Peer support reduces hospitalizations in diabetics with comorbid depression
Peer support reduces the utilization of acute care (AC) in type 2 diabetes patients with comorbid depression, reports a recent study.
Researchers randomly assigned 360 adults (mean age 60.2±12.1 years; 75.3 percent female) with type 2 diabetes to receive either peer support or usual care. Depressive symptoms were measured using the Patient Health Questionnaire (PHQ), while AC and hospital utilization was evaluated through self-reports.
At baseline, half of the participants had PHQ >5 and a fourth had PHQ >10. Mean glycated haemoglobin level was 7.9 percent, and the mean duration of diabetes was 13.3 years. There was no significant difference in baseline AC utilization between intervention and control groups.
At the 12-month follow-up, AC visits (incidence rate ratio [IRR], 0.699; 95 percent CI, 0.386–1.27; p=0.238), hospitalizations (IRR, 0.505; 0.21–1.21; p=0.128) and other visits were statistically comparable between those who received the peer support intervention and usual care control.
However, in the subset of participants with PHQ score >5, the intervention appeared to significantly reduce the rate of hospitalization by 74 percent at follow-up (IRR, 0.26; 0.08–0.84). The same was true for AC visits (IRR, 0.55; 0.28–1.07).
Moreover, the predicted number of hospitalizations in the intervention and control groups were 0.85 and 3.23 per 10 person-years, respectively. In absolute terms, this corresponds to one hospitalization prevented per year for every 4.2 participants enrolled in the intervention.
Researchers obtained similar results when they restricted the analysis to those with PHQ scores >10, but not to those with scores <5. The findings thus indicated that peer support holds value for diabetics with, but not without, depressive symptoms.