Authors' objectives:

The aim of this study was to provide a systematic review of the evidence of the clinical effectiveness of self care support networks in health and social care.

Authors' results and conclusions: The initial searches generated over 48000 references of possible relevance to the review. After three stages of screening, 47 papers describing 46 studies, were included in the review plus one recent systematic review relating to self care support networks in cancer patients. Twenty three of the 46 studies were conducted in the USA, whilst only one was conducted in the UK. Around half of the studies in the review were randomised controlled trials but most were not of high quality. The majority of the included primary studies were of a long-term health condition, and weight loss/obesity programmes were by far the most common interventions. The majority of studies (29 of 46) were of interventions that were peer led, with some professional input. Mutual support was the most common group process used by the study interventions, but in some (such as the weight loss programmes), skills training did in fact take precedent over mutual support. Thirty two of the 46 studies were of self care support networks that had been set up by the researchers. Overall there is evidence that peer led weight loss programmes can result in statistically significant but clinically modest weight loss. In the care-giving settings studied, only interventions for carers of people with schizophrenia or dementia could clearly demonstrate beneficial effects. Across the other indications there is some evidence of beneficial effects of care support networks for people with diabetes, arthritis/rheumatic diseases, bulimia nervosa, and depression. However, the results may not be reliable due to limitations in the quality of the studies. For cardiac recovery, trying to adopt a healthier lifestyle, psoriasis, and systemic lupus erythematosus (SLE) there is some weak evidence of benefit from single studies but again the quality of the studies and reporting make it difficult to accept these findings with confidence. In general, there is a lack of evidence from clinical studies to support a beneficial effect of self care support networks in people experiencing chronic pain, epilepsy, injury, and mental health. Exploration of the statistically significant results by indication, study design, study quality, duration of follow-up, peer or professional leadership, level of professional input, group process and whether the intervention was established by the researchers failed to reveal any clear patterns to indicate optimal features of self care support networks and studies of their evaluation.

Authors' recommendations: Overall the evidence for a beneficial effect of self care support networks as a generic intervention is very weak. The more reliable findings from comparisons with control in the better quality studies suggest that some self care support networks in certain settings can be beneficial. However, as these studies comprised a trial of Weight Watchers, three trials of carers in Hong Kong and one of a tuberculosis (TB) Club in Ethiopia, the generalisability of the findings to the UK healthcare environment can at best be limited. It is disappointing that only one, rather old (published in 1987) study was conducted in the UK.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.york.ac.uk/inst/crd/CRD_Reports/crdreport34.pdf

Year Published: 2006

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: England

Organisation Name: University of York

Contact Address: University of York, York, Y01 5DD, United Kingdom. Tel: +44 1904 321040, Fax: +44 1904 321041,

Contact Name: crd@york.ac.uk

Contact Email: crd@york.ac.uk

Copyright: Centre for Reviews and Dissemination