Telephone based self-management support by ‘lay health workers’ and ‘peer support workers’ to prevent and manage vascular diseases: a systematic review and meta-analysis

BMC Health Services Research

Peter Bower¹  Carolyn A Chew-Graham²  Maria Panagioti¹  Tom Blakeman¹  Christian Blickem¹  Nicola Small¹ 

[1]Greater Manchester Collaboration for Leadership in Applied Health Research and Care, Centre for Primary Care, and Manchester Academic Health Science Centre, University of Manchester, Manchester, UK

[2]Research Institute Primary Care and Health Sciences, Keele University, Keele, UK

关键词: Meta-analysis;    Review;    Randomised controlled trial;    Health services research;    Social disadvantage;    Patients;    Management;    Prevention;    Chronic kidney disease;    Vascular disease;    Telephone;    Lay;    Peer;    Non-healthcare professional;    Chronic care;    Self-management support;   

Others  :  1134392
DOI  :  10.1186/1472-6963-13-533

 received in 2013-07-05, accepted in 2013-12-10,  发布年份 2013

【 摘 要 】

Background

Improved prevention and management of vascular disease is a global priority. Non-health care professionals (such as, ‘lay health workers’ and ‘peer support workers’) are increasingly being used to offer telephone support alongside that offered by conventional services, to reach disadvantaged populations and to provide more efficient delivery of care. However, questions remain over the impact of such interventions, particularly on a wider range of vascular related conditions (such as, chronic kidney disease), and it is unclear how different types of telephone support impact on outcome. This study assessed the evidence on the effectiveness and cost-effectiveness of telephone self-management interventions led by ‘lay health workers’ and ‘peer support workers’ for patients with vascular disease and long-term conditions associated with vascular disease.

Methods

Systematic review of randomised controlled trials. Three electronic databases were searched. Two authors independently extracted data according to the Cochrane risk of bias tool. Random effects meta-analysis was used to pool outcome measures.

Results

Ten studies were included, primarily based in community settings in the United States; with participants who had diabetes; and used ‘peer support workers’ that shared characteristics with patients. The included studies were generally rated at risk of bias, as many methodological criteria were rated as ‘unclear’ because of a lack of information.

Overall, peer telephone support was associated with small but significant improvements in self-management behaviour (SMD = 0.19, 95% CI 0.05 to 0.33, I² = 20.4%) and significant reductions in HbA1c level (SMD = -0.26, 95% CI −0.41 to −0.11, I² = 47.6%). There was no significant effect on mental health quality of life (SMD = 0.03, 95% CI −0.12 to 0.18, I² = 0%). Data on health care utilisation were very limited and no studies reported cost effectiveness analyses.

Conclusions

Positive effects were found for telephone self-management interventions via ‘lay workers’ and ‘peer support workers’ for patients on diabetes control and self-management outcomes, but the overall evidence base was limited in scope and quality. Well designed trials assessing non-healthcare professional delivered telephone support for the prevention and management of vascular disease are needed to identify the content of effective components on health outcomes, and to assess cost effectiveness, to determine if such interventions are potentially useful alternatives to professionally delivered care.

【 授权许可】

   
2013 Small et al.; licensee BioMed Central Ltd.

【 图 表 】

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【 参考文献 】

• [1]Murray C, Lopez A: The global burden of disease: a comprehensive assessment of mortality and disability from disease, injuries and risk factors in 1990. Cambridge: The Harvard School of Public Health: World Health Organization: Harvard University Press; 1996.
• [2]National Institute for Health and Clinical Excellence: Prevention of cardiovascular disease at population level. London: National Institute for Health and Clinical Excellence; 2010.
• [3]Wagner E, Austin B, Davis C, Hindmarsh M, Schaefer J, Bonomi A: Improving chronic illness care: translating evidence into action. Health Aff 2001, 20:64-78.
• [4]National Institute for Health and Clinical Excellence: Chronic kidney disease. Early identification and management of chronic kidney disease in adults in primary and secondary care. 73rd edition. London: Clinical guidelines CG; 2008.
• [5]Michie S: Designing and implementing behaviour change interventions to improve population health. J Health Serv Res Policy 2008, 13:64-69.
• [6]Stewart M, Tilden V: The contributions of health care science to social support. Int J Nurs Stud 1995, 32:535-544.
• [7]Kennedy A, Reeves D, Bower P, Lee V, Middleton E, Richardson G, et al.: The effectiveness and cost effectiveness of a national lay led self care support programme for patients with long-term conditions: a pragmatic randomised controlled trial. J Epidem Comm Health 2007, 61:254-261.
• [8]Lewin S, Dick J, Pond P, Zwarenstein M, Aja G, van Wyk B: Lay health workers in primary and community health care. Coch Data Syst Rev 2005., 25doi: 10.1002/14651858.CD004015.pub2
• [9]Dale J, Caramlau I, Sturt J, Friede T, Walker R: Telephone peer-delivered intervention for diabetes motivation and support: the telecare exploratory RCT. Pat Ed Couns 2009, 75:91-98.
• [10]Dale J, Caramlau I, Docherty A, Sturt J, Hearnshaw H: Telecare motivational interviewing for diabetes patient education and support: a randomised controlled trial based in primary care comparing nurse and peer supporter delivery. Trials 2007, 8:1-8. BioMed Central Full Text
• [11]Kim H, Oh J: Adherence to diabetes control recommendations: impact of nurse telephone calls. J Adv Nurs 2003, 44:256-261.
• [12]Kirkman M, Weinberger M, Landsman P, Samsa G, Shortliffe E, Simel D, Feussner J: A telephone-delivered intervention for patients with NIDDM. Effect on coronary risk factors. Diab Care 1994, 17:840-846.
• [13]Dale J, Caramlau I, Lindenmeyer A, Williams S: Peer support telephone calls for improving health. Coch Data Syst Rev 2009., 8doi: 10.1002/14651858.CD006903.pub2
• [14]Inglis S, Clark R, McAlister F, Ball J, Lewinter C, Cullington D, et al.: Structured telephone support or telemonitoring programmes for patients with chronic heart failure. Coch Data Syst Rev 2010., 4doi: 10.1002/14651858.CD007228.pub2
• [15]Dennis C: Peer support within a healthcare context: a concept analysis. Int J Nurs Stud 2003, 40:321-332.
• [16]Blickem C, Blakeman T, Kennedy A, Bower P, Reeves D, Gardner C, et al.: The clinical and cost-effectiveness of the BRinging Information and Guided Help Together (BRIGHT) intervention for the self-management support of people with stage 3 chronic kidney disease in primary care: study protocol for a randomised controlled trial. Trials 2013, 14:1-11. BioMed Central Full Text
• [17]Gansevoort R, Correa-Rotter R, Hemmelgarn B, Jafar T, Heerspink H, Mann J, et al.: Chronic kidney disease and cardiovascular risk: epidemiology, mechanisms, and prevention. Lancet 2013, 382:339-352.
• [18]de Lusigan S, Gallagher H, Stevens P, Harris K, Dimitrieva O, Tahir A, et al.: Chronic Kidney Disease Frequently Asked Questions. London: NHS Employers and the General Practitioners Committee of the British Medical Association; 2011.
• [19]Medical Research Council: Developing and evaluating complex interventions: new guidance. London: MRC; 2008.
• [20]Bodenheimer T, Wagner E, Grumbach K: Improving primary care for patients with chronic illness: the chronic care model, part 2. JAMA 2002, 288:1909-1914.
• [21]Centre for Reviews and Dissemination: Undertaking Systematic Reviews of Research Effectiveness: CRD's Guidance for those carrying out or commissioning reviews. York: Centre for Reviews and Dissemination; 2001.
• [22]Higgins J, Green S: Cochrane Hanbook for Systematic Reviews of Interventions. Chichester, UK: The Cochrane Collaboration. John Wiley & Sons Ltd; 2008. [Cochrane Book Series]
• [23]Royle P, Waugh N: A simplified search strategy for identifying randomised controlled trials for systematic reviews of healthcare interventions: a comparison with more exhaustive strategies. Med Res Method 2005, 5:1-7. BioMed Central Full Text
• [24]Jacobson N, Trojanowski L, Dewa C: What do peer support workers do? A job description. HSR 2012, 12:1-11.
• [25]Department of Health: Self Care: A National View in 2007 Compared to 2004–05. London: The Stationery Office; 2007.
• [26]Lipsey M, Wilson D: Practical Meta-Analysis. Thousand Oaks: CA: Sage Publications; 2001.
• [27]Turner B, Hollenbeak C, Liang Y, Pandit K, Joseph S, Weiner M: A randomised trial of peer coach and office staff support to reduce coronary heart disease risk in African-Americans with uncontrolled hypertension. J Gen Intern Med 2012, 27:1258-1264.
• [28]Walker E, Blanco E, Shmukler C, Scollan-Koliopoulus M, Ullman R, Cohen H: Results of a successful telephonic intervention to improve diabetes control in urban adults. Diab Care 2011, 34:2-7.
• [29]Heisler M, Vijan S, Makki F, Piette J: Diabetes control with reciprocal peer support versus nurse care management: a randomized trial. Annals Int Med 2010, 153:507-515.
• [30]Samuel-Hodge C, Keyserling TC, Park S, Johnston L, Bangdiwala S: A randomized trial of a church-based diabetes self-management program for African Americans with type 2 diabetes. Diab Edu 2009, 35:439-454.
• [31]Parry MW-WJ, Hodnett E, Tranmer J, Dennis C, Brooks D: Cardiac Home Education and Support Trial (CHEST): a pilot study. Canadian J Cardiol 2009, 25:e393-e398.
• [32]Batik O, Phelan E, Walwick J, Wang G, LoGerfo J: Translating a community-based motivational support program to increase physical activity among older adults with diabetes at community clinics: a pilot study of Physical Activity for a Lifetime of Success (PALS). Prev Chron Disease 2008, 5:1-7.
• [33]Carroll D, Rankin S, Cooper B: The effects of a collaborative peer advisor/advanced practice nurse intervention: cardiac rehabilitation participation and rehospitalization in older adults after a cardiac event. J Cardio Nurs 2007, 22:313-319.
• [34]Young RTJ, Friede T, Hollis S, Mason J, Lee P, Burns E, et al.: Pro-active call center treatment support (PACCTS) to improve glucose control in type 2 diabetes: a randomized controlled trial. Diab Care 2005, 28:278-282.
• [35]Keyserling T, Samuel-Hodge C, Ammerman A, Ainsworth B, Henriquez-Roldan C, Elasy T, et al.: A randomized trial of an intervention to improve self-care behaviors of African-American women with type 2 diabetes: impact on physical activity. Diab Care 2002, 25:1576-1583.
• [36]Tang T, Guadalupe X, Cherrington A, Rana G: A review of volunteer-based peer support interventions in diabetes. Diab Spect 2011, 24:85-98.
• [37]Heisler M: Overview of peer support models to improve diabetes self-management and clinical outcomes. Diab Spect 2007, 20:214-223.
• [38]Heisler M: Different models to mobilize peer support to improve diabetes self-management and clinical outcomes: evidence, logistics, evaluation considerations, and needs for future research. Fam Pract 2010, 27:i23-i32.
• [39]Brownson C, Heisler M: The role of peer support in diabetes care and self-management. Patient 2009, 2:5-17.
• [40]Norris S, Chowdhury F, Van Le K, Horsley T, Brownstein J, Zhang X, et al.: Effectiveness of community health workers in the care of persons with diabetes. Diab Med 2006, 23:544-556.
• [41]Perez-Escamilla R, Hromi-Fiedler A, Vega-Lopez S, Bermudez-Millan A, Segura-Perez S: Impact of peer nutrition education on dietary behaviours and health outcomes among Latinos: a systematic literature review. J Nutr Edu Behav 2008, 40:208-225.
• [42]American Diabetes Association: Standards of Medical Care in Diabetes - 2013. Diab Care 2013, 36:S11-S66.
• [43]National Kidney Foundation: KDQOI clinical practice guidelines and clinical practice recommendations for diabetes and chronic kidney disease. American J Kidney Disease 2007, 49:S1-S180.
• [44]Blakeman T, Protheroe J, Chew-Graham C, Rogers A, Kennedy A: Understanding the management of early-stage chronic kidney disease in primary care: a qualitative study. BJGP 2012, 62:e233-e242.
• [45]NICE National Institute for Health and Care Excellence: CG169 Acute kidney injury: full guideline. http://guidance.nice.org.uk//CG169/Guidance webcite [Accessed on 27 Aug 2013]
• [46]Feehally J, Gilmore I, Barasi S, Bosomworth M, Christie B, Davies A, et al.: RCPE UK Consensus statement on management of acute kidney injury: the role of fluids, e-alerts and biomarkers. Edinburgh: Royal College of Physicians of Edinburgh; 2012.
• [47]Barnett K, Mercer S, Norbury M, Watt G, Wyke S, Guthrie B: Epidemiology of mutlimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet 2012, 380:37-43.