Peer Support in Inflammatory Bowel Disease (IBD): A Systematic Review

Abstract

Background: The support provided by people with the same condition, including inflammatory bowel diseases (IBD) has the potential to improve a range of psychosocial outcomes by allowing people with the disease to receive emotional support as well as to learn coping strategies from more experienced peers. The aim of this systematic review was to summarise the evidence on peer support interventions and their effectiveness on people with IBD.Methods: Bibliographic databases, conference proceedings, grey literature, and clinical trial registers were searched from inception to November 2021. Comparative and single-arm studies that evaluated interventions that were solely or contained in part peer support, on people with IBD and/or their carers were included. Effectiveness was evaluated in a range of outcomes relating to physical and psychosocial function, disease control and healthcare utilisation. Data for each of the outcomes were tabulated and presented in narrative synthesis. Study design specific tools were used to assess risk of bias in duplicate.Results: Fourteen completed studies and five ongoing studies met the inclusion criteria. Substantial heterogeneity was observed in the studies in relation to the intervention type. Overall, no significant evidence of beneficial effects of peer support interventions on quality of life and other psychosocial outcomes was found. As all but one of the included studies analysed only the total effect of the interventions, it was not possible to isolate the effect of the peer support components. The appropriateness of outcomes and outcome measurement tools for the assessment of the effects of peer support interventions was a key issue. Conclusions: New randomised controlled trials are needed to evaluate the (net) effects of peer support only. Agreement on the choice of reliable and validated measurement tools and on the outcomes to be targeted by standalone peer support interventions would provide a focus for further intervention design and evaluation.Systematic review registration: The protocol was accepted in the international prospective register of systematic reviews (PROSPERO CRD42020168817). This work was part supported by a grant from Bowel Research UK.