Effectiveness of Peer-Led Self-Management Programmes for Adults with Schizophrenia and Other Psychotic Disorders: A Systematic Review

Friday, 3 August 2012: 10:15 AM

Ziqiang Li, RN, RMN, BS
Sally Wai-Chi Chan, RN (Psy), RMN, PhD, MSc, BSc
Piyanee Klainin-Yobas, PhD, MSc, BS, RN
Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore, Singapore

Learning Objective 1: The learner will be able to dissemminate the synthesised knowledge on the topic of interest to the audiance through presentation

Learning Objective 2: The learner will be able to share and exchange innovative research and evidence based practice ideas with global pespecticves through question and answer, and discussion.

Background and hypothesis

Peer-led self-management programmes (PLSMP) for mental illness have become widely used in the western countries. Many studies reported the benefits and effectiveness of such programmes in facilitating recovery in patients with schizophrenia or other psychotic disorders.

This review aimed to synthesise the current evidence on the effectiveness of PLSMPs for adults with schizophrenia and other psychotic disorders in participants’ empowerment, hopefulness, perceived recovery, self-advocacy, social support and symptom reduction.



A three-step search strategy and search terms were formulated based on the selection criteria on population, intervention and outcome measures. Independent critical appraisals on selected studies were undertaken. JBI CReMS and MAStARI were used in data extraction and meta-analysis.


Main results

A total of nine English studies were included for the review with six outcome measures were synthesised by meta-analysis. The synthesised evidence suggests that PLSMPs had a significant effect in improving participants’ empowerment (SMD=-0.31, 95% CI, -0.96 to-0.34; p=0.35), hopefulness (SMD=-0.37, 95% CI, -0.55 to-0.19; p<0.0001), perceived recovery (WMD=-3.20, 95% CI, -6.01 to-0.39; p=0.0258), self-advocacy (SMD=-0.49, 95% CI, -0.72 to-0.27; p<0.0001), social support (SMD=-0.29, 95% CI, -0.59 to 0.01, p=0.0562), and reducing symptom severity (SMD=0.33, 95% CI, 0.17 to0.49, p<0.0001). However, most of the studies lacked randomisation, control group, follow-up assessments, measures to reduce confounders and intention-to-treat analysis with considerable dropout rate.



PLSMPs can be implemented with care in psychiatric service to promote patient’s recovery. These programmes may help improve patients’ psychosocial well-being and promote social integration. Future research studies need to utilise randomisation, control group, clear inclusion/exclusion criteria, follow-up assessments, and intention-to-treat analysis with multivariate statistical analysis.