Individuals with diabetes and depression could decrease their acute care (AC) visits if they have peer support, new research has found.
Researchers assessed adults with type 2 diabetes looking for help with self-management. Patients without a doctor, who had limited life expectancy, who planned to move within the next year, and who would not work with a peer advisor were excluded. Depression symptoms were evaluated with the Patient Health Questionnaire (PHQ-8), and patients self-reported AC and hospital visits. Data were gathered at baseline, six months, and one year.
About half of patients had initial symptoms of mild depression (52% intervention, 48% control; P = 0.37). A quarter had moderate symptoms (25% intervention, 26% control; P = 1.0). AC and hospital visit rates were similar between the groups. Mild depression patients had an incident rate ratio (IRR) for hospitalization among intervention compared with control patients of 0.26 (95% CI 0.08–0.84) per 10 patient-years. For AC, the IRR was 0.55 (95% CI 0.28–1.07) per 10 person-years. Rates were similar in moderately depressed patients.
“We found that, for those with diabetes and mild to severe depression, peer support reduced hospitalizations by 70 percent and acute care by 50 percent,” said lead author Andrea Cherrington, M.D., professor in the Division of Preventive Medicine.
The results call for new disease management strategies, according to Dr. Cherrington.
“Diabetes is a costly disease,” she said. “We need to come up with strategies to enhance an individual’s self-management and improve health outcomes, all while simultaneously managing cost.”
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