More evidence needed on the cost-effectiveness of peer support in type 2 diabetes

Tug of war

A recently study looked at the cost-effectiveness of a peer support intervention in type 2 diabetes.

Study question:

In type 2 diabetes in primary care, are peer-support programmes cost effective?

Quality of life outcomes were assessed in a randomised trial while long term costs were derived from analysis of the UKPDS model.

The evidence:

The researchers randomly assigned 395 patients to a peer-support intervention or usual care.

The study reported a statistically non-significant improvement in quality of life for participants in the peer-support intervention.  Further analysis of patient costs found a non-significant reduction in costs.  Nevertheless, the researchers concluded:

The likelihood of the intervention being cost-effective was appreciably higher than 80 percent for a range of potential willingness-to-pay cost-effectiveness thresholds.

Whilst this study shows promise, more research is needed to reduce the uncertainty around the findings.

Appraisal hints:

  • Was the intervention adequately described in the paper?  Is it feasible in other settings?
  • Was randomisation carried out properly?
  • Were the control and intevention groups similar at the start of the trial and treated equally throughout?
  • Were patients analysed in the groups to which they were originally assigned?
  • Blinding will be difficult in this study;  did the researchers try to compensate for this by blinding outcomes assessors and analysts?
  • Does the UKPDS provide an appropriate model of outcomes for your setting?
  • Were both direct and indirect costs included?


Gillespie P, O’Shea E, Paul G, O’Dowd T, Smith SM. Cost effectiveness of peer support for type 2 diabetes. International Journal of Technology Assessment in Health Care 2012; 28(1): 3-11.

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I am an information scientist with an interest in making knowledge from systematic research more accessible to people who need it. This means you. I've been attempting this in the area of Evidence-Based Health Care since 1995. So far the results have been mixed. For some reason we expected busy clinicians to search databases and appraise papers instead of seeing patients. We also expected publishers to make the research freely available to the people who paid for it.. Ha! Hence The National Elf service.

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