Effects of Peer-Led Education on Quality of Life in Ankylosing Spondylitis

This study attempted to quantify the effects of peer-led education on quality of life in patients with ankylosing spondylitis.

Peer-led education does not improve quality of life levels or depression scores in patients with ankylosing spondylitis (AS), according to research published in the International Journal of Rheumatic Diseases.

Taciser Kaya, MD, of the Department of Physical Medicine and Rehabilitation at the Izmir Bozyaka Training and Research Hospital in Izmir, Turkey, and colleagues conducted a study of 80 patients with AS who were randomly assigned to either a peer-led education group or a control group. Patients in the education group participated in an educational program about AS and received an educational booklet; patients in the control group received the educational booklet only.

“The interventions used in trials, not entirely, but mostly are generic rather than disease specific,” wrote Dr. Kaya and colleagues. “As a consequence, the need for exploration of disease-specific interventions has been [suggested as a topic] for future research.”

Quality of life levels were measured using the Turkish version of the Medical Outcomes Study Short Form 36 (SF-36) health survey, which evaluates 8 areas of physical and mental health. Depression scores were taken at baseline, at 4 weeks, and at 6 months for each group. Results were based on 56 participants (27 in the education group and 29 in the control group) and showed that both quality of life level and depressive symptoms did not change; however, data showed deterioration in the social functioning subgroup questions of SF-36 in both groups.

“Peer-led education did not alter quality of life levels or depression scores,” Dr. Kaya concluded. “However, because of the maintenance of quality of life levels, this type of intervention may be considered as a supplementary intervention to the standard medical care for management of AS.”

Summary and Clinical Applicability

“There have been no published studies in the English literature investigating the effect of peer-instructed education on the quality of life level of patients with AS to date,” Dr. Kaya noted. In this study, researchers targeted the intervention at not only the educational aspects of disease management, but also at emotional and social support.

Additional randomized controlled studies assessing similar measures reported no improvement in quality of life levels of those with arthritis, and a Cochrane Review article stated that “self-management education programs by lay leaders for people with chronic conditions were … ineffective in improving health-related quality of life.”

“Although we could not show any beneficial effect of peer-led education on outcome measures, it is possible to make the following optimistic assertion related to our results. … There was no deterioration in both outcome measures and in physical functioning … and [no deterioration in] the physical function subgroup of SF-36.”

“These results may be assumed to be meeting expectations, because it is argued that in chronic disease the effects achieved may be valuable, even if they are not statistically significant.”


1. Kaya T, Goskel Karatepe A, Atici Ozturk P, Gunaydin R. Impact of peer-led group education on the quality of life in patients with ankylosing spondylitis. Int J Rheum Dis. 2016;19(2):184-191.