A narrative review of peer support barriers and facilitators in kidney care

Abstract

Introduction Patients with chronic kidney disease often experience emotional/mental challenges and benefit from peer support, as it provides insight/information from others with the same condition. Previous studies show it is effective in improving health outcomes and aids in treatment decisions. Literature Review There is low peer support uptake among patients with chronic kidney disease in the United Kingdom and staff do not utilise peer support services fully. Few studies within the United Kingdom have focused on peer support barriers/facilitators, so this narrative review aimed to understand them from staff and patient perspectives. Materials and Methods A comprehensive search strategy and inclusion/exclusion criteria were applied with a two‐step process of article selection employed using two reviewers. Thematic analysis was applied. Results Five articles were included and six themes emerged. Low referrals and difficulty matching were staff barriers; concern regarding the relationship dynamic and the format/delivery were patient barriers. Promotion of the service aided the uptake from staff, while patients valued inclusivity. Discussion Increased promotion of peer support benefits through training/awareness may improve staff referrals and there should be greater exposure nationally. A flexible format is essential to ensure ample opportunity for access. Conclusion This review highlights the current literature on peer support barriers/facilitators. Further study is needed to evidence which approaches best overcome staff‐ and patient‐barriers.

Barriers and facilitators to implementing and sustaining peer support in kidney care

“…Two semistructured interview guides—one for healthcare professionals, and one for PS recipients and supporters—were designed based on the existing literature (Trasolini et al, 2020 ). Questions covered the same three categories: perceptions and views of PS; format of PS; barriers and facilitators to PS; but the guides were varied slightly because of the differences between how professionals and patients can interact with PS.…”

“…However, engagement levels remain low, with many PS programmes reporting lower than expected levels of uptake (Day, 2012 ; Hughes et al, 2009 ; Taylor et al, 2016 ). A recent narrative review called for more studies to be carried out (Trasolini et al, 2020 ).…”

“…A recent narrative review (Trasolini et al, 2020 ) on the barriers and facilitators to PS uptake among people with CKD, five themes emerged: staff barriers to utilising, patient barriers to engaging, staff facilitators to utilising, patient facilitators to engaging, and positive outcomes of engaging. Among healthcare workers, low staff referrals and difficulty matching supporters to recipients were cited as two main barriers to utilisation while increased promotion of PS helped staff refer.…”

Healthcare provider perspectives on integrating peer support in non-dialysis-dependent chronic kidney disease care: a mixed methods study

“…Peer support can further influence decision-making through offering practical advice, sharing experiences, and normalizing kidney replacement therapies for people with kidney failure [ 9 – 12 ]. Delivery of peer support can take place as informal supportive encounters between peers [ 13 ], or alternatively through formalized programs within kidney care programs or in partnership with external organizations [ 14 , 15 ]. Despite its benefits, the role of peer support in the comprehensive care of persons with non-dialysis-dependent CKD remains unestablished [ 16 ].…”

“…Despite its benefits, the role of peer support in the comprehensive care of persons with non-dialysis-dependent CKD remains unestablished [ 16 ]. Opportunities for informal peer connection in non-dialysis-dependent CKD are uncommon, and uptake of formal peer support programs has traditionally been low with variability in how it is promoted and offered [ 15 – 17 ].…”