Peer mentorship to improve self-management of hip and knee osteoarthritis: a randomised feasibility trial

Abstract

ObjectiveTo determine the feasibility of conducting a randomised controlled trial (RCT) of a peer mentorship intervention to improve self-management of osteoarthritis (OA).DesignSix-month parallel group non-blinded randomised feasibility trial.SettingOne secondary care and one primary care UK National Health Service Trust.ParticipantsFifty adults aged ≥55 years old with hip and/or knee OA.InterventionsParticipants were allocated 1:1 to the intervention or control group using an online randomisation service. Intervention group participants received usual care (information resources) and up to eight community-based self-management support sessions delivered by a peer mentor (trained volunteer with hip and/or knee OA). Control group participants received usual care only.Outcome measuresKey feasibility outcomes were participant and peer mentor recruitment and attrition, intervention completion and the sample size required for a definitive RCT. Based on these feasibility outcomes, four success criteria for proceeding to a definitive RCT were prespecified. Patient-reported outcomes were collected via questionnaires at baseline, 8 weeks and 6 months.ResultsNinety-six individuals were screened, 65 were eligible and 50 were randomised (25 per group). Of the 24 participants who commenced the intervention, 20 completed it. Four participants did not complete the 6-month questionnaire. Twenty-one individuals were eligible for the peer mentor role, 15 were trained and 5 withdrew prior to being matched with a participant. No intervention-related harms occurred. Allowing for 20% attrition, the sample size required for a definitive RCT was calculated as 170 participants. The intervention group showed improvements in self-management compared with the control group.ConclusionsThe feasibility outcomes achieved the prespecified criteria for proceeding to an RCT. The exploratory analyses suggest peer mentorship may improve OA self-management. An RCT of the OA peer mentorship intervention is therefore warranted with minor modifications to the intervention and trial procedures.Trial registration numberISRCTN:50675542.

Exploring the feasibility, acceptability and value of volunteer peer mentors in supporting self-management of osteoarthritis: a qualitative evaluation

“…Volunteers were given an educational resource manual and handouts to use in support sessions with mentees. Additional information about peer mentor training and associated costs can be found in the feasibility trial paper [ 42 ].…”

“…The overall aim of the study was to develop and trial a peer mentorship support intervention to improve self-management amongst older people with hip/knee osteoarthritis, and determine the feasibility of conducting a definitive randomised controlled trial (RCT). Using the Medical Research Council guidance on developing and evaluating complex interventions [ 41 ] as a theoretical structure we developed, piloted and evaluated the peer mentorship support intervention as a two-arm randomised feasibility trial, reported elsewhere [ 42 ], with a nested qualitative evaluation, reported here. Key objectives were to assess feasibility and acceptability of the intervention and trial procedures, including: mentor and mentee recruitment and retention; mentor training; intervention costs; completion rates; and potential impacts of the intervention on participants.…”

Mediating effect of self-efficacy on the relationship between social support and self-management behaviors among patients with knee osteoarthritis: a cross-sectional study

“…Few studies have investigated the relationship between self-efficacy, social support, and self-management in patients with KOA, which are limited to exploring the effect of self-efficacy on self-management of pain control and physical activity [22][23][24], as well as peer support for self-management behaviors [25]. Therefore, underlying mechanisms for associations between social support, self-efficacy and overall self-management behaviors remains unclear.…”

Protocol for a pragmatic feasibility randomised controlled trial of peer coaching for adults with long-term conditions: PEER CONNECT

“… 8 9 13 A recent feasibility RCT of peer mentorship for people with osteoarthritis in the UK reports a mixed picture with challenges in matching coaches to peers and difficulties with coach retention alongside positive reports of coach enjoyment and satisfaction. 7 16 We have not located any studies of peer coaching that have targeted peer coaching interventions at patients reporting low levels of activation. People with low levels of activation stand to benefit most from an intervention designed to improve confidence, problem solving and ability to manage their healthcare and well-being.…”

“…An alternative approach to staff delivery of coaching services is to involve patients with lived experience as coaches (peer coaches) especially if they are highly activated (PAM levels 3 and 4). There is an expanding body of research exploring the effectiveness of peer coaching provided via a range of delivery modes; in-person7 8; telephone9 10 and digital 11. Recent randomised controlled trials (RCTs) of peer coaching have included people with diabetes9 12 13 and chronic pain 8 14 15.…”