The Effect of a Peer-Based Educational and Supportive Intervention on Diabetes Distress and Treatment Adherence in Patients with Type 2 Diabetes: A Clinical Trial

Abstract Background and Objective: Type 2 diabetes mellitus (T2DM) is one of the most prevalent chronic non-communicable diseases, characterized not only by physical complications but also by psychological distress and diminished treatment adherence. Diabetes-related psychological distress can adversely affect self-care behaviors and compliance with therapeutic regimens. Consequently, identifying effective interventions to reduce distress and enhance treatment adherence is of critical importance. To this end, the present study aimed to evaluate the effect of a peer-based educational and supportive intervention on the levels of psychological distress and treatment adherence among patients with type 2 diabetes. Methods This clinical trial study was conducted among patients with type 2 diabetes. Sixty-six patients meeting the inclusion criteria were randomly assigned to either an intervention or a control group (n = 33 per group). The data were collected using the Diabetes Distress Scale and the Treatment Adherence Questionnaire for Chronic Diseases. The participants in the intervention group received peer-based education and support during five weekly sessions, each lasting 30 to 40 minutes. Assessments were performed at three stages: baseline (pre-test), immediately after the intervention, and at a two-month follow-up. The data were analyzed using the independent samples t-test, analysis of covariance (ANCOVA), and repeated measures ANOVA via SPSS (version 23). Results The results indicated a statistically significant reduction in the mean psychological distress scores of the intervention group immediately after the intervention (p = 0.01) and at the two-month follow-up (p = 0.001), whereas no significant changes were observed in the control group (p = 0.86). Furthermore, the total treatment adherence score and all its dimensions—including effort, participation, adaptability, integration of treatment into daily life, persistence, commitment, and implementation—increased significantly in the intervention group (p < 0.05). These effects remained sustained for up to two months following the intervention (p < 0.05). Conclusion The peer-based educational and supportive intervention significantly improved treatment adherence and reduced psychological distress in patients with type 2 diabetes. Due to its cost-effectiveness, ease of implementation, and cultural acceptability, this approach can be utilized as an effective strategy in education and care programs for diabetic patients within primary healthcare systems.