Data_Sheet_1_Lived Experience in New Models of Care for Substance Use Disorder: A Systematic Review of Peer Recovery Support Services and Recovery Coaching.pdf

Peer recovery support services (PRSS) are increasingly being employed in a range of clinical settings to assist individuals with substance use disorder (SUD) and co-occurring psychological disorders. PRSS are peer-driven mentoring, education, and support ministrations delivered by individuals who, because of their own experience with SUD and SUD recovery, are experientially qualified to support peers currently experiencing SUD and associated problems. This systematic review characterizes the existing experimental, quasi-experimental, single- and multi-group prospective and retrospective, and cross-sectional research on PRSS. Findings to date tentatively speak to the potential of peer supports across a number of SUD treatment settings, as evidenced by positive findings on measures including reduced substance use and SUD relapse rates, improved relationships with treatment providers and social supports, increased treatment retention, and greater treatment satisfaction. These findings, however, should be viewed in light of many null findings to date, as well as significant methodological limitations of the existing literature, including inability to distinguish the effects of peer recovery support from other recovery support activities, heterogeneous populations, inconsistency in the definitions of peer workers and recovery coaches, and lack of any, or appropriate comparison groups. Further, role definitions for PRSS and the complexity of clinical boundaries for peers working in the field represent important implementation challenges presented by this novel class of approaches for SUD management. There remains a need for further rigorous investigation to establish the efficacy, effectiveness, and cost-benefits of PRSS. Ultimately, such research may also help solidify PRSS role definitions, identify optimal training guidelines for peers, and establish for whom and under what conditions PRSS are most effective.

同伴康复支持服务（Peer Recovery Support Services，PRSS）正日益被应用于各类临床场景，以帮助物质使用障碍（Substance Use Disorder，SUD）及共病精神障碍（co-occurring psychological disorders）患者。PRSS为由具备物质使用障碍及康复经历的个体提供的同伴主导的辅导、教育与支持服务，这类个体凭借自身的康复经验，具备为当前正经历物质使用障碍及相关问题的同伴提供支持的资质。本系统综述梳理了当前有关PRSS的各类研究，包括实验性研究、类实验性研究、单组与多组前瞻性及回顾性研究，以及横断面研究。截至目前的研究结果初步显示出同伴支持在多种SUD治疗场景中的应用潜力，相关积极结果体现在多项评估指标中：物质使用量降低、SUD复发率下降、与治疗提供者及社会支持系统的关系改善、治疗留存率提升，以及治疗满意度增高。但鉴于当前已有诸多零结果研究，以及现有文献存在的显著方法学局限，对上述结果需审慎解读。这些局限包括：无法区分同伴康复支持与其他康复支持活动的效应、研究人群异质性较高、同伴工作者与康复教练的定义缺乏统一标准，且未设置或未设置恰当的对照组。此外，PRSS的角色定义，以及临床场景中同伴工作者面临的临床边界复杂性，均为这类用于SUD管理的新型干预手段带来了重要的落地挑战。目前仍需开展更多严谨的研究，以明确PRSS的疗效、有效性及成本效益。最终，这类研究还有助于明确PRSS的角色定义，制定同伴工作者的最优培训指南，并确定PRSS的适宜适用人群与应用场景。