Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
Syst Rev. 2022 Sep 12;11(1):200. doi: 10.1186/s13643-022-02064-6.
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.
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, for people with IBD and/or their carers of any age and in any setting were included. Effectiveness was evaluated using outcomes relating to physical and psychosocial function, disease control and healthcare utilisation. Data for each outcome were tabulated and presented in a narrative synthesis. Study design specific tools were used to assess risk of bias. Study selection and risk of bias assessment were undertaken by two reviewers independently.
Fourteen completed studies and five ongoing studies met the inclusion criteria. Substantial heterogeneity was observed in the studies in relation to the intervention type and peer support was usually part of a wider intervention. All but one study analysed the total effect of the intervention, so it was not possible to fully isolate the effect of the peer support alone. The appropriateness of outcomes and outcome measurement tools for the assessment of effects was a further key issue. As such, overall, no significant evidence of beneficial effects of peer support interventions on quality of life and other psychosocial outcomes was found.
New randomised controlled trials designed to isolate the effects of peer support are needed to evaluate the (net) effects of peer support only. Agreement on the outcomes to be targeted, and the choice of reliable and validated measurement tools for standalone peer support interventions would provide a focus for further intervention design and evaluation.
The protocol was accepted in the international prospective register of systematic reviews (PROSPERO CRD42020168817).
具有相同条件的人提供的支持,包括炎症性肠病(IBD),通过让患者从更有经验的同龄人那里获得情感支持和学习应对策略,有可能改善一系列心理社会结果。本系统评价的目的是总结关于同伴支持干预及其对 IBD 患者有效性的证据。
从创建到 2021 年 11 月,检索了文献数据库、会议记录、灰色文献和临床试验登记处。纳入了评估仅或部分为同伴支持的干预措施的比较和单臂研究,这些研究针对任何年龄和任何环境的 IBD 患者及其护理人员。使用与身体和心理社会功能、疾病控制和医疗保健利用相关的结果来评估有效性。为每个结果制表并以叙述性综合形式呈现。使用特定于研究设计的工具评估偏倚风险。两名评审员独立进行研究选择和偏倚风险评估。
符合纳入标准的有 14 项已完成的研究和 5 项正在进行的研究。研究在干预类型方面存在很大的异质性,同伴支持通常是更广泛干预的一部分。除一项研究外,所有研究都分析了干预的总体效果,因此无法完全孤立出同伴支持的单独效果。适当的结局和结局测量工具用于评估效果也是一个关键问题。因此,总体而言,没有发现同伴支持干预对生活质量和其他心理社会结局有显著有益影响的证据。
需要新的随机对照试验来设计仅评估同伴支持的效果。对于同伴支持的目标结局和可靠有效的独立同伴支持干预措施的选择达成一致意见,将为进一步的干预设计和评估提供重点。
该方案已在国际前瞻性系统评价注册库(PROSPERO CRD42020168817)中获得接受。