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Priorities for peer support delivery among adults living with chronic kidney disease: a patient-oriented consensus workshop

Meghan J. Elliott, Maoliosa Donald, Janine Farragher, Nancy Verdin, Shannan Love, Kate Manns, Brigitte Baragar, Dwight Sparkes, Danielle Fox and Brenda R. Hemmelgarn
August 15, 2023 11 (4) E736-E744; DOI: https://doi.org/10.9778/cmajo.20220171
Meghan J. Elliott
Departments of Medicine (Elliott, Love, Manns) and Community Health Sciences (Elliott, Donald, Fox), University of Calgary, Calgary, Alta.; Department of Occupational Science and Occupational Therapy (Farragher), University of Toronto, Toronto, Ont.; Medicine Strategic Clinical Network (Verdin), Alberta Health Services; Patient and Community Engagement Research (PaCER) Program (Verdin), O’Brien Institute for Public Health, University of Calgary, Calgary, Alta.; Patient Partner (Verdin, Sparkes), Canadians Seeking Solutions and Innovations to Overcome Chronic Kidney Disease (Can-SOLVE CKD) Network, Vancouver, BC; Max Rady College of Medicine (Baragar), University of Manitoba, Winnipeg, Man.; Faculty of Medicine and Dentistry (Hemmelgarn), University of Alberta, Edmonton, Alta.
MD MSc
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Maoliosa Donald
Departments of Medicine (Elliott, Love, Manns) and Community Health Sciences (Elliott, Donald, Fox), University of Calgary, Calgary, Alta.; Department of Occupational Science and Occupational Therapy (Farragher), University of Toronto, Toronto, Ont.; Medicine Strategic Clinical Network (Verdin), Alberta Health Services; Patient and Community Engagement Research (PaCER) Program (Verdin), O’Brien Institute for Public Health, University of Calgary, Calgary, Alta.; Patient Partner (Verdin, Sparkes), Canadians Seeking Solutions and Innovations to Overcome Chronic Kidney Disease (Can-SOLVE CKD) Network, Vancouver, BC; Max Rady College of Medicine (Baragar), University of Manitoba, Winnipeg, Man.; Faculty of Medicine and Dentistry (Hemmelgarn), University of Alberta, Edmonton, Alta.
BScPT PhD
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Janine Farragher
Departments of Medicine (Elliott, Love, Manns) and Community Health Sciences (Elliott, Donald, Fox), University of Calgary, Calgary, Alta.; Department of Occupational Science and Occupational Therapy (Farragher), University of Toronto, Toronto, Ont.; Medicine Strategic Clinical Network (Verdin), Alberta Health Services; Patient and Community Engagement Research (PaCER) Program (Verdin), O’Brien Institute for Public Health, University of Calgary, Calgary, Alta.; Patient Partner (Verdin, Sparkes), Canadians Seeking Solutions and Innovations to Overcome Chronic Kidney Disease (Can-SOLVE CKD) Network, Vancouver, BC; Max Rady College of Medicine (Baragar), University of Manitoba, Winnipeg, Man.; Faculty of Medicine and Dentistry (Hemmelgarn), University of Alberta, Edmonton, Alta.
OT Reg PhD
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Nancy Verdin
Departments of Medicine (Elliott, Love, Manns) and Community Health Sciences (Elliott, Donald, Fox), University of Calgary, Calgary, Alta.; Department of Occupational Science and Occupational Therapy (Farragher), University of Toronto, Toronto, Ont.; Medicine Strategic Clinical Network (Verdin), Alberta Health Services; Patient and Community Engagement Research (PaCER) Program (Verdin), O’Brien Institute for Public Health, University of Calgary, Calgary, Alta.; Patient Partner (Verdin, Sparkes), Canadians Seeking Solutions and Innovations to Overcome Chronic Kidney Disease (Can-SOLVE CKD) Network, Vancouver, BC; Max Rady College of Medicine (Baragar), University of Manitoba, Winnipeg, Man.; Faculty of Medicine and Dentistry (Hemmelgarn), University of Alberta, Edmonton, Alta.
BScOT
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Shannan Love
Departments of Medicine (Elliott, Love, Manns) and Community Health Sciences (Elliott, Donald, Fox), University of Calgary, Calgary, Alta.; Department of Occupational Science and Occupational Therapy (Farragher), University of Toronto, Toronto, Ont.; Medicine Strategic Clinical Network (Verdin), Alberta Health Services; Patient and Community Engagement Research (PaCER) Program (Verdin), O’Brien Institute for Public Health, University of Calgary, Calgary, Alta.; Patient Partner (Verdin, Sparkes), Canadians Seeking Solutions and Innovations to Overcome Chronic Kidney Disease (Can-SOLVE CKD) Network, Vancouver, BC; Max Rady College of Medicine (Baragar), University of Manitoba, Winnipeg, Man.; Faculty of Medicine and Dentistry (Hemmelgarn), University of Alberta, Edmonton, Alta.
MSLP
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Kate Manns
Departments of Medicine (Elliott, Love, Manns) and Community Health Sciences (Elliott, Donald, Fox), University of Calgary, Calgary, Alta.; Department of Occupational Science and Occupational Therapy (Farragher), University of Toronto, Toronto, Ont.; Medicine Strategic Clinical Network (Verdin), Alberta Health Services; Patient and Community Engagement Research (PaCER) Program (Verdin), O’Brien Institute for Public Health, University of Calgary, Calgary, Alta.; Patient Partner (Verdin, Sparkes), Canadians Seeking Solutions and Innovations to Overcome Chronic Kidney Disease (Can-SOLVE CKD) Network, Vancouver, BC; Max Rady College of Medicine (Baragar), University of Manitoba, Winnipeg, Man.; Faculty of Medicine and Dentistry (Hemmelgarn), University of Alberta, Edmonton, Alta.
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Brigitte Baragar
Departments of Medicine (Elliott, Love, Manns) and Community Health Sciences (Elliott, Donald, Fox), University of Calgary, Calgary, Alta.; Department of Occupational Science and Occupational Therapy (Farragher), University of Toronto, Toronto, Ont.; Medicine Strategic Clinical Network (Verdin), Alberta Health Services; Patient and Community Engagement Research (PaCER) Program (Verdin), O’Brien Institute for Public Health, University of Calgary, Calgary, Alta.; Patient Partner (Verdin, Sparkes), Canadians Seeking Solutions and Innovations to Overcome Chronic Kidney Disease (Can-SOLVE CKD) Network, Vancouver, BC; Max Rady College of Medicine (Baragar), University of Manitoba, Winnipeg, Man.; Faculty of Medicine and Dentistry (Hemmelgarn), University of Alberta, Edmonton, Alta.
MD
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Dwight Sparkes
Departments of Medicine (Elliott, Love, Manns) and Community Health Sciences (Elliott, Donald, Fox), University of Calgary, Calgary, Alta.; Department of Occupational Science and Occupational Therapy (Farragher), University of Toronto, Toronto, Ont.; Medicine Strategic Clinical Network (Verdin), Alberta Health Services; Patient and Community Engagement Research (PaCER) Program (Verdin), O’Brien Institute for Public Health, University of Calgary, Calgary, Alta.; Patient Partner (Verdin, Sparkes), Canadians Seeking Solutions and Innovations to Overcome Chronic Kidney Disease (Can-SOLVE CKD) Network, Vancouver, BC; Max Rady College of Medicine (Baragar), University of Manitoba, Winnipeg, Man.; Faculty of Medicine and Dentistry (Hemmelgarn), University of Alberta, Edmonton, Alta.
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Danielle Fox
Departments of Medicine (Elliott, Love, Manns) and Community Health Sciences (Elliott, Donald, Fox), University of Calgary, Calgary, Alta.; Department of Occupational Science and Occupational Therapy (Farragher), University of Toronto, Toronto, Ont.; Medicine Strategic Clinical Network (Verdin), Alberta Health Services; Patient and Community Engagement Research (PaCER) Program (Verdin), O’Brien Institute for Public Health, University of Calgary, Calgary, Alta.; Patient Partner (Verdin, Sparkes), Canadians Seeking Solutions and Innovations to Overcome Chronic Kidney Disease (Can-SOLVE CKD) Network, Vancouver, BC; Max Rady College of Medicine (Baragar), University of Manitoba, Winnipeg, Man.; Faculty of Medicine and Dentistry (Hemmelgarn), University of Alberta, Edmonton, Alta.
RN MN
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Brenda R. Hemmelgarn
Departments of Medicine (Elliott, Love, Manns) and Community Health Sciences (Elliott, Donald, Fox), University of Calgary, Calgary, Alta.; Department of Occupational Science and Occupational Therapy (Farragher), University of Toronto, Toronto, Ont.; Medicine Strategic Clinical Network (Verdin), Alberta Health Services; Patient and Community Engagement Research (PaCER) Program (Verdin), O’Brien Institute for Public Health, University of Calgary, Calgary, Alta.; Patient Partner (Verdin, Sparkes), Canadians Seeking Solutions and Innovations to Overcome Chronic Kidney Disease (Can-SOLVE CKD) Network, Vancouver, BC; Max Rady College of Medicine (Baragar), University of Manitoba, Winnipeg, Man.; Faculty of Medicine and Dentistry (Hemmelgarn), University of Alberta, Edmonton, Alta.
MD PhD
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    Figure 1:

    Thematic summary, supporting quotes and suggestions to address priorities for peer support delivery.

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    Table 1:

    Participant characteristics

    CharacteristicNo. of participants
    All participants21
    Geographic location
     Alberta15
     Ontario4
     Saskatchewan1
     Manitoba1
    Employment status
     Full-time14
     Retired4
     Part-time1
     Disability, not employed2
    Education
     University degree11
     Professional or graduate degree (e.g., MD)4
     Technical diploma3
     High school2
     Did not respond1
    Age, yr
     < 404
     40–6413
     ≥ 654
    Ethnicity
     White18
     Asian2
     Latin American1
    Gender
     Woman16
     Man5
    Patients (n = 5) and caregivers (n = 4)*9
    Marital status
     Married7
     Common law2
     Divorced0
     Single0
    Cause of CKD†
     Diabetes3
     High blood pressure1
     Other1
    Time with CKD, yr†
     < 52
     5–92
     10–201
    Self-reported kidney function (eGFR in mL/min/1.73 m2)†
     < 152
     15–290
     30–440
     45–601
     Did not respond2
    Peer mentors4
    Length of time as mentor, yr
     1–41
     5–100
     > 103
    Treatment experience‡
     Kidney transplant4
     Hemodialysis4
     Peritoneal dialysis2
    Non-patient stakeholders8
    Role
     Allied health2
     Nephrologist2
     Nurse/nurse practitioner2
     Peer support program representative2
    Time in current position, yr
     < 100
     10–152
     > 156
    Clinical time in current role, %
     < 251
     25–501
     > 504
     Not applicable2
    • Note: CKD = chronic kidney disease, eGFR = estimated glomerular filtration rate, MD = medical doctor.

    • ↵* Caregivers attended either with (n = 2) or without (n = 2) their loved one with CKD.

    • ↵† Patient participants only.

    • ↵‡ All peer mentors reported having experience with peritoneal dialysis, hemodialysis or both, in addition to transplantation.

    • View popup
    Table 2:

    Peer support in chronic kidney disease (CKD) topic areas with suggested options, corresponding dot counts and priority status

    CategorySuggested optionsDot countPriority*
    Peer support format
    Who deliversMatching peer mentor11High
    Knowledgeable and trained peer mentor6Medium
    Health care provider involvement in peer support3Medium
    Varied mentor experiences1Low
    Who receivesCombination of persons with CKD and caregivers8High
    Person with CKD3Medium
    Family members, caregivers2Low
    Public1Low
    How deliveredSmall group3Medium
    One-on-one3Medium
    By telephone3Medium
    By email or direct messaging3Medium
    In-person1Low
    Virtual1Low
    Blog or social media1Low
    Social activities1Low
    When deliveredFlexible8High
    Scheduled3Medium
    Ongoing1Low
    Peer support content
    Informational supportWhat to expect with kidney disease9High
    Hands-on experience3Medium
    Diet3Medium
    Travel2Low
    Family planning, sexuality1Low
    Emotional supportFeeling supported and not alone7High
    Coping and coaching skills4Medium
    Building relationships with peers and others4Medium
    Appraisal supportReassurance and validation4Medium
    Instrumental supportDay-to-day tasks1Low
    Caregiver supportDedicated caregiver programming6Medium
    Peer support processes
    Promotion of peer supportSocial media8High
    Organizational outreach6Medium
    Peer mentors on site5Medium
    Brochures, posters1Low
    Cultural organizations or avenues1Low
    Referral to peer supportClinic-initiated14High
    Repeated reminders10High
    Self-referral2Low
    Mandatory peer support2Low
    • ↵* Priority assignment based on number of votes (i.e., dots), defined as high (≥ 7 dots), medium (3–6 dots) and low (< 3 dots).

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CMAJ Open: 11 (4)
Vol. 11, Issue 4
1 Jul 2023
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Priorities for peer support delivery among adults living with chronic kidney disease: a patient-oriented consensus workshop
Meghan J. Elliott, Maoliosa Donald, Janine Farragher, Nancy Verdin, Shannan Love, Kate Manns, Brigitte Baragar, Dwight Sparkes, Danielle Fox, Brenda R. Hemmelgarn
Jul 2023, 11 (4) E736-E744; DOI: 10.9778/cmajo.20220171

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Priorities for peer support delivery among adults living with chronic kidney disease: a patient-oriented consensus workshop
Meghan J. Elliott, Maoliosa Donald, Janine Farragher, Nancy Verdin, Shannan Love, Kate Manns, Brigitte Baragar, Dwight Sparkes, Danielle Fox, Brenda R. Hemmelgarn
Jul 2023, 11 (4) E736-E744; DOI: 10.9778/cmajo.20220171
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