This systematic review and meta-analysis critically examined the evidence for peer support interventions to reduce pain and improve health outcomes in community-dwelling adults with chronic musculoskeletal pain (PROSPERO CRD42022356850). A systematic search (inception-January 2023) of electronic databases and grey literature was undertaken to identify relevant randomised controlled trials, with risk of bias and GRADE assessments performed on included studies. Meta-analyses used a generic, inverse-variance, random-effects model, calculating mean difference (MD) or standardised mean difference (SMD). Of 16,445 records identified, 29 records reporting on 24 studies (n = 6202 participants) were included. All evidence had unclear/high risk of bias and low-very low certainty. Peer support interventions resulted in small improvements in pain (medium-term: MD -3.48, 95% CI -6.61, -0.35; long-term: MD -1.97, 95% CI -3.53, -0.42), self-efficacy (medium-term: SMD 0.26, 95% CI 0.16, 0.36; long-term: SMD 0.21, 95% CI 0.07, 0.36), and function (long-term: SMD -0.10, 95% CI -0.19, -0.00) relative to usual care and greater self-efficacy (medium-term: SMD 0.36, 95% CI 0.20, 0.51) relative to waitlist control. Peer support interventions resulted in similar improvement as active (health professional led) interventions bar long-term self-efficacy (MD -0.41, 95% CI -0.77, -0.05), which favoured active interventions. No point estimates reached minimal clinically important difference thresholds. Pooled health service utilisation outcomes showed unclear estimates. Self-management, quality of life, and social support outcomes had mixed evidence. Despite low-very low evidence certainty, peer support interventions demonstrated small improvements over usual care and waitlist controls for some clinical outcomes, suggesting that peer support may be useful as an adjunct to other treatments for musculoskeletal pain.

中文翻译：

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同伴支持干预措施对患有慢性肌肉骨骼疼痛的社区成年人的有效性：随机试验的系统评价和荟萃分析。


这项系统回顾和荟萃分析严格审查了同伴支持干预措施的证据，以减轻患有慢性肌肉骨骼疼痛的社区成年人的疼痛和改善健康结果（PROSPERO CRD42022356850）。对电子数据库和灰色文献进行了系统检索（自 2023 年 1 月开始），以确定相关的随机对照试验，并对纳入的研究进行偏倚风险和 GRADE 评估。荟萃分析使用通用的逆方差随机效应模型，计算平均差（MD）或标准化平均差（SMD）。在已识别的 16,445 条记录中，包括报告 24 项研究（n = 6202 名参与者）的 29 条记录。所有证据均具有不明确/高偏倚风险和低至非常低的确定性。同伴支持干预导致疼痛（中期：MD -3.48，95% CI -6.61，-0.35；长期：MD -1.97，95% CI -3.53，-0.42）、自我效能（中等）小幅改善。长期：SMD 0.26，95% CI 0.16，0.36；长期：SMD 0.21，95% CI 0.07，0.36），以及功能（长期：SMD -0.10，95% CI -0.19，-0.00）相对于候补名单控制，常规护理和更高的自我效能（中期：SMD 0.36，95% CI 0.20，0.51）。同伴支持干预措施与积极（卫生专业人员主导）干预措施取得了类似的改善，但长期自我效能感却没有得到改善（MD -0.41，95% CI -0.77，-0.05），这有利于积极干预措施。没有点估计达到最小的临床重要差异阈值。汇总的卫生服务利用结果显示出不明确的估计。自我管理、生活质量和社会支持结果的证据好坏参半。 尽管证据确定性低至极低，但同伴支持干预措施在某些临床结果方面比常规护理和候补名单控制略有改善，这表明同伴支持可能有助于作为其他肌肉骨骼疼痛治疗的辅助手段。