Can peer support be cost saving? An economic evaluation of RAPSID: a randomized controlled trial of peer support in diabetes compared to usual care alone in East of England communities

Abstract

BackgroundDiabetes peer support, where one person with diabetes helps others, may improve diabetes management. The objective of this study was to perform a cost analysis of peer support strategies used in RAndomized controlled trial of Peer Support in type 2 Diabetes.MethodsWe performed a 2×2 factorial randomized cluster controlled trial in England. People with type 2 diabetes were invited to participate as either ‘peer’ or ‘peer support facilitator’ (PSF) through postal invitation predominantly from general practice. Clusters, based on local communities, were each randomly assigned to one arm of group, 1:1, both group and 1:1 or control interventions. The intervention was delivered over 8–12 months by trained PSFs, supported by monthly meetings with a diabetes nurse. Out-of-pocket expenses/service utilization were self-reported at baseline, midpoint and on trial completion. Intervention costs were collated. Non-hospital costs used National Health Service (NHS) reference costs. Hospital payments were obtained from one local commissioning group and mean payments calculated. The analysis employed a societal perspective. Costs were evaluated at the conclusion of the trial.ResultsParticipants (n=1299) were recruited across 130 clusters. The four arms were well balanced and matched (60% male, mean diabetes duration 9.5 years, mean glycated haemoglobin (HbA1c) 7.4+/-1.3%, 17% insulin treated). Implementation costs at 2013 rates were £13.84/participant/annum, participant out-of-pocket expenses for any intervention were £11.41/participant/annum and the NHS-incurred costs were reduced by £138.38/participant/annum. Savings for the 1:1, group and any intervention were £233.65, £90.52 and £113.13/participant/annum, respectively.ConclusionsWe conclude that both 1:1 and group diabetes peer support over 8–12 months are cost saving in this setting, although much of the benefit is largely derived by differences in self-reported healthcare utilization. Long-term benefits should be investigated.Trial registration numberISRCTN66963621

In-Person and Technology-Mediated Peer Support in Diabetes Care: A Systematic Review of Reviews and Gap Analysis

“…25 Based on our findings, consideration should be given to how peer support can be influential from a population management perspective, especially given evidence on the cost-effectiveness of peer support on acute care outcomes. [26][27][28][29] Although some research exists, 22,30 we do not yet fully understand the specific peer characteristics that would optimize clinical outcomes.…”

Web-Based Peer Support Interventions for Adults Living With Chronic Conditions: Scoping Review

“…Previous research has indicated that peers can support chronic disease self-management [8] in a cost-effective manner [8][9][10]. For example, an economic evaluation conducted by Graffy et al [11] found lower total health care costs due to decreased hospitalization expenses among individuals with diabetes who had received peer support (group or one-to-one delivery) compared with those among control groups.…”

“…In the context of chronic disease management, peer support refers to providing assistance to other individuals with similar conditions [ 8 , 11 ]. Programs with an associated peer support component have 3 commonalities: support for emotional, informational, and appraisal needs [ 12 ].…”

Precision Medicine in Lifestyle Medicine: The Way of the Future?

“…Face-to-face support groups 272 that persist beyond the intervention and peer mentoring/support (the buddy system) 273-275 may be effective means of both supporting behavior change and reducing the negative impact of social isolation by providing new social ties and support, other than that of a paid health professional. They can also be more cost-effective, 276 an important consideration in an era of skyrocketing health costs.…”