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

Abstract

Background Peer support complements traditional models of chronic kidney disease (CKD) care through sharing of peer experiences, pragmatic advice, and resources to enhance chronic kidney disease self-management and decision-making. As peer support is variably offered and integrated into multi-disciplinary CKD care, we aimed to characterize healthcare providers’ experiences and views on peer support provision for people with non-dialysis-dependent CKD within Canada. Methods In this concurrent mixed methods study, we used a self-administered online survey to collect information from multi-disciplinary CKD clinic providers (e.g., nurses, nephrologists, allied health professionals) on peer support awareness, program characteristics and processes, perceived value, and barriers and facilitators to offering peer support in CKD clinics. Results were analyzed descriptively. We undertook semi-structured interviews with a sample of survey respondents to elaborate on perspectives about peer support in CKD care, which we analyzed using inductive, content analysis. Results We surveyed 113 providers from 49 clinics. Two thirds (66%) were aware of formal peer support programs, of whom 19% offered in-house peer support through their clinic. Peer support awareness differed by role and region, and most referrals were made by social workers. Likert scale responses suggested a high perceived need of peer support for people with CKD. Top cited barriers to offering peer support included lack of peer support access and workload demands, while facilitators included systematic clinic processes for peer support integration and alignment with external programs. Across 18 interviews, we identified themes related to peer support awareness, logistics, and accessibility and highlighted a need for integrated support pathways. Conclusions Our findings suggest variability in awareness and availability of peer support among Canadian multi-disciplinary CKD clinics. An understanding of the factors influencing peer support delivery will inform strategies to optimize its uptake for people with advanced CKD.

Priorities for peer support delivery among adults living with chronic kidney disease: a patient-oriented consensus workshop

“…In contrast, few multidisciplinary CKD clinics embed peer support within their care programs. 34 Patients with advanced, non-dialysis CKD often lack overt manifestations yet face challenges related to high symptom burden, metabolic complications, and difficult treatment-related decisions (e.g., choosing among dialysis types). 35 Thus, our findings endorse an inclusive but tailored approach to peer support that purposefully addresses CKD-specific support gaps and connects individuals within the broader kidney community.…”

Barriers and Facilitators to Screening for Kidney Disease Among Older Adults with Hypertension and Diabetes in Mbarara Southwestern Uganda: Healthcare Providers’ Perspective

“…In addition to financial benefits, previous studies have noted that peer support groups allow sharing of experiences, advice on self-management and decision-making. 30 Similarly, other scholars have described peer support as an effective educational method for patients. 31 We found that screening for KD required multi-disciplinary input.…”