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Randomized Controlled Trial
. 2018 May 1;69(5):529-535.
doi: 10.1176/appi.ps.201700352. Epub 2018 Feb 1.

Peer-Led Self-Management of General Medical Conditions for Patients With Serious Mental Illnesses: A Randomized Trial

Benjamin G Druss  1 , Manasvini Singh  1 , Silke A von Esenwein  1 , Gretl E Glick  1 , Stephanie Tapscott  1 , Sherry Jenkins Tucker  1 , Cathy A Lally  1 , Evelina W Sterling  1
Affiliations
Randomized Controlled Trial

Peer-Led Self-Management of General Medical Conditions for Patients With Serious Mental Illnesses: A Randomized Trial

Benjamin G Druss et al. Psychiatr Serv. .

Abstract

Objective: Individuals with serious mental illnesses have high rates of general medical comorbidity and challenges in managing these conditions. A growing workforce of certified peer specialists is available to help these individuals more effectively manage their health and health care. However, few studies have examined the effectiveness of peer-led programs for self-management of general medical conditions for this population.

Methods: This randomized study enrolled 400 participants with a serious mental illness and one or more chronic general medical conditions across three community mental health clinics. Participants were randomly assigned to the Health and Recovery Peer (HARP) program, a self-management program for general medical conditions led by certified peer specialists (N=198), or to usual care (N=202). Assessments were conducted at baseline and three and six months.

Results: At six months, participants in the intervention group demonstrated a significant differential improvement in the primary study outcome, health-related quality of life. Specifically, compared with the usual care group, intervention participants had greater improvement in the Short-Form Health Survey physical component summary (an increase of 2.7 versus 1.4 points, p=.046) and mental component summary (4.6 versus 2.5 points, p=.039). Significantly greater six-month improvements in mental health recovery were seen for the intervention group (p=.02), but no other between-group differences in secondary outcome measures were significant.

Conclusions: The HARP program was associated with improved physical health- and mental health-related quality of life among individuals with serious mental illness and comorbid general medical conditions, suggesting the potential benefits of more widespread dissemination of peer-led disease self-management in this population.

Keywords: Medical morbidity and mortality in psychiatric patients; Public-sector psychiatry; peer specialists; self-management; serious mental illness.

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Conflict of interest statement

The authors report no conflicts of interest.

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