The effectiveness of peer support on the recovery and empowerment of people with schizophrenia: A systematic review and meta-analysis.

BACKGROUND

People with schizophrenia have a shorter life span and high mortality and morbidity rates. Peer support is an important strategy that can improve outcomes for people with schizophrenia. Peer support involves people with a lived experience of recovery who help and support others experiencing mental health problems.

AIMS

The main aim of this systematic literature review was to examine the effectiveness of peer support on the recovery and empowerment outcomes of service users with schizophrenia disorders. The objectives were to contribute to evidence-based practice and promote peer support interventions in mental health services.

DATA SOURCES

We searched for randomised controlled trials (RCTs) on peer support in MEDLINE, CINAHL, AMED, Academic Search Premier, PubMed, PsycArticles, PsycINFO, Cochrane, and Psychology and Behavioural Sciences Collection. We identified additional trials from the citations of previous studies.

METHODS

We assessed the trials' methodological quality and biases using the risk of bias (RoB) and grading of recommendations, assessment, development, and evaluation (GRADE) tools. We performed a meta-analysis in the RevMan application and extracted data from the clinical trials using narrative synthesis. This systematic review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) procedures.

RESULTS

A total of 17 trials with 5974 participants were included in this review. The most common peer support was peer-led self-management interventions. The RE model (SMD = 0.29, 95 % CI = 0.13 to 0.45, p-value = 0.0004) shows that peer support interventions significantly improved the recovery outcome compared to standard care provided to service users with schizophrenia. The RE model (SMD = 0.22, 95 % CI = 0.11 to 0.33, p-value = 0.0001) also shows that peer support interventions significantly empowered service users with schizophrenia. However, the positive effects were small. A sub-group analysis found moderate effects on the recovery outcome among the emerging peer support interventions. The quality of the evidence was moderate.

CONCLUSIONS

Peer support interventions effectively improved the recovery and empowerment outcomes. Current clinical trials indicate that peer support is an essential psychosocial intervention in improving empowerment and recovery in service users with schizophrenia.