An advanced cancer diagnosis can have a significant impact on a patient’s wellbeing. Patients commonly experience anxiety and depression, which, in severe cases, may affect quality of life. Pharmacological and non-pharmacological interventions are both used; the latter may include peer support, a largely under-analyzed strategy. A study published in BMC Palliative Care evaluated the efficacy of peer support and found it may be a worthwhile, effective intervention.
“Peer support is often called a ‘created’ social network, provided with a range of professional support and involvement, ranging from self-help groups with little outside involvement to ‘paraprofessionals’ who may have extensive training for their peer support role. Whilst peer mentoring is often offered in group settings, there is a developing focus on internet facilitation, as well as one-to-one support,” the researchers explained.
For the study, patients were randomized 1:1 to receive either a proactive peer mentor intervention plus usual care or usual care alone. The study included three types of people: advanced cancer patients, their family/informal carers (paid or professional carers were excluded), and peer mentors. Inclusion criteria for the advanced cancer patients included age >16 years; a diagnosis of metastatic cancer, or local or metastatic cancer that spread after treatment; and life expectancy <1 year but >3 months (to complete the study). Peer mentors were aged ≥18 years and had experience living with cancer but were at least six months post-diagnosis. They underwent training and were matched to advanced cancer patients. Quality of life, coping styles, depression, social support, and healthcare/other support utilization were all evaluated, and interviews were conducted to garner data on individual study and intervention experiences.
Recruitment for mentors was not problematic, but it was challenging recruiting patients to participate; the researchers speculated that this may be because patients “might find it hard to admit that they needed support.” One mentor (M504) said of their own experience, “I didn’t tell the family how bad I felt, but there again I didn’t tell anyone, I kept it to myself. Had I had somebody to go to, to off-load, that might have eased it a little bit.”
Because of these recruitment challenges, the study authors were unable to recruit enough patients to meet feasibility targets; the final analysis included 12 patients, six carers, and 12 peer mentors.
However, the researchers observed from they data they had available that patients who participated in the intervention experienced improved quality of life, while in most domains, controls experienced a decline.
The study authors said that their results warranted further research.
“Despite the challenges of this feasibility study, it is likely that such interventions hold promise for further study if the practical and methodological issues demonstrated here can be addressed. Such a study is likely to be a pragmatic trial, where the effectiveness of an intervention is tested in real-world routine practice, given that it is likely inappropriate to further specify the peer-delivered intervention,” they concluded.