINE、PubMed、CINAHL Plus、Scopus、ProQuest Central、ScienceDirect、web of science、Wiley Online Library 和 UOW 图书馆等数据库，以寻找符合条件的论文。本综述纳入了 2008 年至 2021 年期间发表的 13 项随机对照试验（RCT）。随机效应荟萃分析发现，干预后 HbA1c（糖化血红蛋白）有统计学意义的变化。然而，荟萃分析显示，干预后干预组和对照组的 LDL（低密度脂蛋白）、BMI（体重指数）、SBP（血压）和 HRQoL（健康相关生活质量）没有显著变化。已确定的研究主要招募血糖水平不理想的患者；其中大多数属于低收入人群。我们的研究结果表明，同伴指导有助于改善 HbA1c 水平、生活质量、自我效能、糖尿病困扰和患者激活。此外，同伴指导与药物依从性、低血糖症状、糖尿病特定社会支持和抑郁之间的关系尚无定论。本综述得出的结论是，与常规护理相比，在血糖水平不理想的患者中，采用混合方法进行的基于社区的同伴主导干预，在改善 2 型糖尿病自我管理方面更为有效。
