Peer support for people with chronic conditions: a systematic review of reviews

Abstract

Background People with chronic conditions experience functional impairment, lower quality of life, and greater economic hardship and poverty. Social isolation and loneliness are common for people with chronic conditions, with multiple co-occurring chronic conditions predicting an increased risk of loneliness. Peer support is a socially driven intervention involving people with lived experience of a condition helping others to manage the same condition, potentially offering a sense of connectedness and purpose, and experiential knowledge to manage disease. However, it is unclear what outcomes are important to patients across the spectrum of chronic conditions, what works and for whom. The aims of this review were to (1) collate peer support intervention components, (2) collate the outcome domains used to evaluate peer support, (3) synthesise evidence of effectiveness, and (4) identify the mechanisms of effect, for people with chronic conditions. Methods A systematic review of reviews was conducted. Reviews were included if they reported on formal peer support between adults or children with one or more chronic condition. Data were analysed using narrative synthesis. Results The search identified 6222 unique publications. Thirty-one publications were eligible for inclusion. Components of peer support were organised into nine categories: social support, psychological support, practical support, empowerment, condition monitoring and treatment adherence, informational support, behavioural change, encouragement and motivation, and physical training. Fifty-five outcome domains were identified. Quality of life, and self-efficacy were the most measured outcome domains identified. Most reviews reported positive but non-significant effects. Conclusions The effectiveness of peer support is unclear and there are inconsistencies in how peers are defined, a lack of clarity in research design and intervention reporting, and widely variable outcome measurement. This review presents a range of components of peer support interventions that may be of interest to clinicians developing new support programmes. However, it is unclear precisely what components to use and with whom. Therefore, implementation of support in different clinical settings may benefit from participatory action research so that services may reflect local need.

Focusing a realist evaluation of peer support for paediatric mental health

“…In contrast to these myriad routes to service engagement as an outcome of peer support, professionals articulated that hope was singularly generated by peers sharing their lived experience which may inspire other children. The mechanisms and outcomes reported in this paper resemble Gillard's change model of adult peer support interventions (24,25), albeit reformulated from a realist perspective (14). Indeed, some caveats to how peer support interventions generate outcomes in different contexts were revealed by professionals, indicating when mechanisms may not be triggered when working with peers in particular service settings.…”

Towards evidence-based and inclusive models of peer support for long covid: A hermeneutic systematic review

“… Themes Papers included in theme Number of papers Peer support and Long COVID 2 systematic reviews ( Grant et al, 2021 ; Sokol and Fisher, 2016 ). 1 narrative review ( Callard and Perego, 2021 ), 1 service review ( Hope et al, 2021 ) 4 Qualitative studies ( Day, 2022 ; Mikal et al, 2021 ; Rushforth et al, 2021 ;; Russell et al, 2022 ) 1 Voluntary and Community Sector (VCS) report ( Graham, J. T., and Rutherford, K., 2016 ) Total: 9 Peer support in other chronic conditions 10 Systematic reviews ( Berg et al, 2021 ; Dale et al, 2012 ; Eysenbach et al, 2004 ; Gatlin et al, 2017 ; Kowitt et al, 2018 ; Lloyd-Evans et al, 2014 ; Lyons et al, 2021 ; Odgers-Jewell et al, 2017 ; Sokol and Fisher, 2016 ; Thompson et al, 2022 ), 4 scoping reviews ( Barclay and Hilton, 2019 ; Carter et al, 2020 ; Grant et al, 2021 , 2021g, 2021rd-Repål, 2021). 3 narrative reviews ( Carr, 2016 ; Heisler, 2007 ; Tang and Fisher, 2021 ), 5 qualitative papers ( ChemtobCaron et al, 2018 ; Haas et al, 2013 ; Litchman et al, 2018 ; Monroe et al, 2017 ; Power and Hegarty, 2010 ).…”

Peer support for carers and patients with inflammatory bowel disease: a systematic review

“…A systematic review of reviews on peer support across chronic conditions highlighted similar methodological limitations [ 55 ]. Syntheses of peer support for cardiovascular disease and diabetes indicated a significant small-medium effect on clinical surrogates including blood pressure and blood glucose.…”