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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同伴支持干预对患有慢性肌肉骨骼疼痛的社区居民的有效性：随机试验的系统评价和荟萃分析。


本系统评价和荟萃分析批判性地检查了同伴支持干预以减轻疼痛和改善社区成人慢性肌肉骨骼疼痛健康结局的证据 （PROSPERO CRD42022356850）。对电子数据库和灰色文献进行了系统检索（建库至 2023 年 1 月），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。Meta 分析使用通用、逆方差、随机效应模型，计算平均差 （MD） 或标准化平均差 （SMD）。在确定的 16,445 条记录中，纳入了 24 项研究的 29 条记录 （n = 6202 名参与者）。所有证据均存在不明确/高偏倚风险和低-极低质量。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）、自我效能感（中期：SMD 0.26,95% CI 0.16,0.36;长期：SMD 0.21,95% CI 0.07,0.36）和功能（长期：SMD -0.10,95% CI -0.19，-0.00）相对于常规护理和更大的自我效能感（中期：SMD 0.36， 95% CI 0.20， 0.51）。同伴支持干预与主动（卫生专业人员主导）干预类似的改善，禁止长期自我效能感（MD -0.41,95% CI -0.77，-0.05），后者有利于积极干预。没有点估计达到最小临床重要差异阈值。汇总的卫生服务利用结果显示估计不明确。自我管理、生活质量和社会支持结局的证据好坏参半。 尽管证据质量为低到极低，但同伴支持干预显示，与常规护理和候补名单对照相比，某些临床结局的改善很小，这表明同伴支持可能作为肌肉骨骼疼痛其他治疗的辅助手段。