Table 3.

Peer Support Interventions in SLE

Author	Title	Year	Disease	N=	Demographics	Design	Intervention	Follow-Up	Outcomes	Findings
Toral et al44	Evaluation of a Longstanding Telephone Peer Counseling Service on People with Systemic Lupus Erythematosus and Their Loved Ones	2017	SLE	23	67% aged 40–59 years old, 89% female, 47% Black/African American, 35% White, 31% Hispanic, 18% other race; 94% with SLE >12 years	Qualitative	Survey administered to users of telephone peer-counselor service for SLE patients	NA	NA	68% of users initially accessed service for emotional support and SLE education; 95% felt that their expectations were met. Having someone knowledge able about SLE was seen as the most valuable aspect of the service (72%). 85% indicated better coping with SLE since being matched to a peer counselor. 66% reported feeling less depressed, with the majority crediting the service for this improvement. 71% reported feeling less isolated. 58% reported their communication and/or relationship with their physician had improved, 100% felt the program was responsible for this change. 94% would recommend this service to others.
Williams et al45	Peer-to-Peer Mentoring for African American Women With Lupus: A Feasibility Pilot	2018	SLE	27 (20 mentees, 7 mentors)	100% African American women ≥18 years old	Pilot	One-on-one peer mentoring including 1 hour weekly telephone call	12 weeks	Primary outcomes: health-related quality-of-life, depression, anxiety, perceived stress, social support, self-management, disease activity; secondary measures: scales for treatment credibility and satisfaction with care delivery; demographics, health literacy, coping, and trust also assessed	Non-significant improvements in quality-of-life measures of physical function, role function, social function, mental health, health perception, pain, social support, coping, health literacy, and trust. Significant decrease in anxiety, depression. No significant change in self-management items. Significant decrease in global rating of patient reported disease activity.
Faith et al46	Research Ethics in Behavioral Interventions Among Special Populations: Lessons From the Peer Approaches to Lupus Self-Management Study	2018	SLE			Qualitative	Post intervention focus group w/participants, weekly logs from mentors		Analysis of ethical considerations made in the PALS study	No major adverse events occurred. All mentor/mentee pairs remained same throughout study. Although mentors noted they were trained “not to cross the line” in terms of providing clinical advice, this boundary was crossed in some instances. Some mentors found experience of acting as role model and support person for mentees to be stressful. Some mentors/mentees were dissatisfied over the inclusion of certain topics, namely the sexual health/body image module.
Flournoy-Floyd et al47	“We Would Still Find Things to Talk About”: Assessment of Mentor Perspectives in a Systemic Lupus Erythematosus Intervention to Improve Disease Self-Management, Empowering SLE Patients	2018	SLE			Qualitative	Mentor logs and mentor interviews with investigator		NA	Mentors took mentorship responsibilities seriously. Mentors desired to work flexibly and collaborative with mentees to overcome obstacles. Mentors able to discuss topics they felt were often marginalized by health care professionals, which was a source of mentor empowerment.
Williams et al48	Cost-Effectiveness of a Peer Mentoring Intervention to Improve Disease Self-Management Practices and Self-Efficacy Among African American Women with Systemic Lupus Erythematosus: Analysis of the Peer Approaches to Lupus Self-Management (PALS) Pilot Study	2019	SLE			Cost analysis	NA		Cost of intervention; cost effectiveness ratios for anxiety, depression, disease activity; cost savings pre- and post-two-month hospitalization charges	Total cost per patient was $1882.81 or $91.14 per patient per week. Cost effectiveness ratio for anxiety was $3423 per 1 unit decrease in the GAD score, for depression was $818 per 1 unit decrease in PHQ-8, for disease activity was $85.74 per 1 unit decrease in the SLAQ score. Statistically significant difference in pre-hospitalization charges ($24,289) and post-hospitalization charges ($872), representing mean charge savings of $23,426 per individual. Benefit cost ratio of 12.44 (benefits were >12x higher than costs per patient).
White et al49	Support Methodologies for African American Women With Lupus – Comparing Three Methods’ Effects on Patient Activation and Coping	2021	SLE	114 (100 from PALS, 14 from CALLS)	100% African American women. Median age CALLS cohort 45–54 years old, median age PALS cohort 35–44 years old, majority of patients uninsured	Comparative analysis	Comparing the effect on coping and patient activation of peer-to-peer support (PALS intervention), traditional support group (PALS control), and patient navigator intervention (CALLS intervention)	12 weeks	Patient activation and SLE self-efficacy scores	No statistically significant differences among three intervention methodologies from baseline to post-intervention for patient activation (unadjusted and adjusted). Statistically significant difference in total coping score in the patient navigator group, and differences in scores comparing patient navigator with the support group; only difference in total coping remained significant for patient navigator program in the adjusted model.