Overview of Peer Support Models to Improve Diabetes Self-Management and Clinical Outcomes

Diabetes Spectrum Volume 20, Number 4, 2007 The success of therapies for diabetes depends on the ability of adults with diabetes to successfully sustain effective self-management behaviors: taking prescribed medications, following diet and exercise regimens, self-monitoring, and coping emotionally with the rigors of living with diabetes. Yet, many patients face multiple barriers to effective diabetes self-management. These include lack of sufficient knowledge of diabetes or its treatment, lack of self-confidence or skills to manage diabetes well, lack of financial resources for medications and supplies, and other comorbidities and physical limitations. In addition, many adults with diabetes lack effective support from their families and friends for their diabetes selfmanagement. This lack represents an often-neglected barrier to successful diabetes care and self-management.1 Productive health care visits and nurse case management programs are important means of supporting patients’ diabetes self-management but alone often cannot adequately meet many patients’ needs. The time allotted for an outpatient visit is often inadequate to address all of the questions that a patient has about selfcare, and nurses and care managers have the challenge of regularly communicating with a large, dispersed panel of patients and tailoring that communication to each individual’s needs. Moreover, although research has shown that intensive care management interventions, such as faceto-face or telephone contact with a nurse care manager between medical visits, are effective for patients with high-risk chronic diseases, such as diabetes and heart failure,2,3 these programs are laborand resourceintensive. Many health care systems lack the resources to implement intensive nurse-led case management programs. Higher levels of social support— especially illness-specific or regimenspecific support—are associated with better diabetes and other illness selfmanagement.1,4–8 Moreover, observational studies suggest that providing social support to others may result in health benefits comparable to—or even greater than—receiving support. Individuals who provide Overview of Peer Support Models to Improve Diabetes Self-Management and Clinical Outcomes