Study Finds Peer Support Associated With Fewer Acute Care Visits in Patients With COPD

Patients with chronic obstructive pulmonary disease (COPD) who received peer support had significantly lower COPD-related acute care use and significantly higher self-efficacy and hope levels vspatients who only used a health care professional (HCP) for support and self-management.

This new study was recently published in Annals of the American Thoracic Society.

The study took place in a 6-month period at Johns Hopkins Bayview Medical Center (JHBMC) and Howard County General Hospital (HCGH). JHBMC serves low-income populations in an urban setting and HCGH serves a suburban area. There were 292 participants enrolled in the study aged 40 and older.

All participants were split into 2 groups: the HCP support group, which relied on the HCP as the primary communicator about COPD self-management, and the HCP plus peer support group, which utilized both HCPs and peer supporters to give tailored COPD self-management support.

Participants in the HCP support group were provided a written guide on COPD self-management, had a 1-hour session with a respiratory care practitioner, and were given a respiratory care practitioner phone number to call for follow-up. Participants in the HCP plus peer support group had the same HCP support group components plus an invitation to a peer support program that included 8 group gatherings in which self-management topics were discussed.

The majority of the 292 participants were white (70.9%) and female (61.3%) with a mean (SD) age of 67.7 (9.4) years; 26.4% of participants were on home oxygen therapy.

There were no differences in quality of life (QOL) between the 2 groups after 6 months; the mean change in total St George’s Respiratory Questionnaire score, which gauged change in health-related QOL, was –0.52 points in the HCP plus peer support group and –1.78 in the HCP support arm after 6 months (unadjusted difference, 1.26; 95% CI,­ –5.44 to 7.96).

Participants in the HCP plus peer support group had fewer COPD-related acute care events; the incidence rate ratio between HCP plus peer support and HCP support was 0.68 (95% CI, 0.50-0.93) after 3 months and 0.84 (95% CI, 0.71-0.99) after 6 months.

The participants in the HCP plus peer support group also had significantly higher self-efficacy and hope scores than the HCP support group.

There were some limitations to this study. Itwas conducted at 2 study sites within 1 health system; treatment effects were different at the 2 sites, with participants in more affluent areas having better outcomes than those in the urban hospital; and participation in programs was higher at the suburban site, with more participants who had in-person interaction with their peers.

The researchers concluded that although there was no difference in overall QOL, acute care use was significantly lower for the HCP plus peer support group and higher self-efficacy was observed.

“More research is needed to examine how peer support interventions can best be delivered and their treatment effects assessed among various patient subgroups,” the authors wrote.

Reference

Aboumatar H, Morales EEG, Jager LR, et al. Comparing a self-management program with and without peer support to improve quality of life for patients with COPD. Ann Am Thorac Soc. Published online April 20, 2022. doi:10.1513/AnnalsATS.202108-932OC