22 October 2010

Peer to Peer Diabetes Help More Advantageous

I am happy. This is now the second article about peer to peer assistance taking place under university direction and doing better than those trained to do this. What does that tell us? Apparently there is a need for more peer workers, although it appears that this is on a volunteer basis, there is a need that the trained professional are not meeting. This is what I wrote about the first one I found. The same study is covered here by another Type 2 blogger, Elizabeth Woolley.

This involved a group of veterans and the University of Michigan Medical School. The Veterans Affairs Ann Arbor Health System established the peer partnership group and the study was based on this group. Each peer pair received initial training in peer communication skills. Communicating by telephone at least once a week was expected between the peer pair.

This was a learn by doing example for reinforcing what they were learning. Michele Heisler M.D., the study lead author and research scientist for the Center for Clinical Management Research at the Ann Arbor plus other credentials stated “We are trying to tap into the under-appreciated expertise of patients.” Good for her!

Using 244 VA patients with unmanaged diabetes that were randomly assigned to peer support or traditional nurse care management, the study concluded that peer to peer assistance led to a greater A1c improvement. While we are not informed about the before average of either group, the level of improvement was 0.58 percentage points lower in the peer support when compared to the nurse care management group.

There was overall better results in the peer group and a feeling of success not expressed by the other group. This again points to the need for more efforts to involve patients with diabetes to be allowed to assist new patients and existing patients and shows the need to remove the over trained people and let them function in other areas where that are shortages of trained professionals.

One of the doctors in talking about the study apparently did not like peer to peer or “Johnny-do-gooder” as he called them. He seems to have forgotten who is paying him and was doing his best to downplay the results. Read his comments here in the latter part of the article. (link is broken)

I would encourage finding a way to compensate patients that are doing this, but that will need to be worked out with doctors and the insurance companies. And this may be difficult in view of the attitude of the above doctor and others like him.

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