Peer support interventions for individuals with acquired brain injury, cerebral palsy, and spina bifida: a systematic review

Ben B Levy,Dorothy Luong,Sarah E P Munce,Mark T Bayley,Laure Perrier

doi:10.1186/s12913-019-4110-5

Abstract

BackgroundNeurological disorders may negatively impact community integration and/or quality of life. Peer support has emerged as a potential strategy to enhance patients’ efficacy in managing their own health. This review examines the key characteristics and impact of peer support interventions for adults with acquired brain injury, cerebral palsy, and spina bifida on community integration and quality of life.MethodsEligible studies reported on peer support interventions for adults (16 years of age or older) with acquired brain injury, cerebral palsy, or spina bifida. Only randomized controlled trials published in English in the last 10 years were included. MEDLINE, EMBASE, PsycINFO, and CINAHL were used to conduct the literature search. Two reviewers independently screened studies, abstracted data, and evaluated the risk of bias (for individual study elements and overall) using the Cochrane Risk of Bias Tool.ResultsThe systematic review included 6 trials reporting on acquired brain injury only. Of these studies, 4 reported on stroke and 2 reported on traumatic brain injury. Two studies found significant improvements in quality of life following peer support. No studies reported significant results on community integration. Considerable heterogeneity existed in the key characteristics of interventions.ConclusionsThere are a limited number of studies on the impact of peer support interventions for adults with acquired brain injury, cerebral palsy, or spina bifida on community integration and quality of life. Standardization of key intervention characteristics may aid the global adoption of peer support as a formalized, evidence-based practice.

Highlights

Neurological disorders may negatively impact community integration and/or quality of life
Gaps in the provision of health care services, including their limited availability for rare neurological disorders, restrictions on patients presenting with comorbidities, and imbalanced allocation of resources, Levy et al BMC Health Services Research (2019) 19:288 may further restrict the community integration and/or quality of life (QoL) of patients and their caregivers [6]
The current review found that peer support interventions included a variety of support and combinations of support [13]

Summary

Introduction

Neurological disorders may negatively impact community integration and/or quality of life. Neurological conditions including acquired brain injury (ABI), cerebral palsy (CP), and spina bifida (SB) frequently have significant social and psychological implications that may negatively impact an affected individual’s community integration (CI) and/or quality of life (QoL) [3,4,5] These conditions can impede patients’ abilities to participate in meaningful activities, such as employment, and raise numerous challenges including isolation and disability-associated stigma [6,7,8]. Caregivers provide unpaid support and carry an increased burden of care (i.e., physical, mental, and financial) over the decades [9] For these reasons, there is an imperative for individuals with neurological conditions to self-manage their condition(s) if they possess the capacity (i.e., energy, information, and time) and responsibility (i.e., understanding of their specific role in carrying out selfmanagement tasks) required to do so [10]. Peer support has emerged as a promising alternate intervention for use alongside other treatments; an effective and cost-effective self-management method to counter many of the limitations (i.e., gaps in the provision of health care) present in the current health care context [11]

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Conclusion