BackgroundPeer support is valued by its users. Nevertheless, there is initial low take‐up of formal peer support programmes among patients with chronic kidney disease (CKD), with fewer patients participating than expressing an interest. There is little evidence on reasons for low participation levels. Few studies have examined the perspectives of carers.ObjectiveTo explore with CKD patients and carers their needs, wants and expectations from formal peer support and examine how barriers to participation may be overcome.MethodsQualitative interviews with a sample of 26 CKD stage five patients and carers. Principles of Grounded Theory were applied to data coding and analysis.SettingSix NHS Hospital Trusts.ResultsWhilst informal peer support might occur naturally and is welcomed, a range of emotional and practical barriers inhibit take‐up of more formalized support. Receptivity varies across time and the disease trajectory and is associated with emotional readiness; patients and carers needing to overcome complex psychological hurdles such as acknowledging support needs. Practical barriers include limited understanding of peer support. An attractive peer relationship is felt to involve reciprocity based on sharing experiences and both giving and receiving support. Establishing rapport is linked with development of reciprocity.ConclusionsThere is potential to facilitate active uptake of formal peer support by addressing the identified barriers. Our study suggests several facilitation methods, brought together in a conceptual model, including clinician promotion of peer support as an intervention suitable for anyone with CKD and their carers, and opportunity for choice of peer supporter.

SummaryAims/background: With the ageing population, numbers of glaucoma patients are an increasing problem in ophthalmic outpatient clinics. A postal questionnaire survey was carried out in Northern Ireland with the aim of finding out how well placed optometrists are to become involved in the monitoring of glaucoma.Results: Of the 171 practices surveyed, 68% of the senior practitioners responded. One practice was without a tonometer and one practice was without visual field instrumentation. Age criteria were used by 95% of practitioners for measuring intraocular pressure (IOP) and 82% used appropriate selection criteria for visual field testing. An IOP of 25 or 26 mmHg was used by 45% of practitioners as the level for referral if there are no risk factors; 89% would refer at any level if a visual field defect and disc cupping were present.Conclusion: The results confirm that the majority of optometrists are well equipped for the screening of glaucoma. However a significant investment in training and equipment would be required if any sort of shared care scheme were to be introduced. #

The results confirm that the majority of optometrists are well equipped for the screening of glaucoma. However a significant investment in training and equipment would be required if any sort of shared care scheme were to be introduced.

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